AirDuo Digihaler (Fluticasone propionate and Salmeterol) - Inhalation

Warning:

What Is AirDuo Digihaler?

AirDuo Digihaler (fluticasone propionate and salmeterol) is a combo dry-powder asthma inhaler. It contains two different medications: fluticasone propionate and salmeterol.

Fluticasone propionate is an inhaled corticosteroid (ICS) that lessens airway swelling. Salmeterol, on the other hand, is a long-acting beta-agonist (LABA), which works by relaxing the airways.

AirDuo Digihaler is available as a prescription dry powder for oral inhalation.

Drug Facts

Generic Name: Fluticasone propionate and salmeterol

Brand Name: AirDuo Digihaler

Drug Availability: Prescription

Therapeutic Classification: Inhaled corticosteroid (ICS) and long-acting beta-agonist (LABA)

Available Generically: No

Controlled Substance: No

Administration Route: Oral (by mouth) inhalation

Active Ingredient: Fluticasone propionate and salmeterol

Dosage Form: Dry-powder inhalation

What Is AirDuo Digihaler Used For?

AirDuo Digihaler is a long-term treatment option for asthma.

In the United States (U.S.), millions of adults and children are living with asthma. People with asthma have swollen lung airways that can cause the following symptoms: coughing, wheezing, and breathing difficulties.

How to Use AirDuo Digihaler

Since directions might vary for different inhalers, carefully read the directions and packaging label on the container.

In general, however, you don't need to prime or spray the medication away from you if AirDuo Digihaler is new or if you haven't used this inhaler in a while.

AirDuo Digihaler is typically used twice daily without a spacer. When using this inhaler, keep in mind that the medication is a fine, dry powder. So, you may not feel or taste the medicine.

The following are additional steps for using AirDuo Digihaler.

  1. Keep the new inhaler inside its foil packaging until you're ready to use it.
  2. Hold the inhaler upright and open the yellow cap all the way until you hear a clicking sound. If you hear a clicking sound, then the inhaler is "activated" and ready to give you a dose. Don't open the yellow cap to expose the mouthpiece until you're ready to use the inhaler.
  3. Breathe out as much air from your lungs as you can.
  4. Tightly seal your lips around the mouthpiece—making sure to not block the vent above the mouthpiece.
  5. Breathe in quickly and deeply through your mouth for the medication to go into your lungs.
  6. Remove the inhaler from your mouth.
  7. Hold your breath for as long as you can for up to 10 seconds—if possible.
  8. Tightly cover the mouthpiece with the yellow cap. Make sure to do this after each inhalation.
  9. Rinse your mouth with water and spit after each use.
  10. When you have 20 doses left, you will notice a red color in the dose counter. Request a refill at this time. Once there is a 0 in the dose counter, you are out of doses.

Storage

Once you receive AirDuo Digihaler from the pharmacy, store it in a cool and dry place between 59 degrees to 77 degrees Fahrenheit (F). Protect the inhaler from extreme heat, cold, or moist conditions. If the inhaler is dirty, wipe it with a dry cloth or tissue. Don't wash or expose the inhaler to water.

After removing the inhaler from its foil packaging, the medication will only be good for 30 days from the opened date. If you haven't removed the inhaler from its foil packaging, then the medication will be good until the expiration date on the container. When you are ready to discard an empty or expired AirDuo Digihaler, the inhaler contains lithium-manganese dioxide batteries. So, don't place it in your regular garbage. You will need to throw the inhaler away according to local and state regulations.

If you're going to travel with AirDuo Digihaler, become familiar with your final destination's regulations. In general, however, keep the original container from the pharmacy, with your name on it. Also, have a copy of your AirDuo Digihaler prescription available. Since the AirDuo Digihaler device contains lithium-manganese dioxide batteries, you will also need to carry the inhaler in your carry-on bag.

Off-Label Uses

The Food and Drug Administration (FDA) only approved AirDuo Digihaler as a long-term treatment option for asthma.

