- What is Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler)?
- What are the uses for Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler)?
- What are the side effects of Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler)?
- What is the dosage for Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler)?
- Which drugs or supplements interact with Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler)?
- Is Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler) safe to use during pregnancy or while breastfeeding?
- What else should I know about Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler)?
What is Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler)?
What brand names are available for fluticasone propionate and salmeterol oral inhaler?
Advair Diskus and Advair HFA are the brand names available for fluticasone propionate and salmeterol oral inhaler in the US.
Is Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler) available as a generic drug?
Do I need a prescription for Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler)?
What are the uses for Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler)?
- 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.
What are the side effects of Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler)?
- Use of long acting agents like salmeterol, an active ingredient in Advair, may increase the risk of asthma-related death. Therefore, Advair should only be used in patients whose asthma is uncontrolled by other agents, and who are using long-term asthma-controlling medications such as an inhaled corticosteroid.
- Upper respiratory tract infections occur in 20% to 25% of patients using Advair.
- Headaches occur in about 1 in 8 patients who use it.
- Other common adverse events include:
Use of long acting agents like salmeterol, an active ingredient in Advair, may increase the risk of asthma-related death. Therefore, Advair should only be used in patients whose asthma is uncontrolled by other agents, and who are using long-term asthma-controlling medications such as an inhaled corticosteroid.
Serious adverse events of Advair include:
Serious allergic reactions include:
What is the dosage for Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler)?
- 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.
Which drugs or supplements interact with Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler)?
- Monoamine oxidase inhibitors or MOAIs (for example, tranylcypromine) and tricyclic antidepressants (for example, amitriptyline [Endep, Elavil]) 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.
- Ritonavir (Norvir), atazanavir (Reyataz), clarithromycin (Biaxin), indinavir (Crixivan), itraconazole (Sporanox), ketoconazole, nelfinavir (Viracept), and telithromycin (Ketek) may increase levels of fluticasone in the body by reducing the breakdown of fluticasone by liver enzymes. This may increase side effects of Advair.
- Beta blockers (for example, propranolol) block the effect of salmeterol and may also produce severe bronchospasm in patients with asthma. Therefore, patients with asthma should not be treated with beta-blockers unless it is absolutely necessary. Beta-blockers that have less effect on the heart should be used if a beta-blocker must be combined with salmeterol.
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Is Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler) safe to use during pregnancy or while breastfeeding?
- Adequate studies of fluticasone or inhaled salmeterol during pregnancy have not been done. Fluticasone use during pregnancy should be avoided unless the potential benefit justifies the potential but unknown risk to the fetus. In some, but not all pregnant animal models, exposure to very high doses of oral salmeterol has led to offspring with birth defects. The concentrations of salmeterol in the blood after these very high doses, however, were much higher than the concentrations observed after inhalation by patients. Nevertheless, salmeterol inhalation should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
- It is not known if fluticasone propionate is secreted in breast milk. Other medications in the same class as fluticasone propionate are secreted into breast milk, but it is not known whether the small amounts that may appear in the milk have effects on nursing infants. In rats, salmeterol is excreted in milk. Therefore, caution should be exercised when salmeterol is administered to nursing women.
What else should I know about Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler)?
What preparations of Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler) are available?
- 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.
How should I keep Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler) stored?
- 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.
How does Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler) work?
- In patients with asthma, the smaller 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 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, production of mucus is reduced. When used in lower doses, very little inhaled fluticasone propionate is absorbed into the body and side effects are infrequent. When higher doses are used, fluticasone is absorbed and may cause side effects elsewhere in the body.
When was Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler) approved by the FDA?
- The FDA approved Advair Diskus in August, 2000 and Advair HFA in June 2006.
Advair Diskus, Advair HFA (fluticasone propionate and salmeterol oral inhaler) is an inhalant drug used to treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). Review side effects, drug interactions, warnings and precautions, and pregnancy and breastfeeding safety information prior to taking any medication.
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Related Disease Conditions
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease. Chronic cough treatment is based on the cause, but may be soothed natural and home remedies.
Neutropenia is a marked decrease in the number of neutrophils, neutrophils being a type of white blood cell (specifically a form of granulocyte) filled with neutrally-staining granules, tiny sacs of enzymes that help the cell to kill and digest microorganisms it has engulfed by phagocytosis. Signs and symptoms of neutropenia include gum pain and swelling, skin abscesses, recurrent ear and sinus infections, sore mouth, low-grad fever, pneumonia-like symptoms, and pain and irritation around the rectal area. Neutropenia has numerous causes, for example, infections (HIV, TB, mono); medications (chemotherapy); vitamin deficiencies (anemia); bone marrow diseases (leukemias), radiation therapy, autoimmune destruction of neutrophils, and hypersplenism. Treatment of neutropenia depends upon the cause and the health of the patient.
Emphysema is a COPD (chronic obstructive pulmonary disease) that often occurs with other obstructive pulmonary problems and chronic bronchitis. Causes of emphysema include chronic cigarette smoking, exposure to secondhand smoke, air pollution, and in the underdeveloped parts of the world. Symptoms of emphysema include chronic cough, chest discomfort, breathlessness, and wheezing. Treatments include medication and lifestyle changes.
