Advair Diskus

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Advair Diskus Overview

Advair Diskus (generic: fluticasone/salmeterol) is a prescription medication used to treat asthma and chronic obstructive pulmonary disease (COPD). Advair contains two drugs, fluticasone and salmeterol. Fluticasone is a steroid medication. It reduces inflammation in the airways. Salmeterol belongs to a group of drugs called beta agonists which relax muscle in the airways. These two drugs act to improve movement of air into the lungs. 

Advair Diskus comes as an inhaler and is usually taken twice a day. 

Common side effects of Advair Diskus are cold-like symptoms and headache.

Uses of Advair Diskus

Advair Diskus is a prescription medicine used to treat symptoms of asthma and chronic obstructive pulmonary disease (COPD).

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

 

Side Effects of Advair Diskus

Advair Diskus can cause serious side effects, including:

Serious allergic reactions. Call your healthcare provider or get emergency medical care if you get any of the following symptoms of a serious allergic reaction:

  • rash
  • hives
  • swelling of the face, mouth, and tongue
  • breathing problems
  • sudden breathing problems immediately after inhaling your medicine

Effects on heart:

  • increased blood pressure
  • a fast and irregular heartbeat
  • chest pain

Effects on nervous system:

  • tremor
  • nervousness

Other side effects include:

  • Reduced adrenal function (may result in loss of energy)
  • Changes in blood (sugar, potassium, certain types of white blood cells)
  • Weakened immune system and a higher chance of infections
  • Lower bone mineral density. This may be a problem for people who already have a higher chance of low bone density (osteoporosis).
  • Eye problems including glaucoma and cataracts. You should have regular eye exams while using Advair Diskus.
  • Slowed growth in children. A child’s growth should be checked often.

People with COPD have a higher chance of getting pneumonia. Advair Diskus may increase the chance of getting pneumonia. Call your healthcare provider if you notice any of the following symptoms:

  • increase in mucus (sputum) production
  • change in mucus color
  • fever
  • chills
  • increased cough
  • increased breathing problems
  •  

Common side effects of Advair Diskus include:

  • upper respiratory tract infection
  • throat irritation
  • hoarseness and voice changes
  • thrush in the mouth and throat
  • bronchitis
  • cough
  • headache
  • nausea and vomiting

 

Advair Diskus Interactions

Tell your doctor about the medicines you take including prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products. Be sure to mention any of the following:

  • antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral) 
  • beta-blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal)
  • cimetidine (Tagamet)
  • clarithromycin (Biaxin)
  • cyclosporine (Neoral, Sandimmune)
  • danazol (Danocrine)
  • delavirdine (Rescriptor)
  • diltiazem (Cardizem, Dilacor, Tiazac)
  • diuretics ('water pills')
  • fluoxetine (Prozac, Sarafem)
  • fluvoxamine (Luvox)
  • HIV protease inhibitors such as atazanavir (Reyataz), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Invirase)
  • isoniazid (INH, Nydrazid)
  • other medications for asthma or COPD
  • medications for seizures
  • metronidazole (Flagyl)
  • nefazodone
  • oral contraceptives (birth control pills)
  • telithromycin (Ketek)
  • troleandomycin (TAO)
  • verapamil (Calan, Covera, Isoptin, Verelan)
  • zafirlukast (Accolate).

Also tell your doctor and pharmacist if you are taking the following medications or have stopped taking them during the past 2 weeks: antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); and monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), and tranylcypromine (Parnate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

Advair Diskus Precautions

Get emergency medical care if:
  • breathing problems worsen quickly and
  • you use your rescue inhaler medicine, but it does not relieve your breathing problems.

1. Advair Diskus should be used only if your healthcare provider decides that your asthma is not well controlled with a long-term asthma control medicine, such as inhaled corticosteroids.

2. When your asthma is well controlled, your healthcare provider may tell you to stop taking Advair Diskus. Your healthcare provider will decide if you can stop Advair Diskus without loss of asthma control. Your healthcare provider may prescribe a different asthma control medicine for you, such as an inhaled corticosteroid.

3. Children and adolescents who take LABA medicines may have an increased risk of being hospitalized for asthma problems. People with asthma who take long-acting beta2-adrenergic agonist (LABA) medicines, such as salmeterol (one of the medicines in Advair Diskus), have an increased risk of death from asthma problems. It is not known whether fluticasone propionate, the other medicine in Advair Diskus, reduces the risk of death from asthma problems seen with salmeterol.

Do not use Advair Diskus:

  • to treat sudden, severe symptoms of asthma or COPD and
  • if you have a severe allergy to milk proteins. Ask your doctor if you are not sure.

