Advair (fluticasone propionate/salmeterol)

What is Advair?

Advair is a brand-name prescription medication. It comes in
two forms: Advair Diskus and Advair HFA. Both forms contain two active drugs:

• fluticasone propionate, which is a corticosteroid
• salmeterol, which is a long-acting beta2-agonist
  (LABA)

The two forms of Advair have different uses. Advair Diskus is
used to treat asthma
and chronic
obstructive pulmonary disease (COPD), while Advair HFA is only used to
treat asthma.

Advair Diskus vs. Advair HFA

Advair Diskus is:

• Approved by the Food and Drug Administration
  (FDA) to treat asthma in adults and children ages 4 years and older.
• FDA-approved as a maintenance (ongoing)
  treatment for adults with COPD. It can reduce the number of COPD exacerbations
  (flare-ups) that people have.

Advair HFA is:

• FDA-approved to treat asthma in adults and
  children ages 12 years and older.
• Not approved to treat COPD.

Advair Diskus and Advair HFA contain the same active
ingredients but come in different types of inhalers.

Advair Diskus is an inhalation powder. To use the Advair
Diskus inhaler, you breathe in deeply to take the medication into your mouth.

Advair HFA is an inhalation aerosol. To use the Advair HFA
inhaler, you press down on the top of the canister to deliver a spray of
medication into your mouth.

The two products contain different strengths of fluticasone
propionate and salmeterol. They also have different recommended dosages, based
on the condition they’re being used to treat.

You shouldn’t switch from using one Advair product to the
other unless your doctor tells you to.

Effectiveness

Advair Diskus has been found to be effective for treating
asthma and COPD. Advair HFA has been found to be effective for treating asthma.
For more information, see the “Advair Uses” section.

Advair generic

Advair HFA is available only as a brand-name medication.
It’s not currently available in generic form.

Advair HFA contains two active drug ingredients: fluticasone
propionate and salmeterol.

Advair Diskus is available in a generic form called Wixela
Inhub. It contains the same active drugs as Advair Diskus. For more details, see
the “Advair vs. Wixela” section below.

Advair side effects

Advair can
cause mild or serious side effects. The following lists contain some of the key
side effects that may occur while taking Advair. These lists do not include all
possible side effects.

For more
information on the possible side effects of Advair, talk with your
doctor or pharmacist. They can give you tips on how to deal with any side
effects that may be bothersome.

More common side effects

The more common
side effects of Advair can include:

• headache
• dizziness
• nausea
• vomiting
• throat irritation
• strained or hoarse voice
• muscle pain
• bone pain

Other common side
effects, explained below in “Side effect details,” include:

• thrush (fungal
  infection in your mouth or throat)
• upper respiratory infections, such as the common
  cold or sinus infections

These side effects may vary depending on which Advair device
you use and the condition you’re using Advair to treat.

Most of these side effects may go away within a few days or
a couple of weeks. If they’re more severe or don’t go away, talk with your
doctor or pharmacist.

Serious side effects

Serious side effects from Advair aren’t common, but they can
occur. Call your doctor right away if you have serious side effects. Call 911
if your symptoms feel life-threatening or if you think you’re having a medical
emergency.

Serious side effects may vary based on which Advair device you
use and the condition you’re using Advair to treat.

Serious side effects and their symptoms can include the
following:

• Reduced function of your adrenal gland (a hormone-producing gland). Symptoms can include:
• Paradoxical bronchospasm (unexpected tightening of your airways). Symptoms can include:
  • cough
  • trouble breathing that doesn’t get better with use of your inhaler
• Decrease in bone density, which can lead to osteoporosis. Symptoms can include:
• Eye problems, such as glaucoma and cataracts. Symptoms can include:
  • increased pressure in your eyes
  • blurry vision
  • changes in vision
• Increased risk for serious infections, such as measles and chickenpox. Symptoms can include:
  • fever
  • cough
  • chills
  • fatigue (lack of energy)
  • rash
• Serious allergic reaction. See the “Side effect details” section below.
• Pneumonia (in people with COPD). See “Side effect details” below.

Side effect details

You may wonder how often certain side effects occur with
this drug. Here’s more detail on some
of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic
reaction after taking Advair. Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms
of a severe allergic reaction can include:

• swelling under your skin, typically in your
  eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

In clinical
studies, allergic reactions occurred in 1%–3% of people who took Advair
HFA. However, it’s not known if these reactions were caused by the drug. It’s
also not known how many people who took Advair Diskus in clinical studies had
an allergic reaction.

It’s important to note that Advair Diskus contains milk
proteins in the drug powder. These milk proteins can cause serious allergic
reactions in people with a severe sensitivity to them. You shouldn’t take
Advair Diskus if you have a severe allergy to milk proteins.

If you’re unsure of whether you’ve had a severe reaction to
milk proteins in the past, talk with your doctor. (Note: Advair HFA does
not contain milk proteins.)

Call your doctor right away if you have a severe allergic
reaction to Advair. Call 911 if your symptoms feel life-threatening or if you
think you’re having a medical emergency.

Thrush

Thrush (a fungal
infection in your mouth and throat) is a possible side effect of taking Advair.

In clinical
studies, 1% to 4% of people who took Advair Diskus for asthma had thrush. In
comparison, 2% of people who took fluticasone propionate (one of the active
drugs in Advair Diskus) on its own had thrush. No one who took salmeterol (the
other active drug in Advair Diskus) on its own or a placebo (a treatment
without an active drug) reported having thrush.

In clinical
studies of people with chronic obstructive pulmonary disease (COPD), 10% of
people who took Advair Diskus had thrush. This was compared to 6% of people who
took fluticasone propionate alone, and 3% of people who took salmeterol alone. Of
the people who took a placebo, 1% had thrush.

In clinical
studies, 1% to 3% of people who took Advair HFA had thrush. It’s not known
how many people in the comparison groups (who took another drug or a placebo)
had thrush.