There are several other inhaler devices, which also contain fluticasone and salmeterol. In addition to asthma, these inhalers (e.g., Advair Diskus, Wixela) may also be used for another lung condition called chronic obstructive pulmonary disease (COPD).

How Long Does AirDuo Digihaler Take to Work?

You might notice some improvement in your symptoms as soon as 15 minutes of using AirDuo Digihaler. The medication, however, typically requires one to two weeks for maximum effects.

What Are the Side Effects of AirDuo Digihaler?

Side effects are possible with AirDuo Digihaler.

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Common side effects with AirDuo Digihaler include:

Severe Side Effects

Severe side effects are possible with AirDuo Digihaler. Get medical help right away if you experience the following serious side effects:

  • Severe allergic reaction: If you have a severe allergic reaction to AirDuo Digihaler, you may experience symptoms of rash, swelling, and breathing problems.
  • Adrenal insufficiency: Adrenal insufficiency is also sometimes known as Addison's disease. People with this medical condition don't make enough of certain hormones, such as cortisol. If you have adrenal insufficiency, you might experience symptoms of low blood pressure, weakness, nausea, and vomiting.
  • Bone loss: AirDuo Digihaler is linked to bone loss, which might raise the likelihood of having osteoporosis. Risk factors for osteoporosis may include family history, inactivity, and certain medications (e.g., steroids and anti-seizure drugs). If you have these risk factors, your healthcare provider may want to closely monitor your bone mineral density (BMD).
  • Eye problems: AirDuo Digihaler might raise your risk for eye problems, such as glaucoma (high eye pressure) and cataracts (cloudy eyesight). Be alert for any vision changes.
  • Heart-related effects: Some heart-related effects with AirDuo Digihaler may include high blood pressure, chest pain, fast heartbeat, or abnormal heartbeat.
  • Infections: AirDuo Digihaler might suppress your immune system, which is the body's defense system. Suppressing your immune system may raise the likelihood of infections. If you suspect that you might have symptoms of an infection, notify your healthcare provider.
  • Slow growth rate in children: AirDuo Digihaler might slow down the growth rate in children. To minimize this side effect, your healthcare provider will start your child on the lowest effective dose. They will also closely monitor your child for side effects.
  • Tightening airways: In some people, AirDuo Digihaler might cause sudden breathing problems.

Long-Term Side Effects

Long-term use of AirDuo Digihaler is linked to the following side effects:

  • Bone loss
  • Eye problems
  • Slow growth rate in children

Report Side Effects

AirDuo Digihaler may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or call the FDA by phone (800-332-1088).

Dosage: How Much AirDuo Digihaler Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For inhalation dosage form (aerosol liquid):
    • For preventing an asthma attack:
      • Adults and children 12 years of age and older—2 puffs in the morning and another 2 puffs in the evening. The doses should be at least 12 hours apart.
      • Children younger than 12 years of age—Use and dose must be determined by your child's doctor.
  • For inhalation dosage form (aerosol powder):
    • Advair® Diskus®:
      • For preventing an asthma attack:
        • Adults and children 12 years of age and older—1 inhalation 2 times per day (morning and evening). The doses should be at least 12 hours apart. Your doctor may adjust your dose as needed. However, the dose is not more than 500 micrograms (mcg) of fluticasone and 50 mcg of salmeterol two times a day.
        • Children 4 to 11 years of age—1 inhalation 2 times per day (morning and evening). The doses should be at least 12 hours apart. Each inhalation contains 100 micrograms (mcg) of fluticasone and 50 mcg of salmeterol.
        • Children younger than 4 years of age—Use and dose must be determined by your doctor.
      • For treatment and prevention of worsening attacks of COPD:
        • Adults—1 inhalation 2 times per day (morning and evening). The doses should be at least 12 hours apart. Each inhalation contains 250 micrograms (mcg) of fluticasone and 50 mcg of salmeterol.
        • Children—Use and dose must be determined by your doctor.
    • Airduo™ Respiclick®:
      • For treatment of asthma:
        • Adults and children 12 years of age and older—1 inhalation 2 times per day (morning and evening). The doses should be at least 12 hours apart. Do not use it more than 2 times every 24 hours.
        • Children younger than 12 years of age—Use and dose must be determined by your child's doctor.

