Advair Diskus (Fluticasone and Salmeterol)

Advair Diskus is an inhaler to prevent bronchial asthma. It contains Fluticasone and Salmeterol where Fluticasone is a component of a long-lasting therapy able to improve lung capacity and Salmeterol has properties of short-acting medication to cope with the attack.

Table of Contents

• How does it work?
• How to use?
• How many doses are in it?
• Side effects
• Dosage
• Drug interactions
• How to clean it?
• What is the difference between Advair Diskus and Advair HFA?
• Reviews

 

How does it work?

Advair Diskus is a combination drug for inhalation use; anti-asthma bronchodilator with anti-inflammatory properties. Its action is achieved due to the properties of the active components. Salmeterol prevents the occurrence of bronchospasm, fluticasone propionate improves pulmonary function, suppresses inflammation and prevents bronchospasm exacerbations. This inhaler may be an alternative for patients who are simultaneously receiving a beta2-adrenoreceptor agonist and inhaled glucocorticosteroids.

How to use?

• Open the inhaler;
• Click on the lever;
• Hold the case with one hand, placing the thumb of the other hand in a special groove;
• Click on the lever;
• Hold the inhaler mouthpiece towards your face;
• The inhaler can be held with the right or left hand;
• Push the lever all the way away until you hear a sound;
• Now the inhaler is ready to be used;
• When you press the lever, the next pack with the powder for inhalation is opened, while the number of remaining doses decreases, which is indicated in the special window. Press the lever just before the inhalation, otherwise, it leads to a waste of medication.;
• Inhale the medication dose;
• Before you begin the inhalation, carefully read the instruction for use;
• Keep the inhaler away from your mouth and take a deep breath without any effort;
• Remember never exhale into the inhaler! – tightly clasp the mouthpiece lips;
• Breathe in slowly and deeply through your mouth (not through your nose);
• Remove the inhaler from your mouth;
• Hold your breath for about 10 seconds or longer, as far as you can;
• Make a slow exhalation;
• Close the inhaler.

 

How many doses are in it?

The following dosages of Advair Diskus exist:

• 50/100 mcg;
• 50/250 mcg;
• 50/500 mcg.

There are no data on the use of this drug in children under 4 years of age.

Side effects

Infectious and parasitic diseases

• often: oral and pharyngeal candidiasis, pneumonia (in patients with COPD), bronchitis;
• rarely: esophageal candidiasis.

Immune system disorders

• infrequently: skin hypersensitivity reactions, short breathing;
• rarely: anaphylactic reactions, including anaphylactic shock.

Metabolic and nutritional disorders

• infrequently: hyperglycemia;
• very rare: hypopotassemia.

Mental disorders

• infrequently: anxiety, sleep disorders;
• rarely: behavioral changes, including hyperactivity and irritability (especially in children);
• frequency is unknown: depression, aggressive behavior (especially in children), anxiety.

Nervous system disorders

• very often: headache;
• infrequently: tremor.

Violations by the organ of vision

• infrequently: cataract;
• rarely: glaucoma.

Heart disorders

• infrequently: palpitations, tachycardia, atrial fibrillation, exertional angina;
• rarely: arrhythmia, including ventricular extrasystoles, supraventricular tachycardia, and extrasystoles.

Disorders of the respiratory system, organs of the chest and mediastinum

• very often: nasopharyngitis;
• infrequently: irritation of the pharyngeal mucosa;
• often: sore throat, hoarseness/dysphonia, sinusitis.

Violations of the skin and subcutaneous tissue

often: bruising.

Disorders of the musculoskeletal and connective tissue

often: traumatic fractures, muscle spasm, arthralgia, myalgia.

Dosage

Bronchial asthma

Recommended doses of Advair Diskus in adults and children 12 years and older:

• one inhalation (50 µg salmeterol and 250 µg fluticasone propionate) 2 times a day;
• one inhalation (50 µg salmeterol and 500 µg fluticasone propionate) 2 times a day.

In adults over 18 years of age with a double dosage on the background of the drug use for up to 14 days, the same safety and tolerability are maintained as with the regular use of this combination on the 1st inhalation 2 times a day.