Asthma: Over the Counter Treatment
Patients who have infrequent, mild bouts of asthma attacks may use over-the-counter (OTC) medications to treat their asthma symptoms. OTC asthma medicines are limited to epinephrine and ephedrine. These OTC drugs are best used with the guidance of a physician, as there may be side effects and the drugs may not be very effective.
Bronchitis is inflammation of the airways in the lung. Acute bronchitis is short in duration (10-20 days) in comparison with chronic bronchitis, which lasts for months to years. Causes of acute bronchitis include viruses and bacteria, which means it can be contagious. Acute bronchitis caused by environmental factors such as pollution or cigarette smoke is not contagious. Common symptoms for acute bronchitis include nasal congestion, cough, headache, sore throat, muscle aches, and fatigue. Acute bronchitis in children also my include runny nose, fever, and chest pain. Treatment for acute bronchitis are OTC pain relievers, cough suppressants (although not recommended in children), and rest. Infrequently antibiotics may be prescribed to treat acute bronchitis.
Asthma is a condition in which hyperreactive airways constrict and result in symptoms like wheezing, coughing, and shortness of breath. Causes of asthma include genetics, environmental factors, personal history of allergies, and other factors. Asthma is diagnosed by a physician based on a patient's family history and results from lung function tests and other exams. Inhaled corticosteroids (ICS) and long-acting bronchodilators (LABAs) are used in the treatment of asthma. Generally, the prognosis for a patient with asthma is good. Exposure to allergens found on farms may protect against asthma symptoms.
COPD (Chronic Obstructive Pulmonary Disease)
COPD or chronic obstructive pulmonary disease is a lung condition caused by smoking tobacco, exposure to secondhand smoke, and/or air pollutants. Conditions that accompany COPD include chronic bronchitis, chronic cough, and emphysema. Symptoms of COPD include shortness of breath, wheezing, and chronic cough. Treatment of COPD includes GOLD guidelines, smoking cessation, medications, and surgery. The life expectancy of a person with COPD depends on the stage of the disease.
Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least 3 months, 2 years in a row. Causes of chronic bronchitis include cigarette smoking, inhaled irritants, and underlying disease processes (such as asthma, or congestive heart failure). Symptoms include cough, shortness of breath, and wheezing. Treatments include bronchodilators and steroids. Complications of chronic bronchitis include COPD and emphysema.
There are two types of asthma medications: long-term control with anti-inflammatory drugs and quick relief from bronchodilators. Asthma medicines may be inhaled using a metered-dose inhaler or nebulizer or they may be taken orally. People with high blood pressure, diabetes, thyroid disease, or heart disease shouldn't take OTC asthma drugs like Primatene Mist and Bronkaid.
What Is Bronchiectasis?
Bronchiectasis has three types: cylindrical bronchiectasis, saccular or varicose bronchiectasis, and cystic bronchiectasis. Causes of bronchiectasis include infection, environmental exposure, drug or alcohol abuse, and alpha-1 antitrypsin (congenital). Symptoms of bronchiectasis include shortness of breath, fatigue, chronic cough, bloody sputum, and wheezing. Treatment for bronchiectasis includes antibiotics and possibly surgery.
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There are many unusual symptoms of asthma, including sighing, difficulty sleeping, anxiety, chronic cough, recurrent walking pneumonia, and rapid breathing. These symptoms may vary from individual to individual. These asthma complexities make it difficult to accurately diagnose and treat asthma.
Asthma in Children
Asthma in children manifests with symptoms such as coughing and wheezing. Rates of asthma in children are increasing. Asthma in children is usually diagnosed based on the description of symptoms. Lung function tests may also be used. A variety of medications are used for the treatment of childhood asthma.
Occupational asthma is a type of asthma caused by exposure to a substance in the workplace. Symptoms and signs include wheezing, chest tightness, and shortness of breath. The usual treatment for occupational asthma involves removal from exposure and the use of bronchodilators and inhaled anti-inflammatory medicines.
Adult-onset asthma is asthma that is diagnosed in people over 20 years of age. Symptoms include wheezing, coughing, shortness of breath and difficulty breathing. Treatment may involve anti-inflammatory medications or bronchodilators.
Exercise-induced asthma is asthma triggered by vigorous exercise. Symptoms include coughing, shortness of breath, chest tightness, wheezing, and fatigue while exercising. Preventing exercise-induced asthma attacks involves using inhaled medicines before exercising, performing warm-up exercises and cooling down afterward, avoiding exercising outdoors when pollen counts are high, restricting exercise when you have a viral infection, and wearing a mask over your nose and mouth when exercising in cold weather.
Emphysema, Chronic Bronchitis, and Colds
If you have a COPD such as emphysema, avoiding chronic bronchitis and colds is important to avoid a more severe respiratory infection such as pneumonia. Avoiding cigarette smoking, practice good hygeine, stay away from crowds, and alerting your healthcare provider if you have a sinus infection or cold or cough that becomes worse. Treatment options depend upon the severity of the emphysema, bronchitis, or cold combination.
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