Medications and Drugs
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: fluticasone propionate and salmeterol
oral inhaler
BRAND NAME: Advair Diskus
DRUG CLASS AND MECHANISM: Advair Diskus is a combination of inhaled
drugs that is used to treat asthma and chronic bronchitis. In
patients with asthma, the airways (bronchioles) through which air moves in and out of the
lungs can be narrowed by accumulation of mucus, spasm of the muscles that
surround these airways, or swelling of the lining of the airways due to
inflammation. Airway narrowing leads to symptoms of shortness of breath,
wheezing, cough, and congestion. Medications used in treating asthma include
those that open airways, called bronchodilators, and those that reduce
inflammation.
Advair Diskus contains a combination of salmeterol, a bronchodilator of the
beta-2 agonist type, and fluticasone propionate, an anti-inflammatory
corticosteroid. Beta-2 agonists are medications that attach to beta-2 receptors
on the smooth muscle cells that surround the airways, causing the muscle cells
to relax and open the airways. Fluticasone propionate is a synthetic (man-made)
corticosteroid of the glucocorticoid family which is related to the natural
hormone, cortisol or hydrocortisone, produced by the adrenal glands.
Glucocorticoid steroids have potent anti-inflammatory actions. In asthmatic
patients, the suppression of inflammation within the airways reduces the
swelling caused by inflammation that narrows the airways. At the same time,
mucus is reduced. When used in lower doses, very little inhaled fluticasone
propionate is absorbed into the body. When higher doses are used, fluticasone is
absorbed and may cause side effects elsewhere in the body.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Advair Diskus is available in three different forms
containing the same amount of salmeterol, 50 mcg, but differing in the amount of
fluticasone propionate. 100/50 provides 100 mcg of fluticasone propionate,
250/50 provides 250 mcg of fluticasone propionate, and 500/50 contains 500 mcg
of fluticasone propionate per inspiration.
STORAGE: Advair Diskus should be stored at 36-86 F (2.2-30 C). It should be
kept away from heat or flames and should not be punctured; it should not be
frozen or placed in direct sunlight.
PRESCRIBED FOR: Advair
Diskus is used for the treatment of asthma or
chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis.
Its action starts within 30 to 60 minutes and can last more than 12 hours.
Advair Diskus is generally not needed in patients whose asthma can be controlled
easily with infrequent administration of short acting inhalers. Advair Diskus
should not be used to treat acute episodes of asthma or COPD.
DOSING: The recommended regimen for asthma in individuals 12 years and
older is one inhalation twice daily (morning and evening) approximately 12 hours
apart. The lowest effective strength should be used and the maximum dose is
500/50 mcg twice daily. For children 4 to 11 years old the recommended treatment
is one inhalation of 100/50 mcg twice daily.
The recommended regimen for COPD is one inhalation of 250/50 mcg twice daily.
Higher doses are not more effective.
The Diskus device is held in one hand with the thumb of the other hand placed
on the thumb-grip. The thumb is then pulled away as far as the device allows
until the mouthpiece seems to click into position. With the Diskus then held
horizontally and with the mouthpiece towards the patient, the lever is then slid
away as far as it can go until it clicks. The patient breathes out as far as
comfortable, then placing his mouth to the mouthpiece, breathes in quickly and
deeply and holds his breath for about ten seconds. The patient then washes his
or her mouth without swallowing after inhalation.
DRUG INTERACTIONS: Monoamine oxidase inhibitors (for example,
tranylcypromine) and tricyclic antidepressants (for
example, amitriptyline (Endep)] may
increase the effect of salmeterol on the heart and blood pressure. Since Advair
Diskus contains salmeterol, it should not be used with or within two weeks of
discontinuing monoamine oxidase inhibitors or tricyclic antidepressants.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
- Bronchitis - Learn about bronchitis an inflammation of the lining of the lungs. Bronchitis can be aggravated from colds, cigarette smoking, COPD, and other lung conditions.
- fluticasone propionate nasal inhaler-spray, Flonase, Veramyst - Learn about the nasal spray drug fluticasone (Flonase, Veramyst) used to treat non-allergic and allergic rhinitis and its symptoms like a stuffy and runny nose.
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