How does Advair treat asthma?

It successfully treats the two main components of asthma (airway constriction and inflammation)by using:

• An effective inhaled corticosteroid: fluticasone propionate. This medicine reduces the inflammation in the airways.
• An effective inhaled long-acting bronchodilator: salmeterol. This medicine works by helping to relax the muscles surrounding the airways.

How soon after taking Advair should I notice an improvement?

You may notice improvement within 30 minutes. Maximum results may take a week or longer. It’s important to keep taking your Advair twice a day, every day, as directed by your doctor. Speak to your doctor if symptoms do not improve.

Is there anything I should know before considering Advair?

Advair contains salmeterol. Patients with asthma who take medicines like salmeterol may have an increased chance of asthma-related death. Therefore Advair is not for people whose asthma is under control on another controller medicine.

If your asthma does not improve while taking Advair speak with your doctor. Tell your doctor if you have a heart condition or high blood pressure. Some people may experience increased blood pressure, heart rate, or changes in heart rhythm. Advair is for patients 4 years and older.

• amiodarone (Cordarone);
• a diuretic or “water pill”;
• HIV medicines such as ritonavir (Norvir), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept);
• an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam);
• antidepressants such as amitriptyline (Elavil), desipramine (Norpramin), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), or nortriptyline (Pamelor); or
• antibiotics such as ketoconazole (Nizoral), itraconazole (Sporanox), clarithromycin (Biaxin), erythromycin (E-Mycin, Ery-Tab, E.E.S.).

This list is not complete and there may be other drugs that can interact with Advair. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include angina or chest pain, fast or irregular heartbeats, seizures, tremor, weakness, headache, nausea, and vomiting.

What should I avoid while using Advair?

Do not use a second form of salmeterol (such as Serevent) or use a similar inhaled bronchodilator such as formoterol (Foradil) unless your doctor has told you to.

Advair can lower the blood cells that help your body fight infections. This can make it easier for you to get sick. Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medicines.

• bronchospasm (wheezing, chest tightness, trouble breathing);
• fast or uneven heart beats, restless feeling, tremor;
• fever, chills, cough with yellow or green mucus;
• stabbing chest pain, feeling short of breath;
• white patches or sores inside your mouth or on your lips; or
• worsening asthma symptoms.

Less serious side effects include:

• headache, dizziness;
• nausea, vomiting, diarrhea;
• dryness in your mouth, nose, or throat;
• stuffy nose, sinus pain, cough, sore throat; or
• hoarseness or deepened voice.

This is not a complete lit of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

Advair comes with patient instructions for safe and effective use, and directions for priming the inhaler device. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Do not use Advair to treat an asthma attack that has already begun. It will not work fast enough. Use only a fast-acting inhalation medication to treat an asthma attack. Talk with your doctor if any of your asthma medications do not seem to work as well in treating or preventing asthma attacks.Advair Diskus is a powder form of fluticasone and salmeterol that comes with a special inhaler device preloaded with blister packs containing measured doses of the medicine. The device opens and loads a blister each time you use the inhaler. This device is not to be used with a spacer.

Do not exhale or blow into the Diskus device. Do not take the device apart or allow it to get wet. Do not reuse the Advair Diskus device. Throw it away 1 month after you have taken it out of the foil pouch, or if the dose indicator shows a zero, whichever comes first. Each Diskus device contains 60 doses.

Advair HFA is an aerosol form of fluticasone and salmeterol that comes in a canister that is used with an actuator inhaler device. Use only the inhaler device provided with Advair HFA. This device is not to be used with a spacer.

Shake the Advair HFA inhaler for at least 5 seconds before each spray. When using the inhaler for the first time, prime it by spraying 4 test sprays into the air, away from your face. Shake the canister for 5 seconds before each spray. Also prime the inhaler if you have not used it in more than 4 weeks, or if you have dropped the canister.Keep track of the number of sprays you have used and throw away the Advair HFA canister after 120 sprays, even if it feels like there is still medicine in it.

