Advair Inhaler: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Advair Inhaler (fluticasone and salmeterol) is a combination inhaler used to prevent asthma attacks in adults and children, and to prevent flare-ups of chronic obstructive pulmonary disease (COPD) linked to chronic bronchitis and/or emphysema. It contains fluticasone, a steroid that reduces inflammation, and salmeterol, a long-acting bronchodilator that relaxes airway muscles. It is available as Advair Diskus (a powder inhaler) and Advair HFA (an aerosol inhaler). It is not a rescue medicine, so a fast-acting rescue inhaler should always be kept on hand.

What is Advair Inhaler

Advair is a combination inhaler medicine that contains fluticasone, a steroid that reduces inflammation, and salmeterol, a bronchodilator that relaxes airway muscles to improve breathing. It comes as Advair Diskus (a powder inhaler) or Advair HFA (an aerosol inhaler).

Advair Inhaler uses

• Prevent asthma attacks in adults and children (Advair Diskus for ages 4 and up, Advair HFA for ages 12 and up)
• Prevent flare-ups or worsening of chronic obstructive pulmonary disease (COPD) linked to chronic bronchitis and/or emphysema (Advair Diskus)

Benefits of Advair Inhaler

• Helps control ongoing asthma symptoms such as wheezing, cough, chest tightness, and shortness of breath
• Can reduce the number of COPD flare-ups
• Improves airflow in the lungs by combining an anti-inflammatory steroid with a muscle-relaxing bronchodilator

How Advair Inhaler works

Advair contains two medicines that work together: fluticasone, a steroid that reduces swelling and inflammation in the lungs, and salmeterol, a long-acting bronchodilator that relaxes the muscles around the airways so more air can flow through. Together they help you breathe easier and get more oxygen.

Advair Inhaler dosage

Use exactly as prescribed and follow all directions on your prescription label and any instruction sheets. This medicine is not a rescue treatment and will not work fast enough for a sudden asthma or breathing attack — always keep a fast-acting rescue inhaler with you.

Use Advair HFA at the same time each day, and only with the inhaler device provided. Shake the Advair HFA inhaler before each spray. Do not let a young child use this medicine without help from an adult. Rinse your mouth with water and spit it out (do not swallow) after each use to help prevent mouth and throat infections.

Do not change your dose or schedule without your doctor's advice, even if you have surgery, illness, stress, or a recent asthma attack. If you also take an oral steroid, do not stop it suddenly — follow your doctor's instructions for lowering the dose gradually. Take each dose about 12 hours apart, at the same times each day.

Do not use a spacer device with the Diskus inhaler. Keep the Diskus in a flat, level position when using it, and do not tilt it, close it, or move the lever during use.

Available forms and strengths

• Inhalation powder (Advair Diskus)
• Inhalation aerosol (Advair HFA)

Side effects of Advair Inhaler

Common

• Headache
• Muscle pain, bone pain, back pain
• Nausea, vomiting
• Thrush (fungal infection), throat irritation
• Ongoing cough, hoarseness or deepened voice
• Cold symptoms such as stuffy nose, sneezing, sore throat
• Ear infection in children
• Dizziness
• Weight gain

Serious

• Signs of allergic reaction: hives, difficulty breathing, swelling of face, lips, tongue, or throat
• Wheezing, choking, or other breathing problems right after using the inhaler (paradoxical bronchospasm)
• Fever, chills, cough with mucus, feeling short of breath (possible pneumonia or infection)
• Chest pain, fast or irregular heartbeats, severe headache, pounding in neck or ears
• Tremors, nervousness
• Signs of thrush - sores or white patches in mouth or throat, trouble swallowing
• Blurred vision, tunnel vision, eye pain, or seeing halos around lights (possible glaucoma or cataracts)
• Increased thirst, increased urination, dry mouth, fruity breath odor
• Leg cramps, constipation, irregular heartbeats, fluttering in chest, numbness or tingling, muscle weakness (signs of low potassium)
• Worsening tiredness or weakness, feeling light-headed, nausea, vomiting (signs of adrenal gland problems)
• Slowed growth in children
• Decreased bone density (osteoporosis)

Warnings and precautions

• Advair is not a rescue medicine and will not work fast enough to treat a sudden asthma or bronchospasm attack. Always keep a fast-acting rescue inhaler with you.
• People with asthma who take long-acting beta agonist medicines like salmeterol (one of the medicines in Advair) have an increased risk of death from asthma problems.
• Children and teens who take LABA medicines may have a higher risk of being hospitalized for asthma problems.
• Do not use Advair if you are allergic to fluticasone or salmeterol, have a severe allergy to milk proteins (for Advair Diskus), or are having an asthma attack or severe COPD symptoms.
• Advair can weaken your immune system and increase your risk of infections, including making chickenpox or measles more serious or even fatal.
• Do not use a second long-acting inhaled bronchodilator medicine while using Advair.
• Advair can cause fungal infections of the mouth and throat; rinsing your mouth with water after use can help prevent this. It is also linked to a higher risk of pneumonia in people with COPD.
• It is not known whether Advair will harm an unborn baby. 
• However, untreated or poorly controlled asthma during pregnancy can cause problems like low birth weight, premature birth, or dangerously high blood pressure, so the benefit of treating asthma may outweigh the risks. Talk with your doctor if you are pregnant or planning pregnancy.
• It may not be safe to breastfeed while using this medicine. Ask your doctor about the risks.
• Tell your doctor if you have kidney disease before using this medicine.
• Tell your doctor if you have liver disease before using this medicine.
• There is no known direct interaction between Advair and alcohol, but heavy alcohol use can damage the small hair-like structures in your airways that help clear germs, and can weaken your immune system. This can raise your risk of serious lung infections and make asthma or COPD symptoms worse. Talk with your doctor about how much alcohol is safe for you.

Storage

• Store your medicine at room temperature, away from moisture, heat, and sunlight
• Avoid high heat, such as open flame or in a car on a hot day
• Store Advair Diskus in the unopened foil pouch and only open it when ready to use
• Throw away Advair Diskus 1 month after opening the foil pouch or when the counter reads 0, whichever comes first
• Store Advair HFA and Advair Diskus at room temperature between 68°F and 77°F (20°C and 25°C), in a dry place away from heat and sunlight
• Keep out of the reach of children
• Carefully follow all storage and disposal directions provided with your medicine

When to see a doctor

• Get emergency medical help for signs of a serious allergic reaction: hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.
• Get emergency care if your breathing problems worsen quickly, or if your rescue inhaler does not relieve your symptoms.
• Call your doctor at once if you have wheezing, choking, or other breathing problems after using this medicine, fever, chills, cough with mucus, or feel short of breath.
• Call your doctor at once if you have chest pain, fast or irregular heartbeats, severe headache, or pounding in your neck or ears.
• Call your doctor if you see signs of a fungal mouth or throat infection, such as sores or white patches in the mouth or throat, or trouble swallowing.
• Call your doctor if you have blurred vision, tunnel vision, eye pain, or see halos around lights.
• Call your doctor if you have worsening tiredness or weakness, feeling light-headed, nausea, or vomiting, which may signal adrenal gland problems.
• If you have sudden breathing problems right after inhaling your dose, stop using Advair and call your healthcare provider right away.

Alternatives

• Seretide
• Symbicort
• Flutiform