DrugindexOnline^{2nd edition}

Generic name: Fluticasone propionate, Salmeterol
Brand names: Advair Diskus

Why is Advair Diskus prescribed?

Advair Diskus is used to control asthma and chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis. It is an oral inhaler that contains two types of medication. One is fluticasone propionate, a steroid that reduces inflammation in the lungs. The other, salmeterol, is a long-acting bronchodilator that opens up the airways. Together, the two ingredients provide better symptom control than either does individually.

Most important fact about Advair Diskus

Advair Diskus is used for long-term control of asthma and short-term control of COPD associated with bronchitis. The drug won't end a sudden attack. For relief of acute asthma or bronchial symptoms, your doctor will prescribe a short-acting inhaler such as Proventil or Ventolin.

How should you take Advair Diskus?

Advair Diskus should be used twice a day, once in the morning and once in the evening. You may be able to taste or feel your dose of Advair Diskus. Do not be concerned, however, if you can't detect anything. You're getting the proper dose whether you can taste the medication or not. Never exceed the recommended dose of one inhalation, twice daily.

Follow the detailed directions that came with the inhaler. If you have any questions, ask your doctor or pharmacist. Some important points to keep in mind:

• Do not use a "spacer" with Advair Diskus.
• Never exhale into the diskus.
• Do not try to take the diskus apart.
• Always activate and use the diskus in a level, horizontal position.
• It is important to keep the diskus dry--do not wash any part of the mouthpiece or any part of the diskus.
• To reduce the risk of developing an infection in your mouth, rinse your mouth with water after each inhalation without swallowing.

When first using Advair Diskus, you may notice some improvement within 30 minutes, but its maximum benefits may take a week or more to appear.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule.

--Storage instructions...

Store the diskus at room temperature, away from heat, sunlight, and moisture. Discard the diskus one month after removing it from its moisture-protective foil overwrap pouch or after all blisters have been used, whichever comes first.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Advair Diskus.

• More common side effects may include:
  Bronchitis, cough, diarrhea, difficulty speaking, fungal infection of the mouth, gastrointestinal discomfort and pain, headaches, hoarseness, muscle pain, nausea, sinus problems, sore throat, upper respiratory infection or inflammation, vomiting

Why should Advair Diskus not be prescribed?

Advair cannot be used for acute episodes of asthma that require intensive therapy. You'll also have to avoid it if it gives you an allergic reaction.

Special warnings about Advair Diskus

Call your doctor immediately if you develop hives, rash, or swelling, or if you have shortness of breath that does not respond to your usual medication. Advair Diskus has been known to cause allergic reactions and acute attacks of asthma or bronchial spasms.

A safety study found that one of the ingredients in Advair Diskus, salmeterol, may be associated with rare cases of serious asthma attacks or asthma-related death. If you're concerned, talk with the doctor about your options. Do not, however, stop using Advair Diskus without first consulting your doctor.

Very rarely, Advair Diskus can cause a severe allergic reaction in people who are highly allergic to milk protein.

Be sure to keep track of how often you have to use your short-acting inhaler for relief of acute asthma symptoms. Your doctor will use this information to help determine how well Advair Diskus is working. Notify your doctor if you do not get relief from your short-acting inhaler or if you need more inhalations than usual to get relief. Keep track of your peak flow readings, too. Call your doctor if you notice a drop in this measurement of lung capacity.

Do not use Advair Diskus more often than your doctor has prescribed. Excessive use can cause heart irregularities. Use Advair Diskus with caution if you have any kind of heart disorder or high blood pressure. Alert your doctor immediately if you develop chest pain, heart palpitations, nervousness, or tremor.

Long-term use of the medications in Advair Diskus could exacerbate certain conditions. Your doctor will monitor you closely if you have any of the following: infections caused by a virus, fungus, or bacteria (including tuberculosis); blood sugar problems; overactive thyroid; seizures; eye problems (such as cataracts or glaucoma); blood disorders; and osteoporosis or an increased risk of losing bone mineral density.

Steroids taken by mouth or injection have been shown to slow or stop growth in children and cause reduced adrenal gland function. If enough medication is absorbed following inhalation, it's possible that Advair Diskus could also cause these effects. The doctor will prescribe the lowest possible dose to lessen the chance of an effect on growth or adrenal gland function. It is important that children taking Advair Diskus visit their doctors regularly so that their growth rates may be monitored. Before this medicine is given to a child, you and your doctor should talk about the benefits as well as the risks of using it.

People taking this medicine may be more susceptible to infections. Try to avoid contact with people who have measles or chickenpox, and notify the doctor if you or your child is exposed. The steroid component of Advair Diskus tends to lower immunity and could make these infections worse.

Do not use Serevent (salmeterol), Foradil (formoterol), or other long-acting inhalers while using Advair Diskus. They contain the same type of active ingredient, and will provide no extra benefit.

Possible food and drug interactions when taking Advair Diskus

If Advair Diskus is used with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Advair Diskus with the following:

Antidepressants categorized as "tricyclics," such as Elavil and Tofranil
Antidepressants called "monoamine oxidase inhibitors," such as Nardil and Parnate
Beta blockers (drugs such as Inderal and Tenormin that are used to control blood pressure and treat various heart conditions)
Ketoconazole (Nizoral)
Long-acting inhalers such as Serevent and Foradil
Ritonavir (Norvir)
Water pills (diuretics) such as HydroDIURIL and Lasix

Special information if you are pregnant or breastfeeding

The possibility of harm to a developing baby has not been ruled out. Advair Diskus should be used during pregnancy only if the potential benefit justifies the risk.

It is possible that the ingredients of Advair Diskus may appear in breast milk, so you'll need to choose between nursing the baby or continuing your therapy.

Recommended dosage

ADULTS

The recommended dosage of Advair Diskus is one inhalation twice daily. Take the inhalations morning and evening, 12 hours apart.

The product comes in three strengths. Your doctor will select the best strength for you based on your current therapy. If this selection fails to improve your symptoms after 2 weeks, the doctor may prescribe a higher strength.

CHILDREN

Advair Diskus can be used by adolescents 12 years of age and older. The dosage is the same as for adults.

Advair Diskus can sometimes be used to control asthma in children 4 to 11 years of age. For these children, only the lowest strength of medication is given.

Advair Diskus should not be used by children under 4 years of age.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

• Symptoms of acute Advair Diskus overdose may include:
  Fast or irregular heartbeat, headache, muscle cramps, tremor