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Advair Diskus (fluticasone / salmeterol) Disease Interactions

Drug Interactions (307) Alcohol/Food Interactions (1) Disease Interactions (9)

There are 9 disease interactions with Advair Diskus (fluticasone / salmeterol):

Beta-2 Adrenergic Bronchodilators (Includes Advair Diskus) ↔ Cardiovascular

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperthyroidism, Heart Disease, Hypertension

Adrenergic bronchodilators can stimulate cardiovascular beta-1 and beta-2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta-1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.


Beta-2 Adrenergic Bronchodilators (Includes Advair Diskus) ↔ Diabetes

Moderate Potential Hazard, Low plausibility

Applies to: Diabetes Mellitus

Adrenergic bronchodilators may cause increases in blood glucose concentrations. These effects are usually transient and slight, but may be significant with dosages higher than those normally recommended. Large doses of IV albuterol (not commercially available in the U.S.) and terbutaline sulfate have been reported to cause exacerbation of preexisting diabetes mellitus and ketoacidosis. Therapy with adrenergic bronchodilators should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.


Beta-2 Adrenergic Bronchodilators (Includes Advair Diskus) ↔ Hypokalemia

Moderate Potential Hazard, Low plausibility

Applies to: Hypokalemia

Adrenergic bronchodilators may cause decreases in serum potassium concentrations, primarily when given by nebulization or intravenous administration. Although this effect is usually transient and does not require supplementation, clinically significant hypokalemia may occur in some patients, with the potential to induce cardiovascular adverse effects. The relevance of these observations to oral or oral aerosol/powder for inhalation therapy is unknown. Therapy with adrenergic bronchodilators should be administered cautiously in patients with or predisposed to hypokalemia.


Beta-2 Adrenergic Bronchodilators (Includes Advair Diskus) ↔ Seizures

Moderate Potential Hazard, Low plausibility

Applies to: Seizures

Adrenergic bronchodilators may cause CNS stimulation. Seizures have been reported rarely in patients treated with terbutaline. Therapy with adrenergic bronchodilators should be administered cautiously in patients with seizure disorders. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.


Inhaled Corticosteroids (Includes Advair Diskus) ↔ Hyperadrenocorticism

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperadrenocorticism

The use of inhaled and nasal corticosteroids may rarely precipitate or aggravate conditions of hyperadrenocorticism. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used. The development of symptoms such as menstrual irregularities, acneiform lesions, cataracts and cushingoid features during inhaled or nasal corticosteroid therapy may indicate excessive use.


Inhaled Corticosteroids (Includes Advair Diskus) ↔ Infections

Moderate Potential Hazard, Moderate plausibility

Applies to: Infection - Bacterial/Fungal/Protozoal/Viral, Tuberculosis -- Latent

The immunosuppressant and anti-inflammatory effects of corticosteroids, particularly in higher dosages, may decrease host resistance to infectious agents, decrease the ability to localize infections, and mask the symptoms of infection. Secondary infections may be more likely to develop. Therapy with inhaled and nasal corticosteroids should be administered cautiously in patients with an infection, particularly active or quiescent tuberculosis infection of the respiratory tract or any untreated systemic fungal, bacterial, parasitic, or viral infection. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.


Inhaled Corticosteroids (Includes Advair Diskus) ↔ Ocular Herpes Simplex

Moderate Potential Hazard, Moderate plausibility

Applies to: Ocular Herpes Simplex

Pharmacologic dosages of corticosteroids may increase the risk of corneal perforation in patients with ocular herpes simplex. Therapy with inhaled and nasal corticosteroids should be administered cautiously in such patients.


Inhaled Corticosteroids (Includes Advair Diskus) ↔ Ocular Toxicities

Moderate Potential Hazard, Low plausibility

Applies to: Glaucoma/Intraocular Hypertension, Cataracts

Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with inhaled and nasal corticosteroids has only rarely produced these effects but should be administered cautiously nonetheless in patients with a history of cataracts, glaucoma, or increased intraocular pressure. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.


Inhaled Corticosteroids (Includes Advair Diskus) ↔ Osteoporosis

Moderate Potential Hazard, Moderate plausibility

Applies to: Osteoporosis

Prolonged use of inhaled corticosteroids may be associated with a reduction in bone density. This effect appears to be dose-related and has been reported primarily with high dosages (>= 800 mcg/day of beclomethasone or equivalent for >= 1 year). Reduced levels of total body calcium have also been demonstrated in patients receiving lower dosages. Long-term therapy with inhaled and nasal corticosteroids should be administered cautiously in patients with osteoporosis. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.


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Advair Diskus (fluticasone / salmeterol) drug Interactions

There are 307 drug interactions with Advair Diskus (fluticasone / salmeterol)

Advair Diskus (fluticasone / salmeterol) alcohol/food Interactions

There is 1 alcohol/food interaction with Advair Diskus (fluticasone / salmeterol)

See also...

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date, and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. Multum's drug information does not endorse drugs, diagnose patients, or recommend therapy. Multum's drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2013 Multum Information Services, Inc. The information in contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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