Advair Diskus (fluticasone/salmeterol)

ADVAIR (fluticasone/salmererol) – an inhaled combination product containing a corticosteroid (fluticasone), and a long-acting beta-2 adrenergic agonist (salmeterol) commonly used to treat asthma and chronic obstructive pulmonary disease (COPD).  The mechanism of action for fluticasone/salmererol is related to the two active ingredients. Fluticasone is a potent corticosteroid that posses anti-inflammatory properties, relieving inflammation in the airways of the lungs. Salmererol is a long-acting beta-2 agonist whose actions include relaxation of the bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity form cells, especially mast cells.

FDA approved uses:
1.       Treatment of asthma in patients aged 4 years and older.
2.       Maintenance treatment of airflow obstruction and reducing exacerbations in patients with COPD.
3.       NOT indicated for the relief of acute bronchospasm.

Available dosage forms:  DISKUS device containing a combination of fluticasone propionate (100, 250, or 500 mcg) and salmeterol (50 mcg) as an oral inhalation powder.

Usual dosage:  Treatment of asthma in patients ≥12 years: 1 inhalation of ADVAIR DISKUS 100/50, 250/50, or 500/50 twice daily. Starting dosage is based on asthma severity.  Treatment of asthma in patients aged 4 to 11 years: 1 inhalation of ADVAIR DISKUS 100/50 twice daily. Maintenance treatment of COPD: 1 inhalation of ADVAIR DISKUS 250/50 twice daily.

Contraindications:  Advair should not used for primary treatment of status asthmaticus or acute episodes of asthma or COPD requiring intensive measures. Severe hypersensitivity to milk proteins.

Special Warnings: Long-acting beta2-adrenergic agonists (LABA), such as salmeterol, one of the active ingredients in ADVAIR DISKUS, increase the risk of asthma-related death. Currently available data are inadequate to determine whether concurrent use of inhaled corticosteroids or other long-term asthma control drugs mitigates the increased risk of asthma-related death from LABA. Available data from controlled clinical trials suggest that LABA increase the risk of asthma-related hospitalization in pediatric and adolescent patients.  When treating patients with asthma, only prescribe ADVAIR DISKUS for patients not adequately controlled on a long-term asthma-control medication, such as an inhaled corticosteroid or whose disease severity clearly warrants initiation of treatment with both an inhaled corticosteroid and LABA. Once asthma control is achieved and maintained, assess the patient at regular intervals and step down therapy (e.g. discontinue ADVAIR DISKUS) if possible without loss of asthma control, and maintain the patient on a long-term asthma control medication, such as an inhaled corticosteroid. Do not use ADVAIR DISKUS for patients whose asthma is adequately controlled on low or medium dose inhaled corticosteroids.

Adverse reactions (side effects) of these medications: The most common side effects of Advair include upper respiratory tract infection or inflammation, pharyngitis, dysphonia, oral candidiasis, bronchitis, cough, headaches, throat irritation, musculoskeletal pain, nausea and vomiting. Other adverse reactions reported in clinical trial data include gastrointestinal discomfort and pain, diarrhea, viral gastrointestinal infections, dizziness, fever, malaise and fatigue, muscle cramps and spasms, and back pain.

Common drug interactions: The following drugs have reported or theoretical interactions with Advair: Monoamine oxidase inhibitor (MAOI) drugs, beta blockers, diuretics, ritonavir and ketoconazole.

Special instructions for patients: Use exactly as directed by physician. Do not attempt to use this medication to relieve acute asthma symptoms or exacerbations of COPD, and extra doses should not be used for that purpose. Other long-acting beta-2 agonists for asthma and COPD should not be used concomitantly with Advair. Patients with COPD are at higher risk for pneumonia and should contact their doctor if symptoms of pneumonia develop.

Full prescribing information may be found at the manufacturer‘s official website Advair.com       or at the U.S. Food and Drug Administration’s website at Advair Info on Drugs@FDA 

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