After you take a dose of Advair Diskus or Advair HFA, always
rinse your mouth with water. After rinsing, spit out the water (don’t swallow
it). Rinsing your mouth helps remove any leftover medication that remains in
your mouth, which lowers your risk of getting thrush.

If you get thrush while taking Advair, your doctor will
likely prescribe an antifungal drug to treat the infection. Your doctor may
advise that you stop taking Advair until the thrush goes away.

Weight gain

Weight gain is possible while taking Advair. In clinical
studies, weight gain occurred in 1% to 3% of people who took Advair HFA.
Weight gain also occurred in clinical
studies of Advair Diskus, but it’s not known how common this side effect
is.

If you’re concerned about gaining weight while taking
Advair, talk with your doctor.

Blood pressure changes

Salmeterol, one of the active drugs in Advair, may increase
blood pressure in some people. This side effect is more common if Advair is
taken at higher doses or more frequently than your doctor prescribes.

If you have high blood pressure,
talk with your doctor about whether Advair is safe for you.

Pneumonia

Pneumonia may
occur in people who take Advair Diskus for COPD.

In a 3-year clinical
study, 16% of people who took Advair Diskus for COPD had pneumonia. In
comparison, 14% of people who took fluticasone propionate alone had pneumonia,
and 11% of people who took salmeterol alone had it. Of the people who took a placebo,
9% had pneumonia. Pneumonia infections were more common in people over the age
of 65 years old, compared to those under 65 years old.

In clinical studies of people with asthma, pneumonia wasn’t
reported as a side effect in people using Advair Diskus. It also wasn’t
reported as a side effect in Advair HFA clinical studies.

Symptoms of pneumonia can include:

• cough
• fever
• sweating
• shortness of breath
• chest pain

If you’re concerned about your risk for pneumonia, talk with
your doctor.

Upper respiratory infections

Upper respiratory infections, such as the common cold or
sinus infections, are common side effects of Advair HFA and Advair Diskus.

• With Advair HFA:
  • In 12-week clinical
    studies, 16% to 24% of adults and children (ages 12 to 18 years old) who
    took Advair HFA for asthma had upper respiratory infections. In comparison, 13%
    to 17% of people who took fluticasone propionate alone, salmeterol alone, or a placebo
    had upper respiratory infections.
• With Advair Diskus:
  • In 12-week clinical
    studies, 21% to 27% of adults and children (ages 12 to 18 years old) who
    took Advair Diskus for asthma had upper respiratory infections. In comparison,
    14% to 29% of people who took fluticasone propionate alone, salmeterol alone,
    or a placebo had upper respiratory infections.
  • In 1-year clinical
    studies, more than 5% of adults who took Advair Diskus for COPD had upper
    respiratory infections, including nasal congestion and sinus infections.

If you have an upper respiratory infection while taking
Advair, tell your doctor. They will determine if you need treatment to clear the
infection.

Side effects in children

Many side effects of Advair in children are similar to those
seen in adults, with some exceptions.

Advair Diskus is approved for use in children ages 4 years and
older with asthma. In a clinical
study, children ages 4 to 11 years old who took Advair Diskus had more ear,
nose, and throat infections and throat irritation than adults and children ages
12 years and older.

Advair HFA is approved for use in children ages 12 years and
older with asthma. A clinical
study of Advair HFA did not find any additional side effects in children
ages 12 years and older, compared with adults.

However, the use of inhaled corticosteroids such as fluticasone
propionate, a drug in Advair, may slow down the growth of children. A clinical
study of fluticasone propionate use in children ages 4 to 11 years old was
done to determine whether fluticasone propionate slows growth. The results of
this study weren’t conclusive, though.

To reduce the risk of slowed growth, children who are still
growing should take the lowest dose of Advair that controls their asthma
symptoms. If you’re concerned about your child’s growth while they’re taking
Advair, talk with their doctor.

Advair dosage

The Advair dosage your doctor prescribes will depend on
several factors. These include:

• the type and severity of the condition you’re
  using Advair to treat
• your age
• the form of Advair you take

Typically, your doctor will start you on a low dosage. Then
they’ll adjust it over time to reach the amount that’s right for you. Your
doctor will ultimately prescribe the smallest dosage that provides the desired
effect.

The following information describes dosages that are
commonly used or recommended. However,
be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best
dosage to fit your needs.

Drug forms and strengths

Advair comes in two forms: Advair Diskus and Advair HFA.

Advair Diskus

Advair Diskus is an inhalation powder. To use the inhaler,
you breathe in deeply to take in the medication from the device. Advair Diskus
is available in the following strengths:

• 100/50: 100 micrograms (mcg) fluticasone
  propionate and 50 mcg salmeterol per puff
• 250/50: 250 mcg fluticasone propionate and 50
  mcg salmeterol per puff
• 500/50: 500 mcg fluticasone propionate and 50
  mcg salmeterol per puff

Each Advair Diskus inhaler contains 60 inhalations (puffs).
The Diskus has a counter that tells you how many doses are left in the device.

Advair HFA

Advair HFA is an inhalation aerosol. Its inhaler delivers a
spray of medication when you press down on the top of the canister. Advair HFA
is available in the following strengths:

• 45/21: 45 mcg fluticasone propionate and 21 mcg salmeterol
  per puff
• 115/21: 115 mcg fluticasone propionate and 21
  mcg salmeterol per puff
• 230/21: 230 mcg fluticasone propionate and 21
  mcg salmeterol per puff

Advair HFA inhalers can contain either 60 puffs or 120
puffs. The HFA inhaler has a counter that tells you how many doses are left in
the device.

Dosage for asthma

The usual dosage of Advair Diskus for adults with asthma is one puff
twice a day. Your dosage strength may be 100/50, 250/50, or 500/50, depending
on how severe your asthma is.

