Medications

Advair® MDI   

This product is manufactured by GlaxoSmithKline and is a combination of two ingredients, fluticasone propionate and salmeterol xinafoate.

This product is taken via MDI (metered dose inhaler).


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MDI (metered dose inhaler)


Why is it prescribed?

Advair® is used for maintenance treatment of asthma and chronic obstructive pulmonary disease (bronchitis, emphysema)in patients who require an inhaled corticosteroid medication and a long-acting bronchodilater.
Advair® is not a rescue medication and should not be used to treat a sudden asthmatic episode.


  • Advair® MDI is intended for continual use on a regular basis to prevent symptoms. It should not be used as a relief medication.
  • Advair® MDI should not be used more frequently than twice daily.
  • After inhaling a dose, be sure to rinse your mouth with water and spit it out. This may help prevent developing the fungal infection of the mouth and throat called thrush.
  • Each canister contains 120 doses. The inhaler device has a dose counter that counts down from 120 to 0. It is recommended to replace your inhaler when the counter is approaching zero.
  • Before using your inhaler for the first time, the inhaler should be primed. To do this, shake the inhaler well and release a puff into the air and repeat until the counter reads 120. If your inhaler has not been used for a week or more, it should be primed again by releasing another two doses.
  • If you accidentally take more than the recommended number of inhalations, you may notice that your heart is beating faster than usual, that you have a headache and that you feel shaky. In this case, tell your doctor without delay.
  • If you miss a single dose, skip the dose and just take the next dose when it is due.
  • It is advisable to have your technique reassessed by the pharmacist for the first 2 or 3 refills of your prescription.
  • Remember to shake the inhaler before each use.
  • When 2 inhalations are required, wait at least half a minute between doses.
  • Your inhaler should be stored at room temperature (between 15 to 25 degrees centigrade). The contents of the canister are under pressure and should never be punctured, used or stored near heat or open flame.
  • It should also be protected from direct sunlight and frost.

Alternatives

Other products that have the same ingredients as Advair® MDI are •Advair® Diskus® ••Advair® Diskus® •

See other products used in the treatment of •allergic rhinitis •asthma •nasal polyps •perennial rhinitis •rhinitis •runny nose •seasonal allergies •seasonal rhinitis •bronchitis •bronchospasm associated with COPD •chronic bronchitis (COPD) •COPD •emphysema (COPD) •

The usual dose for asthma in children over 12 years of age and in adults is two puffs twice daily of either the 125mcg or the 250 mcg inhaler.


Advair® contains two different medications, salmeterol and fluticasone that act in two different ways to help you breathe better. Salmeterol is a long-acting bronchodilator. It relaxes the muscles in the walls of the small air passages in the lungs. This helps to open the airways and makes it easier for air to get in and out of the lungs. Fluticasone is a potent corticosteroid that possesses strong local anti-inflammatory activity. It reduces swelling and irritation in the walls of the small air passages in the lungs to ease breathing problems. Fluticasone also helps prevent asthma attacks.


Along with its needed effects, Advair® may cause some unwanted or undesirable effects. The severity and duration of these effects are dependent on many factors including duration of therapy, dose, and individual response. Occasionally, some people feel a little shaky or have a headache or notice that their heart is beating faster than usual. These effects usually wear off with continued treatment. Tell your doctor about unwanted effects, but do not stop treatment unless told to do so.
Common:

  • hoarseness
  • throat irritation
  • thrush of the mouth and throat

Less common:

  • palpitations (awareness of heart beat)
  • cough

Rare:

  • irregular heart rhythms
  • pain in joints
  • muscle cramps

Many of these unwanted effects, especially the most common ones, may disappear with continued use. Check with the doctor or pharmacist if any of them continue or become bothersome.

 


  • Poor control of symptoms with Advair® can often be caused by improper use of the delivery device. Be sure to follow the directions given to you by your pharmacist and read the patient instructions that are provided with the medication.
  • Optimal relief of symptoms may require 2 to 7 days of continuous therapy.
  • If you are not responding to your usual dose, or your symptoms get worse, contact your doctor. Never increase the dose or frequency of the dose without being instructed to do so by your doctor.
  • Do not take any other respiratory medications without your doctor's approval.
  • Treatment with Advair® should never be stopped without first consulting your doctor. Discontinuation requires a gradual tapering of the dose and/or frequency or you may experience a flare-up of your condition.
  • People who have been treated with long term oral corticosteroids (e.g. prednisone) and are being switched to Advair® should start the Advair® before stopping the oral corticosteroid. The oral corticosteroid should then be gradually withdrawn.
  • The fluticasone in Advair® may make people more susceptible to respiratory infections and may mask the symptoms of an existing infection. If you suspect that you may have a respiratory tract infection, contact your physician.
  • This immune system suppression also makes people more susceptible to getting thrush of the mouth and throat. Thrush is a fungal infection that usually presents as milky-white curds on the surface of the skin of the mouth and throat. These curds are easily wiped off and when removed leave a red, raw, painful surface. If you suspect that you might have thrush, see your physician. To best prevent getting thrush, it is wise to rinse your mouth out with water after using Advair®.
  • Drug Interactions: Be sure to tell your doctor and pharmacist about any prescription or over-the- counter medications you are taking in order to avoid any potentially dangerous interactions.The following drugs may interact with Advair®:
    • short-acting beta-agonists (e.g. salbutamol)
    • MAO (monoamine oxidase) inhibitors (e.g. phenelzine, tranylcypromine)
    • tricyclic antidepressants (e.g. amitriptyline, imipramine)
    • methylxanthines (e.g. theophylline)
    • some beta-blockers (e.g. propranolol)
    • ritonavir (e.g. Norvir®)

Use is not recommended in the following situations:

  • allergy to any component of Advair®
  • patients with allergic reactions to lactose or milk
  • cardiac arrhythmia associated with tachycardia (irregular heartbeat associated with rapid heart rate)
  • people with untreated fungal, bacterial or tuberculosis infections

Caution is recommended in the following situations:

  • hypothyroidism
  • diabetes
  • cirrhosis
  • glaucoma
  • cardiovascular disorders
  • cardiac arrhythmia (irregular heartbeat)

Use in pregnancy: The safety of using Advair® in pregnancy has not been established. Taking any drug while pregnant should only be considered if the potential benefits to the mother are greater than any possible risk to the unborn child.
Use while breast-feeding: Advair® is generally considered safe in breast-feeding but consult your doctor or pharmacist before use.
As with all long-acting beta2-agonists and beta2-agonist/corticosteroid combinations, Advair® carries a warning that long-acting beta2-agonists have been associated with asthma death. These warnings are based on a U.S. study using salmeterol.

 


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Page Last Updated: 05/10/2016