Modifications

Your healthcare provider might slightly modify (change) your AirDuo Digihaler treatment or other medications under the following situations:

People with diabetes: Although rare, AirDuo Digihaler is linked to high blood sugar. You might need to monitor your blood sugar closely, and your healthcare provider will adjust your diabetes-related medications accordingly.

People with liver problems: The liver is responsible for clearing out fluticasone and salmeterol from the body. In people with liver impairment, higher amounts of these medications might be in the body. Therefore, your healthcare provider may closely monitor you for side effects and adjust the medication dose accordingly.

People with medical conditions of the heart or brain: If you have medical conditions of the heart or brain, AirDuo Digihaler might worsen your symptoms, which may include seizures, abnormal heart rate, fast heartbeat, and abnormal blood pressure. Your healthcare provider will closely monitor you for worsening heart or brain-related medical conditions.

People with risk factors for osteoporosis: Risk factors for osteoporosis include family history, inactivity, and certain medications (e.g., steroids and anti-seizure drugs). If you use AirDuo Digihaler and have multiple risk factors for osteoporosis, your healthcare provider will closely monitor your bone mineral density (BMD).

Pregnant parents: There are no clinical trials on AirDuo Digihaler or its individual ingredients in pregnant parents. Not having well-controlled asthma, however, is linked to a higher risk of negative effects on the pregnant parent and unborn fetus. Parents might experience preeclampsia, a condition of high blood pressure during pregnancy. Newborn babies, on the other hand, might have low birth weights. If you have any questions or concerns about using AirDuo Digihaler during your pregnancy, talk with your healthcare provider.

Nursing parents: Experts expect very small amounts of fluticasone or salmeterol to be present in breast milk. Therefore, negative effects on the nursing baby are unlikely.

Children: AirDuo Digihaler might slow down the growth rate in children. To limit this side effect, your healthcare provider will use the lowest effective dose. They will also monitor your child for side effects.

Missed Dose

If you accidentally forgot your AirDuo Digihaler dose, skip the missed dose and take the following dose at your next scheduled time. Don't try to double up to make up for the missed dose.

Try to find ways to consistently remember to take your medication. Missing too many AirDuo Digihaler doses might raise your risk of asthma attacks.

Overdose: What Happens If I Take Too Much AirDuo Digihaler?

Symptoms of too much fluticasone may include:

  • Headaches
  • High blood pressure
  • High blood sugar
  • Mood changes
  • Tiredness or low energy

Symptoms of too much salmeterol might include:

  • Abnormal heart rhythm
  • Blood pressure changes
  • Chest pain
  • Dizziness
  • Dry mouth
  • Fast heart rate
  • Headaches
  • Muscle cramps
  • Nausea
  • Nervousness
  • Seizures
  • Tiredness or low energy
  • Tremors

This is not a complete list of possible overdose symptoms with AirDuo Digihaler. If you suspect that you're experiencing life-threatening side effects, seek immediate medical attention.

What Happens If I Overdose on AirDuo Digihaler?

If you think you or someone else may have overdosed on AirDuo Digihaler, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking AirDuo Digihaler, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

If you will be using this medicine for a long time, it is very important that your doctor check the progress of you or your child at regular visits. This will allow your doctor to see if the medicine is working properly and to check for any unwanted effects.

Tell your doctor if you or your child are also using other medicines for your COPD. Your doctor may want you to stop using the medicine and use it only during a severe COPD attack. Follow your doctor's instructions on how you should take your medicine.