The usual dosage of Advair HFA for adults with asthma is two
puffs twice a day. Your dosage strength may be 45/21, 115/21, or 230/21,
depending on how severe your asthma is.

Dosage for COPD

The usual dosage of Advair Diskus for adults with COPD is
one puff twice a day. The recommended strength of Advair Diskus to treat COPD is
250/50.

Advair HFA is not approved by the Food and Drug
Administration to treat COPD.

Pediatric dosage for asthma

The usual dosage of Advair Diskus for children ages 12 to 18
years with asthma is one puff twice a day. A child’s dosage strength may be
100/50, 250/50, or 500/50, depending on how severe their asthma is.

The usual dosage of Advair Diskus for children ages 4 to 11
years old with asthma is one puff twice a day. The recommended strength is
100/50.

The usual dosage of Advair HFA for children ages 12 to 18
years old with asthma is two puffs twice a day. A child’s dosage strength may be
45/21, 115/21, or 230/21, depending on how severe their asthma is.

What if I miss a dose?

If you miss a dose of either Advair Diskus or Advair HFA,
just skip that dose. Wait and take your next dose at the usual time.

Don’t take more than one dose at a time. This can increase
your risk for serious side effects.

To help make sure you don’t miss a dose, try setting a reminder
on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Advair is meant to be used as a long-term treatment. If you
and your doctor determine that Advair is safe and effective for you, you’ll
likely take it long term.

Alternatives to Advair

Other drugs are available that can treat your condition. Some may be a better fit for you
than others. If you’re interested in finding an alternative to Advair,
talk with your doctor. They can tell you about other medications that may work
well for you.

Note: Some of the drugs listed here are used off-label
to treat these specific conditions. Off-label use is when a drug that’s
approved to treat one condition is used to treat a different condition.

Alternatives for asthma

Examples of other drugs that may be used to treat asthma include:

• short-acting beta2-agonists, such as:
  • albuterol (ProAir HFA, Proventil HFA, Ventolin HFA)
  • levalbuterol (Xopenex, Xopenex HFA)
• short-acting anticholinergics, such as ipratropium (Atrovent HFA)
• inhaled corticosteroids, such as:
  • beclomethasone (Qvar Redihaler)
  • budesonide (Pulmicort Flexhaler, Pulmicort Respules)
  • ciclesonide (Alvesco)
  • flunisolide (Aerospan HFA)
  • fluticasone furoate (Arnuity Ellipta)
  • fluticasone propionate (Flovent Diskus)
  • mometasone (Asmanex HFA)
• long-acting beta2-agonists (LABAs), in combination with an inhaled corticosteroid. Examples include:
  • budesonide/formoterol (Symbicort)
  • mometasone/formoterol (Dulera)
  • fluticasone furoate/vilanterol (Breo Ellipta)
  • fluticasone propionate/salmeterol (Wixela Inhub, AirDuo RespiClick)
• mast cell stabilizers, such as:
  • cromolyn
  • nedocromil
• antileukotrienes, such as:
  • montelukast (Singulair)
  • zafirlukast (Accolate)
  • zileuton (Zyflo)
• xanthine derivatives, such as theophylline
• biologic therapies (drugs made from parts of living organisms), such as:
  • omalizumab (Xolair)
  • mepolizumab (Nucala)
  • reslizumab (Cinqair)
  • benralizumab (Fasenra)
  • dupilumab (Dupixent)

Alternatives for chronic obstructive pulmonary disease

Examples of other drugs that may be used as maintenance (ongoing) treatment of chronic obstructive pulmonary disease (COPD) include:

• Long-acting anticholinergics, such as:
  • tiotropium (Spiriva)
  • glycopyrrolate (Seebri)
  • aclidinium (Tudorza)
• Long-acting beta2-agonists (LABAs), such as:
  • formoterol (Foradil, Perforomist)
  • arformoterol (Brovana)
  • salmeterol (Serevent)
  • indacaterol (Arcapta)
  • olodaterol (Striverdi)
• Combination medications that contain two or more active drugs. Some of these combination medications contain an inhaled corticosteroid, like fluticasone propionate, one of the active drugs in Advair. Examples include:
  • fluticasone furoate/vilanterol (Breo Ellipta)
  • fluticasone furoate/vilanterol/umeclidinium (Trelegy)
  • tiotropium/olodaterol (Stiolto)
  • budesonide/formoterol (Symbicort)
  • glycopyrrolate/formoterol (Bevespi Aerosphere)

Advair vs. Wixela

You may wonder how Advair compares to other medications that
are prescribed for similar uses. Here we look at how Advair and Wixela are alike
and different.

Wixela Inhub is the generic form of Advair Diskus.

Note: Wixela Inhub is not a generic form of
Advair HFA. There is currently no generic form of Advair HFA.

Uses

Advair Diskus and Wixela Inhub are both approved by the Food
and Drug Administration (FDA) to treat adults and children ages 4 years and
older with asthma.

They are both also FDA-approved as maintenance (ongoing)
treatments of chronic obstructive pulmonary disease (COPD).

Drug forms and administration

Advair Diskus and Wixela Inhub contain the same two active
drugs: fluticasone propionate and salmeterol. They’re also both inhalation
powders.

Both Advair Diskus and Wixela Inhub are available in the
same micrograms (mcg) strengths:

• 100 mcg of fluticasone propionate/50 mcg of
  salmeterol
• 250 mcg of fluticasone propionate/50 mcg of
  salmeterol
• 500 mcg of fluticasone propionate/50 mcg of
  salmeterol

Side effects and risks

Advair and Wixela Inhub contain the same drugs. Therefore, these
medications can very cause similar side effects. Below are examples of these
side effects.

More common side effects

These lists contain examples of more common side effects
that can occur with both Advair and Wixela Inhub (when taken individually).
Side effects may differ depending on which Advair device you use and what
condition you’re using Advair or Wixela Inhub to treat.