The dose can be doubled in cases when patients need additional short-term (up to 14 days) inhaled glucocorticosteroid therapy, as described in some guidelines for the treatment of bronchial asthma.

Chronic Obstructive Pulmonary Disease (COPD)

For adult patients, the maximum recommended dose is 1 inhalation (50 µg salmeterol and 500 µg fluticasone propionate) 2 times a day. This dosage of the drug reduced mortality from any causes.

Special patient groups

There is no need to reduce the drug dose in elderly patients, as well as in patients with impaired renal or hepatic function.

Drug interactions

In diseases accompanied by reversible airway obstruction, it is not recommended to prescribe both non-selective and cardio-selective beta-blockers (Inderal, Atenolol, Metoprolol, etc.), unless it is really necessary and justified (due to the risk of developing bronchospasm).

In normal situations, fluticasone propionate inhalation is accompanied by low plasma concentrations due to intensive first-pass metabolism and high systemic clearance under the influence of the cytochrome P450 isoenzyme CYP3A4 in the intestine and liver. Because of this, clinically significant interactions involving fluticasone propionate are unlikely to happen.

Be careful to combine Advair Diskus and inhibitors of the CYP3A4 enzyme (for example, erythromycin, ketoconazole, ritonavir), since the systemic effect of fluticasone propionate may increase, resulting in significantly reduced serum cortisol concentrations. There are reports of clinically significant drug interactions in patients who took fluticasone propionate and ritonavir at the same time. These interactions caused such side effects as Cushing’s syndrome and adrenal suppression.

Xanthine derivatives (Theophylline, Aminophylline), corticosteroids (Prednisone, triamcinolone, dexamethasone) and diuretics (furosemide, Hypothiazide) increase the risk of hypokalemia (especially in patients with exacerbation of bronchial asthma, with hypoxia).

MAO inhibitors and tricyclic antidepressants increase the risk of side effects of the cardiovascular system.

Advair Diskus is compatible with cromoglicic acid (sodium cromoglycate).

How to clean it?

Wash hands thoroughly with soap or alcohol-based solution. Since a quick way to clean does not include handling soap, we need to kill all the bacteria on our hands in order not to transfer them to the inhaler.

Take the nebulizer apart, if possible. Most devices are divided into 3 parts – a mask or mouthpiece, a tube connecting the mask and the main unit, and the unit supplying pressurized air.

Disconnect all parts from each other. You do not need to clean the main unit, you just need to clean the mask and the tube. Although the mask will already be enough.

In general, nebulizers are divided into 2 types – inhalers supplying steam under pressure and ultrasound inhalers. They are very different. The first type supplies air under pressure and thus turns the medicine into steam, and the second type with the help of sound waves turns the medicine into steam. But they both have the same mask and tube design.

There are also portable nebulizers. They have fewer parts which can be removed. The most important thing is to remove the mask or mouthpiece – this is quite enough.

Wash the mask or mouthpiece under warm water. Be sure to flush all T-shaped connections. Run the item under water and hold it for half a minute, up to a minute. Make sure all parts are cleaned.

Never wash the injection unit in this way. It can be wiped outside, but cannot be wetted.

After you have washed the mouthpiece (or mask), shake off any excess moisture from it and put it on a clean towel. Let the water dry naturally. It can take about 20 minutes to an hour.

After all the parts are dry, assemble the nebulizer in the correct state.

What is the difference between Advair Diskus and Advair HFA?

Advair HFA vs Advair Diskus ensure not similar ways to bring the drugs prescribed for the treatment of severe asthma and chronic pulmonary obstructive disease (COPD). Both forms are comprised of a combination of a steroid drug (fluticasone) that decreases lungs’ inflammation, and a bronchodilator (salmeterol) that brings relaxation to your airways. In Advair HFA, the inhaler provides the medication in an aerosol form, while in Advair Diskus it looks like a powder.

Reviews

Ava Reid: “Advair Diskus is a universal means for me. My doctor prescribed it to me. It helps me really.”

Noah Godfrey: “I have suffered from bronchial constriction for several months. After a detailed examination, my doctor prescribed this asthma drug to me. It really works.”

Keira Holt: “Advair Diskus is the latest my prescription drug. It helps relieve my asthma. I feel good when using this medication.”