Fluticasone/salmeterol (By breathing)

Introduction

Fluticasone Propionate (floo-TIK-a-sone PROE-pee-oh-nate), Salmeterol Xinafoate (sal-ME-ter-ol zye-NAF-oh-ate)

Prevents symptoms of asthma or COPD (chronic obstructive pulmonary disease), including chronic bronchitis and emphysema. This medicine is a combination of a steroid and a bronchodilator.

Brand Name(s)

There may be other brand names for this medicine.

Advair Diskus 250/50, Advair Diskus 500/50, Advair Diskus 100/50, Advair HFA, Advair Diskus

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to salmeterol, fluticasone, or milk proteins. Do not use this medicine to treat an asthma attack or a COPD flare-up.

How to Use This Medicine

Liquid Under Pressure, Powder Under Pressure, Disk

  • Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to. Using too much medicine can cause serious side effects.
  • This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one. Your doctor might ask you to sign some forms to show that you understand this information.
  • This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
  • Advair Diskus® and Advair® HFA are used with other medicines to treat your breathing problems. Use all other medicines your doctor has prescribed as part of your combination treatment. Keep using these medicines for the full treatment time, even if you feel better after the first few doses.
  • Advair Diskus® is a powder that is used with its own special inhaler device. Individually measured doses of the powder are held in a foil blister package that is placed into the Diskus®. The Diskus® pierces (pokes a hole) in each blister one at a time to load the correct dose into the chamber when you are ready to use the medicine. Do not use the Diskus® with a spacer.
  • If you use the Advair Diskus® form:
    • Keep the Diskus® inhaler closed when you are not using it. Keep the inhaler dry at all times. Do not blow into it.
    • Before inhaling your dose, breathe out fully, trying to get as much air out of the lungs as possible. Hold the Diskus® level and away from your mouth.
    • Open your mouth and breathe in quickly and deeply through the Diskus®. Do not breathe in through your nose.
    • Remove the Diskus® from your mouth. Hold your breath for about 10 seconds or as long as possible, then breathe out slowly.
  • Advair® HFA is a liquid. To use:
    • You will use this medicine with a device called a metered-dose inhaler. The inhaler fits on the medicine canister and turns the medicine into a fine spray that you breathe in through your mouth and to your lungs. You may be told to use a spacer, which is a tube that is placed between the inhaler and your mouth. Your caregiver will show you how to use your inhaler and the spacer (if needed).
    • Shake the inhaler well just before each use. Avoid spraying this medicine into your eyes.
    • Test spray in the air before using for the first time or if the inhaler has not been used for a while.
    • To inhale this medicine, breathe out fully, trying to get as much air out of the lungs as possible. Put the mouthpiece just in front of your mouth with the canister upright.
    • Open your mouth and breathe in slowly and deeply (like yawning), and at the same time firmly press down on the top of the canister once.
    • Hold your breath for about 5 to 10 seconds, then breathe out slowly.
    • If you are supposed to use more than one puff, wait 1 to 2 minutes before inhaling the second puff. Repeat these steps for the next puff, starting with shaking the inhaler.
    • When you have finished all your inhalations, rinse your mouth out with water.
    • The inhaler has a window that shows the number of doses remaining. This tells you when you are getting low on medicine. The doses counting down from 20 to 0 will show up in red to remind you to refill your prescription. Throw away the inhaler when the count is 000. You may not receive the right amount of medicine if you are going to keep using this medicine.

If a dose is missed:

  • If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

  • Keep the medicine in the foil pouch until you are ready to use it. Store at room temperature, away from heat and direct light. Do not freeze.
  • Store the canister at room temperature, away from heat and direct light. Do not freeze. Do not keep this medicine inside a car where it could be exposed to extreme heat or cold. Do not poke holes in the canister or throw it into a fire, even if the canister is empty.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of the used medicine container and any leftover medicine. You will also need to throw away old medicine after the expiration date has passed. Throw the Advair Diskus® away 1 month after it is removed from the foil pouch or after all the blisters have been used.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • This medicine should not be used together with similar inhaled medicines such as arformoterol (Brovana?), budesonide/formoterol (Symbicort®), formoterol (Foradil®, Perforomist?), or salmeterol (Serevent®).
  • Make sure your doctor knows if you have used medicine for depression (such as amitriptyline, doxepin, nortriptyline, Elavil®, Pamelor®, or Sinequan®) or an MAO inhibitor (such as Eldepryl®, Marplan®, Nardil®, or Parnate®) within the past 2 weeks.
  • Tell your doctor if you are using medicine to treat depression (such as nefazodone, Serzone®), medicine to treat an infection (such as clarithromycin, itraconazole, ketoconazole, telithromycin, Biaxin®, Ketek®, Nizoral®, or Sporanox®), or medicine to treat HIV or AIDS (such as atazanavir, indinavir, nelfinavir, ritonavir, saquinavir, Crixivan®, Fortovase®, Invirase®, Kaletra®, Norvir®, Reyataz®, or Viracept®).
  • Make sure your doctor knows if you are also using any diuretics or "water pills" (such as furosemide, hydrochlorothiazide [HCTZ], torsemide, Demadex®, or Lasix®) or blood pressure medicines (such as atenolol, metoprolol, propranolol, Inderal®, Tenormin®, or Toprol®).

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have liver disease, heart disease, blood vessel disease (such as Churg-Strauss syndrome), high blood pressure, heart rhythm problems, seizures, or low potassium in the blood. Tell your doctor if you have bone problems (such as osteoporosis), diabetes, cataracts, glaucoma, herpes simplex in your eye, thyroid problems, tuberculosis, or any type of infection.
  • This should not be the first medicine you use for asthma. It should only be used along with other asthma medicines such as corticosteroids that are taken by mouth or inhaled (cortisone, prednisone, Azmacort®, Cortone®, Deltasone®, Flovent®, Pediapred®, Prelone®, or Vanceril®).
  • Before you start using this medicine, tell your doctor if your breathing problems have been worse recently. Tell your doctor if you have had to use more medicine to help your breathing, or if you have been to the emergency room lately for breathing problems.
  • This medicine will not stop an asthma attack that has already started. You should have another medicine to use in case of an acute asthma attack or for sudden COPD flare-ups.
  • If any of your asthma medicines do not seem to be working as well as usual, call your doctor right away. Do not change your doses or stop using your medicines without asking your doctor.
  • You may get infections more easily while using this medicine. Tell your doctor right away if you or your child have been exposed to chickenpox or measles.
  • 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 right away if you or your child start having increased sputum production, change in sputum color, fever, chills, increased cough, or increased breathing problems.
  • Using too much of this medicine or using it for a long time may cause 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 means your breathing or wheezing will get worse. Paradoxical bronchospasm may be life-threatening. Stop using this medicine and check with your doctor right away if you or your child have coughing, difficulty breathing, shortness of breath, or wheezing after using this medicine.
  • If you or your child develop a skin rash, hives, or any allergic reaction to this medicine, stop using the medicine and check with your doctor as soon as possible.
  • 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 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.
  • 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.
  • Your doctor may want you to carry a medical identification (ID) card stating that you 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.
  • If your symptoms do not improve or if they get worse, call your doctor.
  • Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments. You should have regular eye exams while using this medicine.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
  • Chest pain or shortness of breath.
  • Difficulty with swallowing.
  • Dry mouth, increased thirst, muscle cramps, nausea, or vomiting.
  • Eye pain or trouble seeing.
  • Fast, pounding, or uneven heartbeat.
  • Feeling of choking, or tightness or irritation of the throat.
  • Fever, chills, cough, runny or stuffy nose, sore throat, and body aches.
  • Tremors, nervousness, or shaking.
  • Unusual tiredness or weakness.
  • Worsening of breathing problems.

If you notice these less serious side effects, talk with your doctor:

  • Bone or muscle pain.
  • Dry mouth or white patches inside mouth.
  • Diarrhea, upset stomach.
  • Headache or dizziness.
  • Hoarseness or voice changes.
  • Menstrual problems.
  • Pain or weakness in your muscles or joints.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Review Date: 2011-02-04 Reviewed By: Keywords: ,
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