• Can occur
  with both Advair and Wixela Inhub:
  • upper respiratory infections, such as the common
    cold and sinus infections
  • throat irritation
  • thrush (fungal
    infection in your mouth or throat)
  • cough
  • headache
  • nausea
  • vomiting
  • strained or hoarse voice
  • muscle pain
  • bone pain

Serious side effects

This list contains examples of serious side effects that can
occur with both Advair and Wixela Inhub (when taken individually).

• Can occur
  with both Advair and Wixela Inhub:
  • reduced function of your adrenal gland (a hormone-producing
    gland)
  • paradoxical bronchospasm
    (unexpected tightening of your airways)
  • decrease in bone density, which can lead to osteoporosis
  • eye problems, such as glaucoma and cataracts
  • increased risk for serious infections, such as measles and chickenpox
  • serious allergic reaction
  • pneumonia (in
    people with COPD)

Effectiveness

The Food and Drug Administration (FDA) approved Wixela Inhub
as a generic form of Advair Diskus. This means that Wixela Inhub contains exact
copies of the original drugs in Advair Diskus.

FDA-approved generics are expected to have the same effects
in your body as the original drugs. This means that Wixela Inhub is considered
just as effective in treating asthma and COPD as Advair Diskus.

Costs

Advair Diskus is a brand-name drug. Wixela Inhub is the
generic form of Advair Diskus. Brand-name medications usually cost more than
generics.

According to estimates on GoodRx.com,
Advair costs significantly more than Wixela Inhub. The actual price you’ll pay
for either drug depends on your insurance plan, your location, and the pharmacy
you use.

Advair vs. Symbicort

Advair and Symbicort are prescribed for similar uses. Below
are details of how these medications are alike and different.

Advair Diskus and Advair HFA each contain two active drugs: fluticasone
propionate and salmeterol.

Symbicort also contains two active drugs: budesonide and
formoterol.

Advair and Symbicort can help people with asthma or chronic obstructive
pulmonary disease (COPD) breathe more effectively. Both contain a corticosteroid,
which reduces inflammation (swelling) in your lungs. Both drugs also contain a
long-acting beta2-agonist, which relaxes airway muscles.

Uses

Advair Diskus is approved by the Food and Drug
Administration (FDA) to treat asthma in adults and children ages 4 years and
older. Advair Diskus is also approved as a maintenance (ongoing) treatment for chronic
obstructive pulmonary disease (COPD). It helps reduce the number of COPD
exacerbations (flare-ups) people have.

Advair HFA is approved to treat asthma in adults and
children ages 12 years and older.

Symbicort is FDA-approved to treat asthma in adults and
children ages 6 years and older. It’s also approved as a maintenance treatment
for COPD, to reduce the number of COPD flare-ups people have.

Drug forms and administration

Advair Diskus and Advair HFA each contain fluticasone
propionate and salmeterol. Advair Diskus is a powder inhaler. Advair HFA is an
aerosol inhaler. They are each used twice a day. See the “Advair dosage”
section above for more information.

Symbicort contains budesonide and formoterol. It’s an aerosol
inhaler that’s used twice daily.

Side effects and risks

Advair and Symbicort contain different drugs. Therefore, some
of the side effects these medications can cause are similar and some are different.
Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects
that can occur with Advair, with Symbicort, or with both drugs (when taken
individually). Side effects may differ depending on which Advair device you use
and what condition you’re using Advair or Symbicort to treat.

• Can occur with Advair:
  • dizziness
  • nausea
  • throat irritation
  • strained or hoarse voice
  • muscle pain
  • bone pain
• Can occur with Symbicort:

• Can occur with both Advair and Symbicort:
  • upper respiratory infections, such as the common cold and sinus infections
  • headache
  • vomiting
  • thrush (fungal infection in your mouth or throat)

Serious side effects

This list contains examples of serious side effects that can
occur with Advair or Symbicort (when taken individually).

• Can occur
  with both Advair and Symbicort:
  • pneumonia (in people
    with COPD)
  • reduced adrenal gland (steroid-producing gland)
    function
  • paradoxical bronchospasm
    (unexpected tightening of your airways)
  • decrease in bone density, which can lead to osteoporosis
  • eye problems, such as glaucoma and cataracts
  • increased risk for serious infections, such as measles and chickenpox
  • serious allergic reaction

Effectiveness

Advair and Symbicort have different FDA-approved uses, but
they’re both used to treat the following conditions:

• COPD in adults
• asthma in adults and children ages 12 years and older

The use of Advair and Symbicort as maintenance treatments
for COPD has been compared in a real-world
effectiveness analysis of U.S. health insurance claims. A real-world
effectiveness analysis tests how well the drug works in the real world (not in
a controlled setting, which is where a clinical study does testing).

This study looked at health insurance claims for more than
7,000 people with COPD who were new to treatment with either Advair or
Symbicort. In this analysis, there were no differences found between Advair and
Symbicort in the number of COPD flare-ups.

The use of Advair and Symbicort for the treatment of asthma
has also been compared in a database
analysis. This analysis included more than 3,000 people with asthma, ages
12 years and older. People who took Symbicort had an 8% lower risk of
asthma-related flare-ups than people who took Advair.

Many studies have indirectly and directly compared the use
of Advair and Symbicort, with conflicting results. However, Symbicort and both
forms of Advair have been found to be effective for treating asthma. Also,
Symbicort and Advair Diskus have both been found to be effective as maintenance
treatments for COPD.

Costs

Advair and Symbicort are both brand-name drugs. There is a
generic form of Advair Diskus (called Wixela Inhub), but there are no generic
forms of Advair HFA or Symbicort. Brand-name medications usually cost more than
generics.

According to estimates on GoodRx.com,
Advair (either type) and Symbicort generally cost about the same. Wixela Inhub,
the generic form of Advair Diskus, may cost less than either Advair (either
type) or Symbicort. The actual price you’ll pay for a drug will depend on your
insurance plan, your location, and the pharmacy you use.

