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March 22, 1995

Another Word of Caution Regarding a New Long-Acting Bronchodilator

Author Affiliations

From the Office of the President, Medical College of Ohio, Toledo. Dr Bone is a Consulting Editor of JAMA. He has received honoraria for participating in continuing medical education programs supported by unrestricted grants from Glaxo Pharmaceuticals, Research Triangle Park, NC. Allen & Hanburys, the manufacturer of salmeterol, is a division of Glaxo Pharmaceuticals.

JAMA. 1995;273(12):967-968. doi:10.1001/jama.1995.03520360081045

In a JAMA Editorial published on May 11,1994, I first warned of the dangers from misuse of salmeterol xinafoate.1 Newspaper reports assert that since the introduction of salmeterol in the United States, perhaps as many as 20 asthma patients have died because of the possible misuse of this bronchodilator.2,3 The newspaper articles were in reaction to a letter in the November 10,1994, issue of The New England Journal of Medicine in which Dr Frank N. Finkelstein4 of Plymouth, Mass, noted the respiratory deaths of two elderly women who were both found holding salmeterol inhalers. The women had been warned about the delayed reaction of salmeterol, and both had albuterol for emergencies.

It has been hypothesized that these and other deaths may be related to the inappropriate use of salmeterol for an acute attack of asthma. In a January 16,1995, "Dear Doctor" letter from Allen & Hanburys, the

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