To reduce the chance of developing a yeast infection in your mouth, rinse with water after using Advair. Do not swallow.

It is important to use Advair regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Call your doctor right away if you feel that this medicine is not working as well as usual, or if it makes your condition worse. An increased need for medication could be an early sign of a serious asthma attack. If you use a peak flow meter at home, call your doctor if your numbers are lower than normal.Asthma is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor.

If you were switched from an oral (taken by mouth) steroid to Advair, you may need to go back to taking the oral medicine if you are under stress or have an asthma attack or other medical emergency. Carry an identification card or wear a medical alert ID to let others know that you may need an oral steroid in an emergency. Store Advair at room temperature away from moisture and heat. Keep the Atrovent HFA canister away from high heat, such as open flame or in a car on a hot day. The canister may explode if it gets too hot.

Advair may also be used for purposes other than those listed in this medication guide.

Important information about Advair

Do not use Advair to treat an asthma attack that has already begun. Use another, faster-acting inhalation medication to treat an asthma attack. Call your doctor right away if you feel that this medicine is not working as well as usual, or if it makes your condition worse. An increased need for medication could be an early sign of a serious asthma attack. If you use a peak flow meter at home, call your doctor if your numbers are lower than normal. Salmeterol has been shown to increase the risk of asthma-related death. It is critical that you use only the prescribed dose of this medicine and follow all patient instructions for safe use of the medication. Talk with your doctor about your individual risks and benefits in using Advair.

Salmeterol has been shown to increase the risk of asthma-related death. It is critical that you use only the prescribed dose of this medicine and follow all patient instructions for safe use of the medication. Talk with your doctor about your individual risks and benefits in using Advair.Before using Advair, tell your doctor if you are allergic to any medications, or if you have:

• a food or drug allergy;
• heart disease or high blood pressure;
• epilepsy or other seizure disorder;
• diabetes;
• glaucoma;
• tuberculosis;
• osteoporosis;
• a thyroid disorder; or
• liver disease.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use Advair.

FDA pregnancy category C. Advair may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether Advair passes into breast milk or if it could harm a nursing baby. Do not use Advair without telling your doctor if you are breast-feeding a baby.Advair can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using Advair.

Long-term use of steroids may lead to bone loss (osteoporosis), especially if you smoke, if you do not exercise, if you do not get enough vitamin D or calcium in your diet, or if you have a family history of osteoporosis. Talk with your doctor about your risk of osteoporosis.

Important information about ADVAIR DISKUS 250/50
ADVAIR DISKUS 250/50 is approved for controlling symptoms and preventing wheezing in adults with COPD associated with chronic bronchitis. The benefit of using ADVAIR DISKUS for longer than 6 months has not been evaluated. You should only take 1 inhalation of ADVAIR DISKUS 250/50 twice a day. Taking higher doses will not provide additional benefits but may increase your chance of certain side effects. Lower respiratory tract infections, including pneumonia, have been reported with ADVAIR. Patients at risk for developing bone loss (osteoporosis) and some eye problems (cataracts or glaucoma) should be aware that use of inhaled corticosteroids, including ADVAIR DISKUS, may increase your risk. You should consider having regular eye exams. ADVAIR DISKUS does not replace fast-acting inhalers for acute symptoms.

It’s important to know that an important goal of managing your asthma is superior symptom control* most of the time. You shouldn’t always have to change the way you do things as a result of your asthma. And you should be able to do more of the things you love. If you aren’t, let your doctor help you treat your asthma better.

Monitor your asthma between doctor visits by keeping track of your:

• Symptoms
• Triggers
• Fast-acting (rescue) inhaler use
• Peak flow meter readings

If your child with asthma is 4-11 years old, take the Childhood Asthma Control Test with your child.

*People ages 12 years and older taking ADVAIR 100/50 experienced improved lung function and asthma symptom scores, and a reduction in fast-acting inhaler use, compared with people taking either fluticasone propionate 100 mcg or salmeterol 50 mcg (inhalation powders) alone. Your results may vary.