How to use Advair

You should take Advair according to your doctor or
healthcare provider’s instructions.

You will take either Advair Diskus or Advair HFA as inhalations
(puffs) of the medication. The manufacturer of both drugs provides instructions
on how to use the
Advair Diskus inhaler and how
to use the Advair HFA inhaler.

Always rinse your mouth with water after taking a dose of
Advair. After rinsing, spit out the water (don’t swallow it). Rinsing your
mouth after an Advair dose will reduce your risk for thrush (a fungal
infection in your mouth and throat).

When to take

Advair Diskus and Advair HFA are each taken twice a day. You
should take your dose of Advair every 12 hours.

To help make sure you don’t miss a dose, try setting a reminder
on your phone. A medication timer may be useful, too.

Advair uses

The Food and Drug Administration (FDA) approves prescription
drugs such as Advair to treat certain conditions.

Advair for asthma

Advair Diskus is FDA-approved to treat asthma in adults
and children ages 4 years and older. Advair HFA is approved to treat asthma in adults
and children ages 12 years and older.

Asthma is a chronic (long-term) condition that affects your
breathing. Common symptoms include inflammation, muscle tightening, and mucus
in your airways. These lung problems can be triggered by illness, breathing in irritants
or allergens, exercise, or other causes.

Swelling, mucus, and muscle tightening around airways
prevents air from moving through your lungs. When air can’t flow through your
lungs effectively, less oxygen gets into your bloodstream. This reduces the
amount of oxygen that can be delivered throughout your body.

The effectiveness of Advair Diskus and Advair HFA were
measured by using a value called forced expiratory volume in 1 second (FEV1).
This measures how much air you can force from your lungs in 1 second. An
increase in FEV1 shows better airflow in your lungs.

Advair Diskus effectiveness

Advair Diskus has been found to be effective for treating
asthma.

In clinical
studies, adults and children ages 12 years and older used either Advair
Diskus, fluticasone propionate alone, salmeterol alone, or a placebo (a
treatment without an active drug) to treat asthma. At the beginning of the
study, people had an FEV1 measurement that was 63% to 72% the amount of a
normal FEV1.

After 12 weeks of treatment, people in each group had the
following changes in FEV1:

• FEV1 increase of 23% to 25% with Advair Diskus
• FEV1 increase of 13% to 15% with fluticasone
  propionate alone
• FEV1 increase of 4% to 5% with salmeterol alone
• FEV1 decrease of 5% to FEV1 increase of 1% with
  a placebo

Advair HFA effectiveness

Advair HFA has been found effective in treating asthma in
adults and children aged 12 years and older.

In 12-week clinical
studies, people with asthma took either Advair HFA, fluticasone propionate alone,
salmeterol alone, or a placebo. The effectiveness of Advair HFA was measured
using FEV1 at the end of the study. After 12 weeks of treatment, people in each
group had the following changes in FEV1.

• FEV1 increase of 20% to 33% in people who took Advair
  HFA
• FEV1 increase of 9% to 25% in people who took fluticasone
  propionate alone
• FEV1 increase of 8% to 22% in people who took
  salmeterol alone
• FEV1 decrease of 6% to increase of 5% in people
  who took a placebo

Advair for chronic obstructive pulmonary disease

Advair Diskus is FDA-approved as a maintenance (ongoing)
treatment of chronic
obstructive pulmonary disease (COPD). It’s approved to reduce the number of
COPD exacerbations (flare-ups) that people have.

COPD is a group of conditions, including emphysema and chronic
bronchitis.

Emphysema causes damage to your alveoli (small air sacs in
your lungs). This makes it hard to breathe air out of your lungs. Chronic
bronchitis is characterized by swelling in your airways and narrowing of the bronchial
tubes (the main airways in your lungs). Both conditions make it harder for your
body to get the oxygen it needs.

Advair Diskus has also been found to be effective as a maintenance
treatment for COPD.

In a 3-year clinical
study, the effectiveness of Advair was tested by measuring the number of
COPD exacerbations (flare-ups) that people had in 1 year. Exacerbations were
considered moderate to severe if they required treatment with additional
steroids or antibiotics, or treatment in the hospital. People in the study took
either Advair Diskus, fluticasone propionate alone, salmeterol alone, or a placebo.

The study found that people who took Advair Diskus had:

• 12.2% fewer moderate to severe flare-ups per
  year than people who took salmeterol alone
• 9% fewer moderate to severe flare-ups per year
  than people who took fluticasone propionate alone
• 25.1% fewer moderate to severe flare-ups per
  year than people who took a placebo

Advair for children

Advair Diskus is FDA-approved to treat asthma in children
ages 4 years and older.

In a clinical
study, the effectiveness of Advair Diskus in children ages 4 to 11 years old
with asthma was compared with taking fluticasone propionate alone. The study
used a value called FEV1 to measure how much air children could force from their
lungs in 1 second. FEV1 is measured in liters (L), and an increase in FEV1
shows better airflow in the lungs.

After 12 weeks of treatment, improvements of FEV1 were:

• from 1.70 L at the beginning of the study to
  1.88 L after 12 weeks of taking Advair Diskus
• from 1.65 L at the beginning of the study to
  1.77 L after 12 weeks of taking fluticasone propionate alone

Advair HFA is approved to treat asthma in children ages 12
years and older. See “Advair HFA effectiveness” above for more details about
the medication’s effectiveness in adults and children 12 years and older.

Advair use with other drugs

Advair Diskus and Advair HFA are both used as a daily
treatment to control symptoms of asthma or chronic obstructive pulmonary
disease (COPD). They are not used to treat flare-ups of either condition. This
is because they don’t work quickly enough to relieve your symptoms in an
emergency situation.

Your doctor will likely prescribe a rescue inhaler for you,
which you should keep with you at all times. A rescue inhaler works rapidly to
improve your breathing. Examples of rescue inhalers include albuterol (ProAir
HFA, Ventolin HFA) and levalbuterol (Xopenex, Xopenex HFA).

