Cardiac side effects of long-acting beta-2 agonist salmeterol in asthmatic children

BACKGROUND: Salmeterol is a new long-acting beta 2 selective adrenoreceptor agonist. There are some reports about the cardiac side-effects of salmeterol in asthmatic adults. The aim of this study was to determine the cardiac side effects of salmeterol in children. METHODS: Seventeen children with moderate asthma (aged between 6 and 13 years, mean 8.76 years) received salmeterol with a spacer device (Volumatic 200 micrograms daily, b.i.d.) for 3 weeks. All the children were evaluated by 24 h ambulatory electrocardiography monitoring and echocardiography before, on the second and on the 21st day of treatment. RESULTS: In minimum heart rate measurements, there were significant differences between the baseline (mean +/- SD 54.29 +/- 7.13), second (59.24 +/- 6.86) and 21st day (60.65 +/- 8.23) results. Also, the mean heart rate before the treatment (89.59 +/- 6.78) was significantly different from that on the second (94.76 +/- 6.51) and 21st day (92.65 +/- 8.90) of treatment. Although all the values were within normal limits and there were no significant differences between the control group's values, a trend of increase in mean and the minimum heart rates was seen. There were no significant differences in blood pressure, serum K+, maximum heart rate, supraventricular and ventricular ectopic beats, ejection fraction, stroke volume, cardiac output and corrected QT interval at any time. No complaints of tremors or palpitations were reported. CONCLUSIONS: As no cardiac side effects were detected, it could be concluded that salmeterol is quite a safe drug for use in childhood asthma treatment.