 

Advair Diskus Food Interactions

Grapefruit and grapefruit juice may interact with Advair Diskus and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Inform MD

Tell your doctor about all of your health conditions, including if you:

  • have heart problems
  • have high blood pressure
  • have seizures
  • have thyroid problems
  • have diabetes
  • have liver problems
  • have osteoporosis
  • have an immune system problem
  • are pregnant or planning to become pregnant. It is not known if Advair Diskus may harm your unborn baby.
  • are breastfeeding. It is not known if Advair Diskus passes into your milk and if it can harm your baby.
  • are allergic to any of the ingredients in Advair Diskus, any other medicines, or food products. 
  • are exposed to chickenpox or measles

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Advair Diskus and certain other medicines may interact with each other. This may cause serious side effects. Especially, tell your healthcare provider if you take ritonavir. The anti-HIV medicines NORVIR (ritonavir capsules) Soft Gelatin, NORVIR (ritonavir oral solution), and KALETRA (lopinavir/ritonavir) Tablets contain ritonavir.

Advair Diskus and Pregnancy

Tell your doctor if you are pregnant or if you are planning to become pregnant. It is not known if Advair Diskus will harm your unborn baby.

Advair Diskus and Lactation

Tell your doctor if you are breastfeeding or if you are planning to breastfeed. It is not known if Advair Diskus is excreted into breast milk or if it will harm your baby.

Advair Diskus Usage

  • Children should use Advair Diskus with an adult’s help, as instructed by the child’s healthcare provider.
  • Use Advair Diskus exactly as prescribed. Do not use Advair Diskus more often than prescribed. Advair Diskus comes in 3 strengths. Your healthcare provider has prescribed the one that is best for your condition.
  • The usual dosage of Advair Diskus is 1 inhalation 2 times each day (morning and evening). The 2 doses should be about 12 hours apart. 
  • Rinse your mouth with water after using Advair Diskus. This will prevent you from getting an oral/throat yeast infection known as thrush.
  • If you take more Advair Diskus than your doctor has prescribed, get medical help right away if you have any unusual symptoms, such as worsening shortness of breath, chest pain, increased heart rate, or shakiness.
  • If you miss a dose of Advair Diskus, just skip that dose. Take your next dose at your usual time. Do not take 2 doses at one time. Do not use a spacer device with Advair Diskus.
  • Do not breathe into Advair Diskus.
  • While you are using Advair Diskus 2 times each day, do not use other medicines that contain a LABA for any reason. Ask your healthcare provider or pharmacist if any of your other medicines are LABA medicines.
  • Do not stop using Advair Diskus or other asthma medicines unless told to do so by your healthcare provider because your symptoms might get worse. Your healthcare provider will change your medicines as needed.
  • Advair Diskus does not relieve sudden symptoms. Always have a rescue inhaler medicine with you to treat sudden symptoms. If you do not have an inhaled, short-acting bronchodilator, call your healthcare provider to have one prescribed for you.

Advair Diskus Dosage

Advair Diskus is usually used twice a day, in the morning and evening, about 12 hours apart. Use Advair Diskus at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use Advair Diskus exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Advair Diskus Overdose

If you take too much Advair Diskus, call your local Poison Control Center or seek emergency medical attention right away.

Forms of Advair Diskus

Advair Diskus 100/50, Advair Diskus 250/50 and Advair Diskus 500/50 are the available combinations of fluticasone propionate and salmeterol xinafoate.

Active ingredients: fluticasone propionate, salmeterol xinafoate

Inactive ingredient: lactose (contains milk proteins)

Other Requirements

  • Store Advair Diskus at room temperature between 68°F to 77°F (20°C to 25°C). Keep in a dry place away from heat and sunlight.
  • Safely discard Advair Diskus one month after you remove it from the foil pouch, or after the dose indicator reads “0”, whichever comes first.
  • Keep Advair Diskus and all medicines out of the reach of children.

Advair Diskus FDA Warning

ASTHMA-RELATED DEATH

Long-acting beta2-adrenergic agonists (LABAs), such as salmeterol, one of the active ingredients in ADVAIR DISKUS, increase the risk of asthma-related death. A US study showed an increase in asthma-related deaths in patients receiving salmeterol (13 deaths out of 13,176 patients treated for 28 weeks on salmeterol versus 3 out of 13,179 patients on placebo). Currently available data are inadequate to determine whether concurrent use of inhaled corticosteroids or other long-term asthma control drugs mitigates the increased risk of asthma-related death from LABAs. Available data from controlled clinical trials suggest that LABAs increase the risk of asthma-related hospitalization in pediatric and adolescent patients. 

When treating patients with asthma, only prescribe ADVAIR DISKUS for patients not adequately controlled on a long-term asthma control medication, such as an inhaled corticosteroid, or whose disease severity clearly warrants initiation of treatment with both an inhaled corticosteroid and a LABA. Once asthma control is achieved and maintained, assess the patient at regular intervals and step down therapy (e.g., discontinue ADVAIR DISKUS) if possible without loss of asthma control and maintain the patient on a long-term asthma control medication, such as an inhaled corticosteroid. Do not use ADVAIR DISKUS for patients whose asthma is adequately controlled on low- or medium-dose inhaled corticosteroids.

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Reviewed by: 
Beth Bolt, RPh
Last Updated:
February 28, 2013