Advair and alcohol

There is no known interaction between Advair and alcohol.

However, studies have
found that chronic alcohol drinking can damage the cilia in your airways. Cilia
are small, hair-like structures that help trap and remove germs from the air
you breathe. Damaged cilia make it easier for germs to cause infections in your
lungs. Chronic drinking can also decrease your immune system’s ability to fight
off infections.

These effects can lead to a higher risk for serious
infections, such as pneumonia. They
can also make your symptoms of asthma or chronic obstructive
pulmonary disease (COPD) worse.

If you drink alcohol, talk with your doctor about how much
alcohol is safe for you to drink.

Advair interactions

Advair can interact with several other medications. It can
also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For
instance, some interactions can interfere with how well a drug works. Other
interactions can increase side effects or make them more severe.

Advair and other medications

Below is a
list of medications that can interact with Advair. This list does not contain
all drugs that may interact with Advair.

Before taking
Advair, talk with your doctor and pharmacist. Tell them about all
prescription, over-the-counter, and other drugs you take. Also tell them about
any vitamins, herbs, and supplements you use. Sharing this information can help
you avoid potential interactions.

If you have questions about drug interactions that may
affect you, ask your doctor or pharmacist.

Advair and certain HIV drugs

Taking Advair with certain drugs used to treat viral
infections, such as HIV, can
increase levels of fluticasone propionate and salmeterol in your body. This is
because certain antiviral drugs prevent the breakdown of fluticasone propionate
and salmeterol in your body. Higher levels of fluticasone propionate and
salmeterol can increase your risk for serious side effects.

Examples of antiviral drugs that can increase fluticasone
propionate levels include:

• ritonavir (Norvir)
• atazanavir (Reyataz)
• indinavir (Crixivan)
• nelfinavir (Viracept)
• saquinavir (Invirase)

Taking Advair with these antiviral drugs is not recommended.
If you are undergoing treatment for HIV while taking Advair, your doctor may
prescribe a different HIV medication.

Advair and certain antibiotics or antifungal drugs

Taking Advair with certain antibiotic or antifungal drugs
can increase your risk for serious side effects. This is because these
antibiotics or antifungal drugs prevent the breakdown of fluticasone propionate
and salmeterol in your body. This causes higher than usual levels of fluticasone
propionate and salmeterol.

An example of an antibiotic drug that can increase fluticasone
propionate and salmeterol levels in your body is clarithromycin (Biaxin XL).

Examples of antifungal drugs that can increase fluticasone
propionate and salmeterol levels in your body include:

• ketoconazole (Extina, Nizoral, Xolegel)
• itraconazole (Omnel, Sporanox, Tolsura)
• voriconazole (Vfend)

Taking Advair with these medications is not recommended. If
you need treatment with one of these drugs while taking Advair, your doctor will
monitor you closely for increased side effects.

Advair and certain antidepressants

Taking certain antidepressants with Advair (or within 2
weeks of taking Advair) can raise your risk of serious side effects, such as
heart problems.

Examples of antidepressants that can increase your risk for
heart problems if taken with Advair include:

• selegiline (Emsam, Zelapar)
• phenelzine (Nardil)
• isocarboxazid (Marplan)
• amitriptyline
• nortriptyline (Pamelor)
• desipramine (Norpramin)
• imipramine (Tofranil)

If you need to take an antidepressant with Advair, talk with
your doctor. They may suggest a different option than the ones listed above.

Advair and certain blood pressure or heart rate
medications

Taking Advair with certain blood pressure or heart rate
medications can increase your risk for serious breathing problems.

Examples of blood pressure or heart rate medications that can
increase your risk for breathing problems if taken with Advair include:

• metoprolol (Lopressor, Toprol XL)
• atenolol (Tenormin)
• carvedilol (Coreg)
• propranolol (Inderal, Innopran XL)

Advair should only be taken with one of these medications in
an emergency situation (such as a heart attack) or if there are no other
preferred options. If you need to take Advair with one of these drugs, your
doctor will monitor you closely for serious breathing problems.

Advair and certain diuretics

Taking Advair with certain diuretics (water pills) can
increase your risk for hypokalemia (low potassium levels). It can also raise
your risk for serious heart problems, including abnormal heart rhythms.

Examples of diuretics that can increase your risk for these
serious effects if taken with Advair include:

• furosemide (Lasix)
• torsemide (Demadex)
• hydrochlorothiazide (Microzide)
• chlorthalidone

Some diuretics also come as part of a combination medication
(which contains more than one active drug). Be sure to check all of your
medications to see if any contain one of the diuretics listed above.

If you need to take one of these diuretics with Advair, your
doctor will monitor you closely for hypokalemia and abnormal heart rhythms.

Advair cost

As with all medications, the cost of Advair can vary. To
find current prices for Advair in your area, check out GoodRx.com.

The cost you find on GoodRx.com is what you may pay without
insurance. The actual price you’ll pay depends on your insurance plan, your location,
and the pharmacy you use.

Financial and insurance assistance

If you need financial support to pay for Advair, or if you
need help understanding your insurance coverage, assistance is available.

GlaxoSmithKline, the manufacturer of Advair, offers coupons
that can lower the cost of Advair. For more information and to find out if
you’re eligible to use these coupons, visit the program website.

The manufacturer also has a program called GSKForYOU. This
program offers financial assistance to people who don’t have insurance coverage
or who can’t afford Advair. For more information and to find out if you’re
eligible for support, call 866-GSK-FOR-U (866-475-3678), or visit the program website.

Advair and pregnancy

It’s not known how safe it is to use Advair during
pregnancy. In animal
studies, harm to the fetus was seen when the pregnant mother received
Advair. However, animal studies don’t always predict what will happen in
humans.