This medicine should not be used if you are having a severe COPD attack, or if symptoms of a COPD attack has already started. Your doctor may prescribe another medicine for you to use in case of an acute COPD attack. If the other medicine does not work as well, tell your doctor right away.

This medicine should only be used as an additional treatment for patients who cannot be treated with other asthma medicines (such as inhaled corticosteroids) or for asthma patients that require two medicines, including salmeterol. Ask your doctor if you have any questions.

Although this medicine decreases the number of asthma episodes, it may increase the chance of a severe asthma attack when they do occur. Be sure to read about these risks in the patient information leaflet and talk to your doctor or pharmacist about any questions or concerns that you have.

You should not use this medicine if your asthma attack has already started. Your doctor will prescribe another medicine (eg, a short-acting inhaler) for you to use in case of an acute asthma attack. Make sure you understand how to use the short-acting inhaler. Talk to your doctor if you need instructions.

Talk with your doctor or get medical care right away if:

  • Your or your child's symptoms do not improve after using this medicine for 1 week or if they become worse.
  • Your short-acting inhaler does not seem to work as well as it used to and you or your child need it more often than normal (eg, you use 1 whole canister of the short-acting inhaler in 8 weeks time, or you need to use 4 or more inhalations of the short-acting inhaler for 2 or more days in a row).
  • You or your child have a big decrease in your peak flow when measured as directed by your doctor.

Do not use this medicine to treat wheezing that is getting worse. Call your doctor right away if wheezing worsens while using this medicine.

Do not use any other asthma medicine or medicine for breathing problems without talking to your doctor. This medicine should not be used with other inhalers that contain budesonide and formoterol combination (Symbicort®), formoterol (Foradil® Aerolizer®, Perforomist™), or arformoterol (Brovona™).

This medicine may cause a fungus infection of the mouth or throat (thrush). Tell your doctor right away if you have white patches in the mouth or throat, or pain when eating or swallowing.

Patients with COPD may be more likely to have pneumonia. Call your doctor if you or your child start having increased sputum (spit) production, change in sputum color, fever, chills, increased cough, or an increase in breathing problems.

Do not change your dose or stop using your medicine without first asking your doctor.

Your doctor may want you to carry a medical identification (ID) card stating that you or your child are using this medicine. The card will say that you may need additional medicine during an emergency, a severe asthma attack or other illness, or unusual stress.

Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems. Talk to your doctor if you or your child have more than one of these symptoms while you are using this medicine: darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.

This medicine may cause paradoxical bronchospasm, which may be life-threatening. Check with your doctor right away if you or your child are having a cough, difficulty with breathing, shortness of breath, or wheezing after using this medicine.

If you or your child develop a skin rash, hives, or any allergic reaction (including anaphylaxis) to this medicine, check with your doctor right away.

Check with your doctor right away if you or your child have chest pain, a fast heartbeat, nervousness, shaking of the hands or feet, noisy breathing, a feeling of choking, or tightness or irritation of the throat while using this medicine.

This medicine may affect blood sugar and potassium levels. If you have heart disease or are diabetic and notice a change in the results of your blood or urine sugar or potassium tests, check with your doctor.

Check with your doctor right away if blurred vision, difficulty in reading, or any other change in vision occurs during or after treatment with this medicine. Your doctor may want you or your child to have your eyes checked by an ophthalmologist (eye doctor).

This medicine may decrease bone mineral density when used for a long time. A low bone mineral density can cause weak bones or osteoporosis. If you have any questions about this, ask your doctor.

This medicine may cause children to grow more slowly than usual. Talk to your child's doctor if you have any concerns.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take AirDuo Digihaler?

Before using AirDuo Digihaler, talk with your healthcare provider if the following applies to you.

