What to Know About Advair Diskus (Fluticasone and Salmeterol)

An Oral Inhaler Used to Treat COPD Symptoms

The human respiratory system.
The human respiratory system. PIXOLOGICSTUDIO/Getty Images

In This Article

Advair Diskus is an inhaled prescription drug intended to be taken regularly to treat chronic obstructive pulmonary disease (COPD) and asthma. It contains a combination of two different drugs: fluticasone propionate, which is a corticosteroid that improves symptoms by reducing inflammation and swelling in your airways, and salmeterol, which is a long-lasting beta-agonist that helps to relax and widen your airways, reducing irritation and swelling often seen in obstructive conditions like COPD and asthma. The generic version is Wixela Inhub.

Uses

Advair is intended to be a long-acting maintenance medication, which prevents breathing symptoms such as wheezing from progressing in cases of COPD and asthma. Advair is not intended as a short-acting rescue medication, as some inhaled medicines are. Taking extra doses of Advair in acute situations won't improve your breathing, and actually, could cause more harm. If you have asthma or experience COPD exacerbations, be sure to have a separate rescue inhaler to serve this purpose.

Advair Diskus is a dry powder inhaler. The dosage may vary depending on the severity of your condition and ranges from 100/50 and 250/50 or 500/50. Generally you'll need to take Advair twice per day for it to be effective.

Advair contains two drugs that make it easier for you to breathe, but they work in different ways, making the combination more effective.

  • Flovent (fluticasone propionate) is a corticosteroid that improves your COPD symptoms by reducing inflammation and swelling in your airways
  • Salmeterol (also known as Serevent) is a long-lasting drug called a beta-agonist that helps to relax and widen your airways

According to the manufacturer, Advair is clinically proven to help improve your lung function, lessening your symptoms of wheezing, chest tightness and chronic cough.

Before Taking

Your doctor will determine if you're a good candidate for Advair Diskus by looking at your health history. If you have COPD, your physician may assess the frequency and severity of past COPD exacerbations, your current lung function (often measured via spirometry) what other medications you're currently taking, and if you have any allergies or liver issues (hepatic impairment).

There is an authorized generic form of Advair Diskus available which contains the exact same drugs and dosages as the brand name formula. Be sure to ask your pharmacist for the authorized generic version, which is called Wixela Inhub.

Precautions and Contraindications

If you have asthma, studies have shown that you have an increased risk of death from asthma complications when you're taking salmeterol alone, which is one of the active ingredients in Advair. If you find you're having more trouble breathing after you start taking Advair regularly, you should talk to your doctor about it. They may decide to change your medication.

People with severe milk protein allergy shouldn't use Advair, as the medication contains both lactose (milk sugar) and milk proteins. Inhaling something to which you're allergic can result in a severe reaction.

In addition, you shouldn't take other similar drugs while taking Advair, as taking more than one long-acting beta-agonist could cause severe side effects. Make sure to tell your doctor about any medications you take, even if they're over-the-counter drugs or supplements, to avoid problems with drug interactions.

Other commonly-prescribed drugs similar to Advair include:

  • AirDuo RespiClick (fluticasone and salmeterol)
  • Serevent Diskus (salmeterol)
  • Breo Ellipta (fluticasone furoate and vilanterol)
  • Trellegy Ellipta (fluticasone furoate, umeclidinium, and vilanterol)
  • Symbicort (formoterol and budesonide)
  • Spiriva (tiotropium)
  • Pulmicort (budesonide)

Dosage

According to the manufacturer, the dosage of Advair is as follows:

  • If you have asthma and are between the ages of 4 and 11: One inhalation of Advair Diskus 100/50 twice daily (every 12 hours). 
  • If you have asthma and are over the age of 12: One inhalation of Advair Diskus 100/50, 250/50, or 500/50 twice daily (every 12 hours). Your initial dosage depends on the severity of your condition.
  • If you have COPD: One inhalation of Advair Diskus 250/50 twice daily (every 12 hours).

Advair Diskus should not be used in children under the age of 4.