Untreated or poorly treated asthma during
pregnancy may cause serious problems for the mother and baby. These include preeclampsia
(high blood pressure during pregnancy), premature birth, and low birth weight. If
your asthma is well controlled, you may have a lower risk of these problems.

Treatment
guidelines state that the combination of an inhaled corticosteroid and
long-acting beta2-agonist is safe for pregnant women with asthma. Advair
contains this combination with the active drugs fluticasone propionate and
salmeterol.

If you have asthma or chronic obstructive pulmonary disease
(COPD) and are pregnant or considering becoming pregnant, talk with your doctor
about your treatment options.

Advair and birth control

It’s not known if Advair is safe to take during pregnancy.
If you are sexually active and you or your partner can become pregnant, talk
with your doctor about your birth control needs while you’re using Advair.

Advair and breastfeeding

It’s not known if Advair passes into human breast milk. In animal
studies, fluticasone propionate, one of the active drugs in Advair, did
pass into breast milk. However, animal studies don’t always predict what will
happen in humans.

You and your doctor should weigh the benefits of
breastfeeding while taking Advair against the risks of untreated asthma or chronic obstructive
pulmonary disease (COPD). Together you can determine if breastfeeding is a
safe option for you and your child.

Advair overdose

Using more than the recommended dosage of Advair can lead to
serious side effects.

Overdose symptoms

Symptoms of an overdose can include:

• dry mouth
• nausea
• fatigue (lack of energy)
• dizziness
• fast heart rate
• changes in blood pressure
• chest pain
• shakiness
• abnormal heart rhythm
• muscle cramps
• seizures

What to do in case of overdose

If you think you’ve taken too much of this drug, call your
doctor. You can also call the American Association of Poison Control Centers at
800-222-1222 or use their online tool. But
if your symptoms are severe, call 911 or go to the nearest emergency room right
away.

How Advair works

Chronic obstructive
pulmonary disease (COPD) is a group of conditions that cause damage in your
lungs that gets worse over time. COPD includes conditions such as chronic bronchitis and emphysema.

Chronic bronchitis causes inflammation (swelling) and mucus
buildup in your airways. This makes it hard for air to flow through your lungs,
reducing the amount of oxygen that you can take in.

Emphysema damages your alveoli, which are small air sacs in
your lungs. This damage makes it hard for you to breathe carbon dioxide out of
your lungs. Trapped carbon dioxide in your lungs prevents you from breathing in
fresh oxygen.

These conditions prevent oxygen from entering your
bloodstream and reaching your organs.

Advair contains two drugs: fluticasone propionate, a corticosteroid,
and salmeterol, a long-acting beta2-agonist.

Corticosteroids like fluticasone propionate reduce the
amount of inflammation in your lungs. This helps clear some of the swelling and
mucus that can block airflow through your lungs. Long-acting beta2-agonists
relax the muscles that line your airways. By doing this, they widen the airways
and allow more air to flow through.

Both of these drugs help improve airflow in people with asthma and
COPD. This helps you breathe easier and get the oxygen you need.

How long does it take to work?

In clinical studies, people’s symptoms usually started
improving within 30 to 60 minutes of taking Advair
HFA. People’s symptoms started improving within about 30 minutes of taking Advair
Diskus. After starting Advair, it might take about a week before you see
the maximum amount of improvement in your symptoms.

Common questions about Advair

Here are answers to some frequently asked questions about Advair.

Will I taste anything when I take Advair?

You might taste some of the medication after you take a dose
of Advair. Always rinse your mouth with water (and spit it out) after taking an
Advair dose, whether you tasted anything or not. This will help reduce your
risk for yeast infections in your mouth and throat.

Will Advair cure my condition? If not, how long will I have to take it?

Advair can’t cure asthma or chronic obstructive
pulmonary disease (COPD). There are currently no cures for either
condition.

Advair is meant for long-term use. If you and your doctor
decide that Advair helps control your asthma or COPD, you’ll likely take it
long term.

Should I use Advair during a COPD or asthma flare-up?

No, Advair shouldn’t be used during a COPD or asthma flare-up
(sudden worsening of your symptoms). It also shouldn’t be used in an emergency
(severe flare-up). Advair doesn’t work quickly enough to provide relief during these
situations. You should always carry a rescue inhaler to give you immediate
relief.

See the “Advair use with other drugs” section for more
details about rescue inhalers. Also, talk with your doctor about what to do if
your asthma or COPD symptoms suddenly get worse.

Can I take Advair to treat allergies?

No, Advair is not used to treat allergies. The causes and
symptoms of allergies are different from those of asthma or COPD, so Advair
won’t fully treat allergy symptoms. If you have asthma or COPD and also have
allergies, talk with your doctor about ways to relieve your allergy symptoms.

Can Advair slow my child’s growth?

It’s possible. Fluticasone propionate, one of the active
drugs in Advair HFA, may slow a child’s growth. If your child needs to take
Advair, their doctor will monitor their growth closely. Their doctor will
prescribe the lowest dosage needed to treat your child’s asthma. This can help
lower the risk of slowing their growth.

Advair precautions

Before taking Advair, talk with your doctor about your
health history. Advair may not be right for you if you have certain medical
conditions or other factors affecting your health. These include:

