Advair

Advair contains a combination of fluticasone and salmeterol. Fluticasone is a steroid that 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 a combination medicine 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. It is available as Advair Diskus or Advair HFA.

Advair Diskus is for use in adults and children who are at least 4 years old. Advair HFA is for use in adults and children who are at least 12 years old.

You should not use this medicine if you are allergic to fluticasone or salmeterol, or if you have a severe allergy to milk proteins (if using Advair Diskus or AirDuo Respiclick).

Advair is not a rescue medicine. It will not work fast enough to treat an asthma or bronchospasm attack.

Seek medical attention if you have worsening breathing problems, or if you think your medications are not working as well.

Advair can lead to fungal infections of the mouth and throat. Rinsing your mouth with water after use can help prevent these infections. Advair is also associated with a higher risk of pneumonia in patients with COPD.

You should not use this medicine if you are allergic to fluticasone or salmeterol (Serevent), or:

• if you have a severe allergy to milk proteins (if using Advair Diskus or AirDuo Respiclick); or
• if you are having an asthma attack or severe COPD symptoms.

Fluticasone can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had. Tell your doctor about any illness or infection you have had within the past several weeks.

Tell your doctor if you have ever had:

• glaucoma or cataracts;
• heart disease or high blood pressure;
• a seizure;
• diabetes;
• a food or drug allergy;
• a weak immune system;
• chronic infections (such as tuberculosis, fungal, bacterial, viral, parasitic, or herpes of the eye );
• osteoporosis;
• a thyroid disorder; or
• liver or kidney disease.

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. Talk with your doctor about your risk.

Tell your doctor if you are pregnant. It is not known whether this medicine will harm an unborn baby. However, having untreated or uncontrolled asthma during pregnancy may cause complications such as low birth weight, premature birth, or eclampsia (dangerously high blood pressure that can lead to medical problems in both mother and baby). The benefit of treating asthma may outweigh any risks to the baby.

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

Do not give Advair to a child without medical advice.

Get emergency medical help if you have 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:

• wheezing, choking, or other breathing problems after using this medicine;
• fever, chills, cough with mucus, feeling short of breath;
• chest pain, fast or irregular heartbeats, severe headache, pounding in your neck or ears;
• tremors, nervousness;
• signs of thrush (a fungal infection) - sores or white patches in your mouth or throat, trouble swallowing;
• blurred vision, tunnel vision, eye pain, or seeing halos around lights;
• increased thirst, increased urination, dry mouth, fruity breath odor;
• leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling; or
• worsening tiredness or weakness, feeling light-headed, nausea, vomiting.

Fluticasone 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.

Common Advair side effects may include:

• headache, muscle pain, bone pain, back pain;
• nausea, vomiting;
• thrush, throat irritation;
• ongoing cough, hoarseness or deepened voice;
• cold symptoms such as stuffy nose, sneezing, sore throat; or
• ear infection (in a child) - fever, ear pain or full feeling, trouble hearing, drainage from the ear, fussiness.

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.

Use Advair exactly as it was prescribed for you. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Using too much of this medicine can cause life-threatening side effects.

Advair is not a rescue medicine for asthma or bronchospasm attacks. Use only fast-acting inhalation medicine for an attack. Seek medical attention if your breathing problems get worse quickly, or if you think your asthma medications are not working as well.

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. Advair HFA comes in a canister that is used with an actuator inhaler device.

Use Advair HFA at the same time each day. Use only the inhaler device provided with your medication.

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

Do not allow a young child to use this medicine without help from an adult.

Read and carefully follow any instructions for use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Rinse your mouth with water without swallowing after each use of your inhaler.

Your dose needs may change due to surgery, illness, stress, or a recent asthma attack. Do not change your medication dose or schedule without your doctor's advice.

If you also use an oral steroid medication, you should not stop using it suddenly. Follow your doctor's instructions about tapering your dose.

If you use a peak flow meter at home, tell your doctor if your numbers are lower than normal.

Your vision and your bone mineral density may need to be checked often.

Store your medicine at room temperature, away from moisture, heat, and sunlight. Avoid high heat, such as open flame or in a car on a hot day. Carefully follow all storage and disposal directions provided with your medicine.

Once your asthma is under control, your doctor may want you to stop using this medicine. Keep all follow-up appointments. Do not stop using the medicine unless your doctor tells you to.

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include chest pain, fast heart rate, and feeling shaky or short of breath.

Long term use of an inhaled steroid can lead to glaucoma, cataracts, thinning skin, changes in body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chickenpox or measles. These conditions can be serious or even fatal in people who are using a steroid such as fluticasone.

Do not use a second long-acting inhaled bronchodilator. This includes formoterol (Perforomist, Symbicort, Bevespi, Dulera), arformoterol (Brovan), indacaterol (Arcapta), olodaterol (Striverdi, Stiolto Respimat), salmeterol (Serevent), or vilanterol (Anoro Ellipta, Breo Ellipta, Trelegy Ellipta).

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your other medicines, especially:

• antifungal medicine (such as ketoconazole); or
• medicine to treat HIV or AIDS.
• antidepressant medications, especially monoamine oxidase inhibitors (including isocarboxazid, rasagiline, selegiline, phenelzine, transcypromine, and methylene blue injection) or tricyclic antidepressants (including amitriptyline, desipramine, doxepin, and others); or
• blood pressure medications such as diuretics (water pills) or beta-blockers (including atenolol, labetalol, metoprolol, propranolol, and others).

This list is not complete and many other drugs may interact with fluticasone and salmeterol. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.