Advair Inhaler (Fluticasone / Salmeterol)

Advair HFA is a combination inhaler containing fluticasone propionate and salmeterol used to treat asthma. The medication combines an inhaled corticosteroid (fluticasone propionate) with a long-acting beta2-adrenergic agonist (salmeterol) to help control symptoms and reduce asthma attacks. Fluticasone propionate works by reducing inflammation in the airways, while salmeterol helps relax the muscles around the airways to make breathing easier. Advair isn't meant for sudden asthma attacks.

Directions

The standard dosage for adults and children 12 years and older is 2 inhalations twice daily, taken approximately 12 hours apart. Before using Advair for the first time, you'll need to prime the inhaler by spraying it 4 times into the air away from your face. If the inhaler hasn't been used for more than 4 weeks or if it's been dropped, you'll need to prime it again with 2 sprays.

To take a dose, breathe out fully, place the mouthpiece in your mouth, and close your lips around it. As you start to breathe in slowly through your mouth, press down on the top of the canister to release the medication. Continue breathing in deeply, hold your breath for about 10 seconds, then breathe out slowly. Wait about 30 seconds between the two inhalations.

After using the inhaler, rinse your mouth with water without swallowing to help prevent thrush, a fungal infection in the mouth.

Ingredients

The active ingredients in this drug are fluticasone and salmeterol.

Cautions

• Before using this medication, you may want to consult a healthcare provider about the following:
  • Any existing health conditions
  • Any allergies
  • A list of all medications currently being taken
• Using long-acting bronchodilators (LABAs) alone for asthma can increase the risk of serious events like hospitalization or even death from asthma, so LABAs should only be used together with an inhaled steroid, as in Advair. Large studies show this combination does not increase the risk of serious asthma complications compared to inhaled steroids alone.
• Advair should not be started during a sudden or severe asthma attack. It does not work fast enough for rescue use, so a quick-acting inhaler is still needed for sudden symptoms.
• Using Advair too often or at higher doses than prescribed can be dangerous and may cause serious heart or nervous system side effects. It also should not be used with other medicines that contain a LABA.
• Advair can sometimes cause a yeast infection in the mouth or throat. Rinsing your mouth with water and spitting after each dose helps lower this risk.
• People with COPD using inhaled steroids, including those in Advair, may have a higher risk of pneumonia, especially older adults. Your provider may monitor you more closely if you have COPD or frequent lung infections.
• Because Advair contains a steroid, it may weaken the immune system slightly and make infections like chickenpox or measles more serious. People who haven't been exposed or vaccinated may need extra precautions if exposed.
• Switching from oral steroids to Advair needs careful monitoring because the body may take time to adjust. Symptoms of adrenal suppression, such as fatigue or nausea, should be reported right away.
• Long-term use of inhaled steroids may affect bone strength or slow growth in children. Providers usually use the lowest effective dose and monitor growth or bone health when needed.
• Rarely, Advair can cause vision problems like increased eye pressure or cataracts. Tell your doctor if you notice changes in your vision.
• In rare cases, inhaled steroids have been linked to eosinophilic conditions such as Churg-Strauss syndrome. Providers watch for symptoms like worsening breathing, rash, or nerve problems.
• Advair should be used carefully in people with certain health conditions, such as heart rhythm problems, seizures, thyroid issues, or diabetes. The medication's bronchodilator component can sometimes raise heart rate or affect blood sugar or potassium levels.

Side Effects

Common side effects of Advair include:

• Upper respiratory infections
• Throat irritation
• Hoarseness
• Headache
• Dizziness
• Nausea or vomiting.

Some people may also develop thrush, a fungal infection in the mouth or throat, which is why rinsing after each use is recommended. These effects are usually mild, but any persistent throat discomfort or voice changes should be discussed with a healthcare provider.

More serious reactions can occur, including pneumonia, weakened immunity, adrenal insufficiency, and sudden breathing problems after inhalation. Advair can also affect heart rhythm or blood pressure, trigger allergic reactions, or cause tremors and nervousness. Long-term use may lead to bone thinning, slowed growth in children, or eye problems such as glaucoma or cataracts. Seek medical attention for worsening breathing, fever, facial swelling, chest pain, or signs of infection.