Advair

Advair is commonly used to treat airway spasms in people with COPD, as well as to prevent them in people with asthma. By opening up the airways and allowing more air to get into and through the lungs, the medication can make it easier for people with airway spasms to breathe. Side effects can include upper respiratory tract infections, headaches, and sore throat.
 

What Is Advair?

Advair® (fluticasone and salmeterol) is a prescription medication used to treat airway spasms (called bronchospasms) caused by chronic obstructive pulmonary disease (COPD) and to prevent these spasms from occurring in people with asthma.
 
The medication comes in two forms: the Advair Diskus® and the Advair® HFA inhaler. The Advair Diskus is approved for both asthma and COPD, while the Advair HFA inhaler is approved only for asthma.
 
(Click Advair Uses for more information, including possible off-label uses.)
 

Who Makes It?

Advair is made by GlaxoSmithKline.
 

How Does Advair Work?

Advair contains two different medications: fluticasone and salmeterol. Salmeterol is part of a class of drugs called beta-adrenergic receptor agonists, or beta agonists for short. Beta agonists stimulate beta receptors in the body, including those on the muscles around the airways. This causes the muscles to relax, which opens up the airways and allows more air to get into and through the lungs.
 
The other component is fluticasone, an asthma medication that belongs to a group of drugs called inhaled corticosteroids, or steroids for short. Inhaled steroids go directly into the lungs and help to decrease the inflammation of airways that makes asthma attacks more likely.
 
Because Advair does not work quickly, it should not be used for treating an asthma attack. Rather, it is used twice a day in order to prevent them.
 

Clinical Effects

Several clinical studies have examined the use of Advair for asthma and COPD.
 
Asthma
In clinical studies, the medicine was shown to improve breathing better than when either of the active ingredients of Advair (fluticasone or salmeterol) was used alone. Sometimes, asthma medications can make symptoms worse.
 
For example, in one study, only 3 percent of people taking Advair had to stop the medication due to worsening asthma, compared to 11 percent of those taking fluticasone alone, 35 percent of those taking salmeterol alone, and 49 percent of those taking neither medication.
 
COPD
In studies Advair was given to people with COPD associated with chronic bronchitis. People taking the drug showed improved lung function, compared to those not taking it.
 

When and How to Take Advair

Advair comes in two forms -- the Advair Diskus, which contains dry powder, and the Advair HFA inhaler, a more traditional inhaler.
 
How to Use the Advair Diskus
Following are some general considerations for when and how to use the Advair Diskus:
 
  • The medication is inhaled into the lungs, usually twice daily, with about 12 hours between doses.
     
  • The Advair Diskus is used differently than older inhalers. It contains small foil pockets that contain the powder. These pockets are punctured (by sliding the lever until it clicks), and the powder is inhaled using your own breath.
     
  • Rinse out your mouth (without swallowing) after each dose in order to prevent thrush.
     
  • Be sure to keep the Advair Diskus horizontal while using it; otherwise, the powder can spill out. Never exhale into the inhaler, as this will also disrupt the powder.
     
  • It is important that you learn exactly how to use your Advair Diskus. It may be difficult at first and may require some practice.
     
  • Some people may not taste or feel the fine powder.
 
  • Advair should be taken at the same time each day to maintain an even level in your blood.
     
  • For the medication to work properly, it must be taken as prescribed. Advair will not work if you stop taking it.
     
How to Use the Advair HFA Inhaler
Advair also comes in a more traditional inhaler, the Advair HFA inhaler. Following are some general considerations for when and how to use this form of the drug:
 
  • Advair HFA comes in a metered-dose inhaler (called an MDI).
     
  • The medication is inhaled into the lungs, usually twice daily, with about 12 hours between doses.
     
  • You should "test spray" each inhaler before you use it for the first time, or if you have not used it for a long time. To test spray the inhaler, spray it into the air by pressing on the top of the canister.
     
  • Shake your Advair HFA inhaler gently before each use.
     
  • Wait at least 30 seconds in between inhalations.
     
  • Rinse out your mouth (without swallowing) after each dose in order to prevent thrush.
     
  • It is important that you learn exactly how to use your Advair HFA inhaler. It may be difficult at first and may require some practice.
     
  • The spray should be inhaled into the lungs, not sprayed onto the back of the throat and swallowed. To accomplish this, you will need to breathe in while spraying the inhaler.
     
  • Most people put the mouthpiece of the inhaler directly into their mouths. However, many healthcare professionals now recommend placing the inhaler an inch or two away from the mouth. Talk with your healthcare provider about the best way for you to use the inhaler.
     
  • Each inhaler contains 120 sprays and comes with a dose counter that counts down how many sprays are remaining.
     
  • For Advair HFA to work properly, it must be taken as prescribed. The medication will not work if you stop taking it.
     

Dosing Information

The dose of Advair your healthcare provider recommends will vary, depending on a number of factors, including:
 
As always, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
 
(Click Advair Dosage for more information.)
 

Side Effects of Advair

As with any medicine, side effects are possible with Advair. However, not everyone who takes the medication will experience side effects. In fact, most people tolerate it well. If side effects do occur, in most cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
 
Common side effects include but are not limited to:
 
  • Upper respiratory tract infections (such as the common cold)
  • Headaches
  • Sore throat
  • Bronchitis
  • Coughing
  • Nausea and vomiting.
     
(Click Advair Side Effects to learn more, including some of the more serious side effects you should report to your healthcare provider.)
 

Drug Interactions

Advair can potentially interact with several other medicines (see Advair Drug Interactions for more information).
 

What Should I Tell My Healthcare Provider?

Talk with your healthcare provider prior to using the drug if you have:
 
Also, let your healthcare provider know if you are:
 
You should also make sure to tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 
(Click Advair Warnings and Precautions for more information, including information on who should not take the drug.)
 

What If I Overdose on Advair?

People who take too much Advair may have overdose symptoms that could include:
 
  • Chest pain (angina)
  • High blood pressure (hypertension) or low blood pressure (hypotension)
  • Nervousness
  • Headaches
  • Shakiness (tremors)
  • Dry mouth
  • Feelings of a rapidly or forcefully beating heart (heart palpitations)
  • Nausea
  • Dizziness
  • Insomnia or fatigue
  • Seizures
  • An irregular heart rhythm (arrhythmia) or a fast heart rate (tachycardia)
  • Low potassium in the blood (hypokalemia)
  • High blood sugar (hyperglycemia)
  • Cardiac arrest
  • Loss of life.
     
If you happen to take too much, seek immediate medical attention.
 
(Click Advair Overdose for more information.)
 

How Should the Medication Be Stored?

Advair should be stored at room temperature, away from moisture and heat. Once an Advair Diskus is removed from its packaging, it must be discarded after one month, even if it is not empty. The Advair HFA inhaler can be used until it has expired or until all 120 doses are used.
 
Keep this and all other medications out of the reach of children.
 

What Should I Do If I Miss a Dose?

If you do not take your Advair as scheduled, take your missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
 

Available Strengths

The Advair Diskus is available in three strengths:
 
The Advair HFA inhaler is also available in three strengths:
 
  • Advair HFA 45/21 -- containing 120 inhalations with 45 mcg fluticasone and 21 mcg salmeterol per inhalation
  • Advair HFA 115/21 -- containing 120 inhalations with 115 mcg fluticasone and 21 mcg salmeterol per inhalation
  • Advair HFA 230/21 -- containing 120 inhalations with 230 mcg fluticasone and 21 mcg salmeterol per inhalation.
     

Generic Advair

Currently, no generic versions of the medication are licensed for sale (see Generic Advair for more information).

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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;
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