  • Severe allergic reaction: If you have a severe allergic reaction to AirDuo Digihaler, milk, or any of the inhaler's other components (ingredients), this medication isn't an ideal option for you.
  • Asthma attack: If you're experiencing an asthma attack, AirDuo Digihaler isn't intended for immediate symptom relief. During an asthma attack, use a rescue inhaler to quickly relieve symptoms.
  • Pregnant parents: There are no clinical studies for AirDuo Digihaler in pregnant parents. Not having well-controlled asthma, however, is linked to negative effects on pregnant parents and the unborn fetus. Talk with your healthcare provider to weigh the benefits and risks of using AirDuo Digihaler during pregnancy.
  • Nursing parents: The small amounts of fluticasone and salmeterol in breastmilk are unlikely to cause negative effects on nursing babies. Therefore, experts find these inhaled medications acceptable while nursing.
  • Children: The FDA approved AirDuo Digihaler as a long-term treatment option for asthma in children 12 years and older. AirDuo Digihaler, however, might slow down the growth rate in children. Therefore, your healthcare provider will use the lowest effective dose and monitor your child for side effects.
  • Older adults: Older adults—people over 65 years of age—and younger adults didn't experience safety and effectiveness differences with AirDuo Digihaler.

What Other Medications Interact With AirDuo Digihaler?

Use caution when taking AirDuo Digihaler with the following medications:

  • Beta-blockers: Beta-blockers are usually used for heart-related medical conditions. In general, there are two types of beta-blockers, heart-specific and non-heart-specific. The non-heart-specific beta-blockers (e.g., carvedilol) might worsen asthma symptoms. Therefore, if necessary, healthcare providers may want to consider a heart-specific beta-blocker, such as Toprol XL (metoprolol succinate).
  • Long-acting beta-agonists (LABAs): AirDuo Digihaler contains salmeterol, which is a LABA. Combining AirDuo Digihaler with other LABAs—like Striverdi (olodaterol)—raises the risk of an overdose.
  • Monoamine oxidase inhibitors (MAOIs): MAOI use within the last two weeks might increase the likelihood of side effects with AirDuo Digihaler. An example of an MAOI is selegiline, which is a treatment option for depression or Parkinson's disease.
  • Tricyclic antidepressants (TCAs): Similar to MAOIs, TCA use within the previous two weeks raises the risk of side effects with AirDuo Digihaler. An example TCA is amitriptyline, which is a treatment option for mental health conditions and nerve pain.
  • Strong CYP3A4 inhibitors: CYP3A4 is a protein in the liver that's responsible for breaking down and clearing out fluticasone and salmeterol from the body. Strong CYP3A4-inhibiting medications—like the clarithromycin antibiotic—prevent the protein from working as well. The build-up of fluticasone and salmeterol levels in the body raises the risk of side effects.
  • Diuretics (water pills): When combined with AirDuo Digihaler, non-potassium-sparing water pills—like loop or thiazide diuretics—might cause low potassium levels in the body. Symptoms of low potassium may include abnormal heartbeat, muscle weakness, spasms, and tingling or numbness sensation.

This isn't a complete list of medication interactions with AirDuo Digihaler. For more detailed information about drug interactions with AirDuo Digihaler, talk with your pharmacist or healthcare provider.

What Medications Are Similar?

AirDuo Digihaler is an asthma inhaler that contains an inhaled corticosteroid (ICS) and a long-acting beta-agonist (LABA). The following combo inhalers also contain an ICS and a LABA.

  • AirDuo RespiClick (fluticasone/salmeterol)
  • Advair Diskus (fluticasone/salmeterol)
  • Advair HFA (fluticasone/salmeterol)
  • Breo Ellipa (fluticasone/vilanterol)
  • Dulera (mometasone/formoterol)
  • Symbicort (budesonide/formoterol)
  • Wixela (fluticasone/salmeterol)

All of these ICS and LABA combination inhalers are used as long-term treatment options for asthma. The following includes additional interesting information about some of these inhalers.