How to Take and Store

To take Advair Diskus, you'll first need to remove the device from its foil packaging. The device should be in its closed position. You'll see a dosage counter on the top that tells you how many doses you have left. Each Advair Diskus comes with 60 doses equalling a one-month supply.

Use your right hand to push the thumb grip and slide the device into its open position, revealing the inhaler mouthpiece. Holding the Diskus level and flat (parallel to the ground), slide the lever until you hear it click. This prepares your dosage.

Before you inhale your dose, exhale as much as you can away from the Diskus. With your next inhalation, bring the level device up to your mouth and breathe in quickly and deeply through the Diskus, being sure not to inhale through your nose. Remove the Diskus from your mouth and hold your breath for 10 seconds. Because the dry powder is so fine, you may not feel the medication in your mouth, but know that it's there. Do not take an extra dose even if you don't taste or feel the medicine. Slowly exhale, then use the thumb grip to close the device.

After inhalation, rinse your mouth with water without swallowing. Follow the included directions from the manufacturer for more information.

The inhaler is not refillable or reusable and should be discarded one month after opening. Write the date of opening in the space provided on the front of the inhaler. Be sure to store your Advair Diskus inhaler away from sunlight and heat, and keep it out of reach of children except at dosage times.

Side Effects

People who use Advair are at risk of developing several side effects. Some are relatively common, such as throat scratchiness, and others are more severe, such as osteopenia.

Common

Common side effects include:

  • Throat irritation
  • Hoarseness
  • Voice changes
  • Lung infections
  • Headaches
  • Bone and muscle pain

Talk to your doctor if these side effects become troublesome.

In addition, you may develop thrush, which is a yeast infection in your mouth and/or throat. Thrush causes a white or yellowish coating, so you may see it if it develops. To avoid this problem, every time after you use your inhaler, rinse your mouth with water and spit it out—don't swallow the water. However, even the most diligent rinsing doesn't always prevent thrush. If you wind up with it, don't worry—your doctor can prescribe a mouthwash that should take care of it.

Severe

People using Advair may develop a weakened immune system and an increased risk of infection. That's because corticosteroids (one of the two active ingredients in the medication) tend to suppress your immune system. To stay well, you should avoid being exposed to chickenpox and measles, and if you know you've been exposed, you should contact your doctor as soon as you can. If you have an existing infection, such as tuberculosis, you may find it gets worse.

Advair also may raise your risk of pneumonia, which is already elevated if you have COPD. If you develop pneumonia symptoms, which include increased mucus, fever, chills, or worsening breathing problems, call your doctor immediately.

In addition, people taking Advair are at risk for weakened bones. If you've been diagnosed with osteoporosis or osteopenia, talk to your doctor about your risks.

Finally, regular eye exams are recommended while you're using Advair since the medication raises your risk of glaucoma and cataracts.

Warnings and Interactions

Advair Diskus does come with a black box warning stating that salmeterol, one of the active ingredients, may increase your risk of asthma-related death. Advair Diskus should only be used in asthma patients if your asthma is not adequately controlled by another medication.

If you are taking Advair and you find your breathing problems worsening quickly (and if your rescue inhaler doesn't help), you should go to the emergency room immediately. Make sure to tell the clinicians there which drugs you're taking (including any over-the-counter drugs) to treat your condition.

Taking more Advair than prescribed won't help your breathing, and overdosing on the medication could lead to serious symptoms such as shakiness, chest pain, fast or irregular heartbeat, weakness, headaches, nausea and vomiting, and even seizures.

Some people develop negative symptoms such as irregular heartbeat, shakiness, and weakness even when they're taking the correct dosage of their medication. If this happens to you, contact your doctor immediately or go to the emergency room.

A Word From Verywell

It's important to know that Advair Diskus is not a rescue inhaler and should only be used as a long-acting medication, and may be best used in those with COPD as opposed to asthma. One of the two active ingredients, salmeterol, has been linked to an increased risk of asthma-related deaths. As with any medication, Advair Diskus should also only be taken as prescribed to minimize side effects. Be sure to bring up any questions and concerns you may have at your next appointment with your physician.

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