Generic Name: fluticasone and salmeterol (floo TIK a sone, sal ME te rol)
Brand Names: Advair Diskus, Advair HFA

What is Advair?

Advair contains fluticasone and salmeterol. Fluticasone is a steroid. Advair prevents the release of substances in the body that cause inflammation. Salmeterol is a bronchodilator. It works by relaxing muscles in the airways to improve breathing.

Advair is used to prevent asthma attacks. It is also used to prevent flare-ups or worsening of chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis and/or emphysema.

Advair may also be used for other purposes not listed in this medication guide.

Important information

Do not use Advair to treat an asthma attack that has already begun.

Salmeterol may increase the risk of asthma-related death. Use only the prescribed dose of Advair, and do not use it for longer than your doctor recommends. Follow all patient instructions for safe use. Talk with your doctor about your individual risks and benefits of using this medication.

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Before using Advair, tell your doctor if you have a food or drug allergy, heart disease, high blood pressure, a seizure disorder, an infection, a weak immune system, diabetes, glaucoma, tuberculosis, osteoporosis, a thyroid disorder, or liver disease.

Seek medical attention if you think any of your asthma medications are not working as well as usual. An increased need for medication could be an early sign of a serious asthma attack. If you use a peak flow meter at home, call your doctor if your numbers are lower than normal.

Before using Advair

Do not use Advair if you are allergic to fluticasone (Flonase, Flovent), salmeterol (Serevent), or milk proteins, or if you are having an asthma attack or severe COPD symptoms.

To make sure you can safely use Advair, tell your doctor if you have any of these other conditions:

  • a food or drug allergy;

  • heart disease or high blood pressure;

  • epilepsy or other seizure disorder;

  • any type of infection;

  • a weak immune system;

  • diabetes;

  • glaucoma;

  • tuberculosis;

  • osteoporosis;

  • a thyroid disorder; or

  • liver disease.

FDA pregnancy category C. It is not known whether Advair is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether fluticasone and salmeterol passes into breast milk or if it could harm a nursing baby. Do not use Advair without telling your doctor if you are breast-feeding a baby.

See also: Pregnancy and breastfeeding warnings (in more detail)

Advair can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medication.

Do not give this medication to a child younger than 4 years old.

Long-term use of steroids may lead to bone loss (osteoporosis), especially if you smoke, if you do not exercise, if you do not get enough vitamin D or calcium in your diet, or if you have a family history of osteoporosis.

How should I use Advair?

Use Advair exactly as it was prescribed for you. Do not use Advair in larger amounts, or use it for longer than recommended by your doctor. Follow all patient instructions for safe use.

Advair comes with patient instructions for safe and effective use, and directions for priming the inhaler device if needed. Follow these directions carefully.

Salmeterol may increase the risk of asthma-related death. Talk with your doctor about your individual risks and benefits of using this medication.

Do not use Advair to treat an asthma attack that has already begun. It will not work fast enough. Use only a fast-acting inhalation medication.

Advair Diskus is a powder form of fluticasone and salmeterol that comes with a special inhaler device pre-loaded with blister packs containing measured doses of the medicine. The device opens and loads a blister each time you use the inhaler. This device is not to be used with a spacer.

Advair HFA is an aerosol form of fluticasone and salmeterol that comes in a canister that is used with an actuator inhaler device. Use only the inhaler device provided with Advair HFA. This device is not to be used with a spacer.

Shake the Advair HFA inhaler for at least 5 seconds before each spray.

To reduce the chance of developing a yeast infection in your mouth, rinse your mouth with water after using this medicine.

Keep track of the number of sprays you have used and throw away the Advair HFA canister after 120 sprays, even if it feels like there is still medicine in it.

If you also use a steroid medication, do not stop using the steroid suddenly or you may have unpleasant withdrawal symptoms. Talk with your doctor about using less and less of the steroid before stopping completely.

Carry an identification card or wear a medical alert ID to let others know that you may need an oral steroid in an emergency.

Seek medical attention if you think any of your asthma medications are not working as well as usual. An increased need for medication could be an early sign of a serious asthma attack. If you use a peak flow meter at home, call your doctor if your numbers are lower than normal.

Use all of your medications as directed by your doctor. Talk with your doctor if your medications do not seem to work as well in treating or preventing attacks. Do not change your doses or medication schedule without advice from your doctor.

Store Advair at room temperature away from moisture and heat. Keep the Advair HFA canister away from high heat, such as open flame or in a car on a hot day. The canister may explode if it gets too hot.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include angina or chest pain, fast or irregular heartbeats, seizures, tremor, weakness, headache, nausea, and vomiting.

What should I avoid?

Do not use a second form of salmeterol (such as Serevent) or use a similar inhaled bronchodilator such as formoterol (Foradil) unless your doctor has told you to.

Advair can lower the blood cells that help your body fight infections. Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medicines.

Advair side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Advair: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

  • bronchospasm (wheezing, chest tightness, trouble breathing);

  • fast or uneven heart beats, restless feeling, tremor;

  • fever, chills, stabbing chest pain, cough with yellow or green mucus;

  • blurred vision, eye pain, or seeing halos around lights;

  • white patches or sores inside your mouth or on your lips; or

  • worsening asthma symptoms.

Less serious Advair side effects include:

  • headache, dizziness;

  • nausea, vomiting, diarrhea;

  • dry mouth, nose, or throat;

  • stuffy nose, sinus pain, cough, sore throat; or

  • hoarseness or deepened voice.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Advair?

Before using Advair, tell your doctor about all other medicines you use, especially:

  • amiodarone (Cordarone);

  • a diuretic or "water pill";

  • HIV medicines such as atazanavir (Reyataz), ritonavir (Norvir), indinavir (Crixivan), nelfinavir (Viracept), or saquinavir (Invirase);

  • an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam);

  • an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), fluoxetine (Prozac), nefazodone, or imipramine (Tofranil)

  • antibiotics such as clarithromycin (Biaxin) or telithromycin (Ketek);

  • antifungal medications such as ketoconazole (Nizoral) or itraconazole (Sporanox); or

  • a beta-blocker such as atenolol (Tenormin), carvedilol (Coreg), metoprolol (Lopressor, Toprol), and others.

This list is not complete and there may be other drugs that can interact with Advair. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about Advair.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Advair only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

Copyright 1996-2014 Cerner Multum, Inc. Version: 10.01. Revision Date: 2012-1-09, 10:00:21 AM.

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