fluticasone and salmeterol oral inhaler, Advair Diskus, Advair HFA (cont.)

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Medical and Pharmacy Editor:

PRESCRIPTION: Yes

GENERIC AVAILABLE: No

PREPARATIONS: Advair Diskus is an oral inhalation powder 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.

Advair HFA is an oral aerosol containing 21 mcg of salmeterol combined with 45, 115, or 230 mcg fluticasone.

STORAGE: Advair should be stored at room temperature, 68 F to 77 F (20 C to 25 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 HFA is used for treating asthma in individuals 12 years old or older. Advair Diskus or HFA should not be used to treat acute episodes of asthma or COPD.

DOSING: The recommended Advair Diskus 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 of Advair Diskus for COPD is one inhalation of 250/50 mcg twice daily. Higher doses are not more effective.

The recommended dose for Advair HFA is 2 inhalations twice daily. The lowest effective dose should be used.

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 contains salmeterol, it should not be used with or within two weeks of discontinuing monoamine oxidase inhibitors or tricyclic antidepressants.

Medically Reviewed by a Doctor on 7/15/2013


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