• History
  of allergic reaction to Advair.
  You shouldn’t use Advair if you’ve had an allergic reaction to it in the past.
  If you’re unsure of whether you’ve had an allergic reaction to Advair, talk
  with your doctor.
• Severe
  allergic reaction to milk proteins. You shouldn’t use Advair Diskus if
  you’ve had a severe allergic reaction to milk proteins in the past. Talk with
  your doctor if you’re unsure if you’ve had a severe allergic reaction to milk
  protein. Note: Advair HFA does not contain milk proteins.
• Rapidly
  worsening asthma or chronic obstructive pulmonary disease
  (COPD). You shouldn’t use Advair if you have rapidly worsening asthma
  or COPD. Also, don’t use Advair during situations that require intense medical
  treatment or hospitalization for asthma or COPD. If you’re unsure if your
  asthma or COPD is stable enough to start Advair, talk with your doctor.
• Serious infections. Advair can decrease
  your immune system’s ability to fight infections. You might not be able to
  start treatment with Advair if you have a serious infection, including tuberculosis.
  If you currently have a serious infection (or you’ve had one in the past), talk
  with your doctor about whether Advair is safe for you.
• Heart
  problems. Salmeterol, one of the active drugs in Advair, can worsen certain
  heart problems, including abnormal heart rhythms and high blood pressure.
  If you have heart problems, talk with your doctor about whether Advair is safe
  for you.
• Seizure disorders. Salmeterol, one of the active drugs in Advair, can
  worsen seizure disorders in some people. If you have a seizure disorder, talk
  with your doctor about whether Advair is safe for you.
• Certain
  hormone disorders. Salmeterol, one of the active drugs in Advair, can
  worsen symptoms of hyperthyroidism
  (high thyroid levels). Fluticasone propionate is the other active drug in
  Advair. It can cause high levels of cortisol (a hormone produced in the adrenal
  glands) in some people. Both of these issues can cause serious side effects. If
  you have a hormone disorder, talk with your doctor about whether Advair is safe
  for you.
• Pregnancy.
  It’s not known how safe Advair is during pregnancy. For more information, see
  the “Advair and pregnancy” section above.
• Breastfeeding.
  It’s not known how safe Advair is during pregnancy. For more information, see
  the “Advair and breastfeeding” section above.

Note: For more
information about the potential negative
effects of Advair, see the “Advair side effects” section above.

Advair expiration, storage, and disposal

When you get Advair from the pharmacy, the pharmacist will
add an expiration date to the label on the bottle. This date is typically 1
year from the date they dispensed the medication.

The expiration date helps guarantee the effectiveness of the
medication during this time. The current
stance of the Food and Drug Administration (FDA) is to avoid using expired
medications. If you have unused medication that has gone past the expiration
date, talk to your pharmacist about whether you might still be able to use it.

Advair Diskus should be thrown away when the counter reads
“0” or 1 month after the foil pouch was opened, whichever comes first.

Advair HFA should be thrown away when the counter reads “000.”

Storage

How long a medication remains good can depend on many
factors, including how and where you store the medication.

Advair Diskus and Advair HFA should be stored at room
temperature, no higher than 77°F (25°C).

They should be stored in their packaging and away from light.
Advair HFA should not be stored near high temperatures because it can burst if
it gets too hot. Don’t keep this medication in areas where it could get damp or
wet, such as bathrooms.

Disposal

If you no longer need to take Advair and have leftover
medication, it’s important to dispose of it safely. This helps prevent others,
including children and pets, from taking the drug by accident. It also helps
keep the drug from harming the environment.

The FDA website provides several useful tips
on medication disposal. You can also ask your pharmacist for information on how
to dispose of your medication.

Professional information for Advair

The following information is provided for clinicians and
other healthcare professionals.

Indications

Advair Diskus is approved by the Food and Drug
Administration (FDA) to treat asthma in adults
and children ages 4 years and older. It’s also FDA-approved for the maintenance
treatment and reduction of exacerbations in adults with chronic obstructive
pulmonary disease (COPD).

Advair HFA is approved to treat asthma in adults and
children ages 12 years and older.

Mechanism of action

Advair Diskus and Advair HFA contain two active drugs: fluticasone
propionate and salmeterol.

Fluticasone propionate is a corticosteroid that improves
asthma and COPD symptoms by reducing inflammation. It does this by binding to
glucocorticoid receptors and reducing the activation and activity of immune
system cells and mediators.

Salmeterol is a long-acting beta2-agonist (LABA) that
improves asthma and COPD symptoms by relaxing bronchial smooth muscle. It also
inhibits mediator release from mast cells, reducing inflammation. Salmeterol
works by binding to beta2-adrenoreceptors and increasing cyclic AMP levels,
prompting smooth muscle relaxation in the lungs.

Pharmacokinetics and metabolism

Following inhalation, absolute bioavailability of fluticasone
propionate is about 5.3% for Advair HFA and about 5.5% for Advair Diskus. Very
low levels of salmeterol reach systemic circulation. Peak concentration
achieved within 0.33 to 1.5 hours for fluticasone propionate and 5 to 10
minutes with salmeterol.

Plasma protein binding is approximately 99% for fluticasone
propionate and 96% for salmeterol. Fluticasone propionate and salmeterol are
both metabolized via the CYP3A4 pathway.

Fluticasone propionate is primarily excreted via fecal
route. Salmeterol excretion is through urine (~25%) and feces (~60%). Terminal
half-life for both drugs is about 5.5 hours.

Contraindications

Advair Diskus is contraindicated as primary treatment of
status asthmaticus or acute episodes of asthma or COPD that require intense
treatment.

Advair HFA is contraindicated as primary treatment of status
asthmaticus or acute episodes of asthma that require intense treatment.

Advair Diskus and Advair HFA are both contraindicated in
people with a history of hypersensitivity to their respective active and
inactive ingredients (including milk proteins in Advair Diskus).

Storage

Advair Diskus and Advair HFA should be stored at room
temperature (68°F to 77°F; 20°C to 25°C). Protect Advair HFA from extreme heat,
as the device can burst.

Disclaimer: Medical News Today
has made every effort to make certain that all information is factually
correct, comprehensive, and up-to-date. However, this article should not be
used as a substitute for the knowledge and expertise of a licensed healthcare
professional. You should always consult your doctor or other healthcare
professional before taking any medication. The drug information contained
herein is subject to change and is not intended to cover all possible uses,
directions, precautions, warnings, drug interactions, allergic reactions, or
adverse effects. The absence of warnings or other information for a given drug
does not indicate that the drug or drug combination is safe, effective, or
appropriate for all patients or all specific uses.