  • Dulera and Symbicort can be used as needed for mild asthma symptoms.
  • Advair Diskus and Wixela can be used to treat asthma in people as young as four years old.
  • Advair Diskus, Wixela, Breo, and Symbicort can also be used to treat another lung condition called chronic obstructive pulmonary disease (COPD).
  • Wixela is the first available generic product of the Advair Diskus inhaler.
  • AirDuo Digihaler and AirDuo RespiClick have the same medication doses in similar devices, except the Dighaler device has the ability to send information to a mobile application (App).

With all of these combo inhalers containing an ICS and a LABA, they're not typically used together. Also, multiple LABAs aren't recommended due to a higher risk of an overdose.

Frequently Asked Questions

  • Where is AirDuo Digihaler available?

    AirDuo Digihaler is available as a prescription from your healthcare provider. Local retail pharmacies may carry this medication. If necessary, the pharmacy staff may be able to order this inhaler for you.

  • How much does AirDuo Digihaler cost?

    AirDuo Digihaler isn't available as a generic product yet. Therefore, this inhaler might be expensive without insurance coverage. If cost is a concern, the manufacturer—Teva—does offer a savings card for people with commercial or no insurance coverage. Visit Teva's website or call 1-888-603-0788 for eligibility questions.


    Another possible option is to talk with your pharmacist or healthcare provider about switching to other less costly inhalers, which are equally effective with similar ingredients.

  • Will I need other medications in addition to AirDuo Digihaler.

    AirDuo Digihaler can help control asthma symptoms. For some people, however, additional medications might be necessary to have well-controlled asthma. If you have questions about your asthma therapy, speak with your healthcare provider.

  • Do I need to stay on the same AirDuo Digihaler doses for life?

    Once your asthma symptoms are well-controlled, your healthcare provider might suggest slowly "stepping down" your therapy or lowering your inhaler doses.

How Can I Stay Healthy While Using AirDuo Digihaler?

Living with asthma may feel challenging and overwhelming at times. Fortunately, there are ways to help you improve your quality of life. Consider the following general tips:

  • Always have an unexpired rescue inhaler with you.
  • Know how to appropriately use your inhaler(s).
  • Avoid triggers that can worsen your asthma symptoms.
  • Use your peak flow meter at least once per day to help you know how your lungs are doing.
  • Have an asthma action plan to help with next steps when you're experiencing worsening symptoms.
  • Participate in exercises (e.g., swimming, tennis) that are less likely to worsen your asthma symptoms.
  • Manage your stress and mental health—consider social support groups or a mental health professional to help you find coping strategies to change the way to think, feel, react, or respond to living with asthma.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

Was this page helpful?
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Adminstration. AirDuo Digihaler label.

  2. Medline Plus. Fluticasone and salmeterol oral inhalation.

  3. Centers for Disease Control and Prevention. Most recent national asthma data.

  4. Medline Plus. Asthma.

  5. Federal Aviation Administration. Lithium batteries in baggage.

  6. Food and Drug Administration. Wixela label.

  7. Food and Drug Administration. Advair Diskus label.

  8. LactMed. Salmeterol.

  9. LactMed. Fluticasone, inhaled.

  10. MedlinePlus. Low blood potassium.

  11. Aalbers R, Vogelmeier C, Kuna P. Achieving asthma control with ICS/LABA: a review of strategies for asthma management and prevention. Respiratory Medicine. 2016;111:1-4. doi:10.1016/j.rmed.2015.11.002

  12. Food and Drug Administration. AirDuo RespiClick label.

  13. Food and Drug Administration. Advair HFA label.

  14. Food and Drug Administration. Breo Ellipta label.

  15. Food and Drug Administration. Dulera label.

  16. Food and Drug Administration. Symbicort label.

  17. Global Initiative for Asthma. Global strategy for asthma management and prevention, 2021.

  18. Mylan. Mylan launches Wixela Inhub (fluticasone propionate and salmeterol inhalation powder, USP), the first generic of Advair Diskus (fluticasone propionate and salmeterol inhalation powder), at a list price 70% less than the brand.

  19. Food and Drug Administration. Orange book: approvedvdrug products with therapeutic equivalence evaluations.