Advair Diskus - Asthma Medication Profile

What It Is:

Advair Diskus is an inhaled asthma medication in powder form that contains two different asthma medications that are sometimes used individually:

• Fluticasone propionate, brand name Flovent
• Salmeterol xinafoate, brand name Serevent

Advair is used on an ongoing basis to control asthma symptoms. It is one of the preventive asthma medicines. (It can also be used to treat COPD that is associated with chronic bronchitis.)

Advair Diskus can be used both in adults and in children age 4 years and older. It is most commonly used in people who have not been able to achieve adequate asthma control with only an inhaled steroid.

How It Works:

Advair Diskus controls asthma in two different ways:

• Salmeterol, a long-acting bronchodilator, reduces airway constriction, which is the tightening of the muscles around the walls of your airways.
• Fluticasone, which is a corticosteroid, reduces airway inflammation, swelling and irritation.

Together, the two medicines combine to relax and widen the airways, thus increasing the airflow through your lungs and lessening or preventing asthma symptoms, such as wheezing, coughing, shortness of breath and chest tightness.

Forms & Doses:

Advair Diskus is what is known as a dry powder inhaler, or DPI for short. Dry powder inhalers have the advantage over metered dose inhalers, in that they are breath activated. You don’t have to shake them, use a spacer, or worry about getting the right amount. The dispenser also has a dose meter built in, so you’ll always know when it’s time to get a refill.

Advair Diskus comes in 3 strengths:

• Advair 100/50
• Advair 250/50
• Advair 500/50

The first number refers to the strength of the Flovent and can range from 50 (weakest) to 500 (strongest). The amount of Serevent in Advair Diskus is always the same, 50.

Advair is taken in 1 puff, twice a day, with the 2 doses about 12 hours apart. It should be taken every day, as prescribed, even if your asthma is under control and you are not having any asthma symptoms.

Risks and Side Effects:

Advair currently has what is known as a “black box warning” from the FDA. This was issued in relation to the salmeterol that is in Advair Diskus. This warning was issued because a few studies showed that salmeterol had a slightly increased risk of breathing problems and death in people with asthma, especially African-Americans.

However, the studies originally looked only at people taking salmeterol by itself. When they took a closer look, they found that there was no increased risk when salmeterol was taken with an inhaled steroid like Flovent (the other ingredient in Advair).

Like most asthma medicines, Advair is usually well-tolerated. However, some of the more common side effects include:

• upper respiratory infections
• lower bone density
• eye problems including glaucoma and cataracts
• slowed growth in children
• increased blood pressure
• fast and irregular heartbeat
• allergic reactions including, rash, hives, and swelling of the face, mouth, and tongue
• headache
• tremor
• nervousness
• throat irritation

If any of these side effects persist or become bothersome, be sure to talk with your doctor.

What You Need to Know:

The kinds of reactions that the black box warning talk about are rare, especially in combination medicines like Advair Diskus. If your doctor has prescribed Advair because an inhaled steroid alone wasn’t controlling your asthma, do not let your fears stop you from taking the medicine. Just be aware of the risk and be sure to contact your doctor right away with any concerns or changes in your breathing.

Advair Diskus can interact with other medicines, especially the anti-HIV medicines, Norvir or Kaletra. So, be sure your doctor knows everything you are taking, even if it is over the counter or an herbal product.

It’s important to follow the package instructions on how to use Advair Diskus. You can also find the instruction here on the Web. Keep track of when you are running low by watching the dose meter and allow time to refill your prescription, so that you don’t miss any doses.

Advair Diskus is a preventive asthma medicine, not a quick-relief medication. So, it should not be used to relieve asthma attacks or other acute asthma symptoms.

When to Call Your Doctor:

Call your doctor right away if any of the following things occur:

• Your breathing problems get worse while you are taking Advair Diskus.
• You need to start using your rescue inhaler more often than usual.
• Your rescue inhaler stops relieving your asthma symptoms.
• You need to use 4 or more puffs of your rescue inhaler for 2 or more days in a row.
• You use 1 whole canister of your rescue inhaler medicine in less than 8 weeks time.
• Your peak flow meter results worsen.
• Your asthma symptoms do not improve after you’ve been using Advair Diskus regularly for 1 week.