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Generic Name:

fluticasone-salmeterol, Inhalation powder

All Brands

  • Advair
SECTION 1 of 4

Highlights for fluticasone-salmeterol

Inhalation powder
1

Fluticasone/salmeterol is a combination of two drugs in a single form that work in different ways to treat asthma and chronic obstructive pulmonary disease (COPD).

2

This drug is available as an inhalation powder (Advair Diskus, AirDuo RespiClick) and inhalation aerosol (Advair HFA).

3

Fluticasone/salmeterol isn’t available as a generic drug. It’s only available as brand-name drugs called Advair Diskus, Advair HFA, and AirDuo RespiClick.

4

Fluticasone/salmeterol doesn’t relieve sudden symptoms of asthma or COPD. Always have a rescue inhaler with you to treat sudden symptoms. If you don’t have a rescue inhaler, ask your healthcare provider to prescribe one for you.

5

The more common side effects include thrush (fungal infection) in your mouth or throat, throat irritation, hoarseness and voice changes, upper respiratory tract infections, headache, nausea and vomiting, and muscle and bone pain.

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to effects that may be dangerous.

  • Risk of death warning. People with asthma who take drugs like salmeterol, one of the medications in this drug, have an increased risk of death from asthma problems. It isn’t known if taking this drug with fluticasone reduces your risk of death. It also isn’t known if salmeterol increases the risk of death in people with chronic obstructive pulmonary disorder (COPD).

This drug may also raise the risk of being hospitalized due to asthma in children and adolescents.

You should only take this drug if your asthma isn’t controlled with a long-term asthma control medication, such as an inhaled corticosteroid, or if you have severe asthma. Your doctor will watch you closely while you take this drug. Once your asthma is controlled, your doctor may take you off of this drug and put you on an inhaled corticosteroid.

Sudden shortness of breath

This drug doesn’t relieve sudden symptoms of asthma or COPD. Always have a rescue inhaler with you to treat sudden symptoms. If you don’t have a rescue inhaler, ask your doctor to prescribe one for you.

When to seek emergency help

If your breathing problems get worse quickly or if your rescue inhaler doesn’t relieve your breathing problems, seek emergency medical help right away.

Thrush

This drug may put you at risk for thrush (a fungal infection in your mouth or throat). To lower your risk of thrush, you should rinse your mouth out with water without swallowing after using this drug.

What is fluticasone-salmeterol?

Fluticasone/salmeterol is a prescription drug. It’s available in these forms: inhalation powder and inhalation aerosol.

Fluticasone/salmeterol isn’t available as a generic drug. It’s only available as the brand-name drugs Advair Diskus, Advair HFA, and AirDuo RespiClick.

Fluticasone/salmeterol is a combination of two drugs, fluticasone and salmeterol, in a single form. It’s important to know both drugs in the combination because each drug may affect you in a different way.

Fluticasone/salmeterol may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

This drug is a combination of two drugs in a single form that work in different ways to treat asthma and chronic obstructive pulmonary disease (COPD).

How it works

Fluticasone belongs to a class of drugs called inhaled corticosteroids. Salmeterol belongs to a class of drugs called long-acting beta-adrenergic agonists.

More Details

How it works

Fluticasone belongs to a class of drugs called inhaled corticosteroids. Salmeterol belongs to a class of drugs called long-acting beta-adrenergic agonists. A class of drugs is a group of medications that work in a similar way. They’re often used to treat similar conditions.

Fluticasone helps decrease inflammation in your lungs to help you breathe better.

Salmeterol helps the muscles around the airways in your lungs stay relaxed. This prevents symptoms such as wheezing, cough, chest tightness, and shortness of breath. This can help you breathe better.

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SECTION 2 of 4

fluticasone-salmeterol Side Effects

Inhalation powder

More Common Side Effects

The adult side effects for this drug are slightly different from the side effects for children.

  • Adult side effects can include:

    • upper respiratory tract infections
    • throat irritation
    • hoarseness, voice changes, and trouble speaking
    • fungal infections in your mouth or throat (thrush). Rinse your mouth with water without swallowing after taking this drug to help prevent this.
    • bronchitis
    • cough
    • headache
    • nausea and vomiting
    • muscle and bone pain
    • dizziness
    • pneumonia
  • The more common side effects for the treatment of asthma in children can include:

    • infections in the ear, nose, and throat

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Thrush (fungal infections in your mouth or throat). Rinse your mouth with water without swallowing after using this drug to help reduce your risk. Symptoms can include:

    • redness and soreness of your throat
    • white spots in your mouth or throat
    • dry mouth
    • trouble swallowing or pain when swallowing
  • Pneumonia. People with COPD have a higher chance of pneumonia. This drug may also increase your chance of pneumonia. Symptoms can include:

    • increase in mucus (sputum) production
    • change in mucus color
    • fever
    • chills
    • increased cough
    • increased breathing problems
  • Infections. Symptoms can include:

    • runny or stuffy nose
    • sore throat
    • drainage from your ear
    • ear pain
    • fever
    • fatigue
  • Adrenal insufficiency (reduced adrenal function).This is a condition where the adrenal glands don’t make enough steroid hormones. This can happen when you stop taking oral corticosteroid drugs (such as prednisone) and start taking fluticasone/salmeterol. When your body is under stress, such as from a fever, trauma (such as a car accident), infection, surgery, or worse COPD symptoms, this condition can get worse. It may even be fatal. Symptoms can include:

    • tiredness
    • loss of energy
    • weakness
    • nausea and vomiting
    • low blood pressure, which may make you feel dizzy or faint
  • Sudden trouble breathing right after you inhale your medication

  • Serious allergic reactions. Symptoms can include:

    • skin rash
    • hives
    • swelling of your face, mouth, and tongue
    • breathing problems
  • Heart problems. Symptoms can include:

    • high blood pressure. Symptoms can include:
      • headache
    • fast or irregular heart rate
    • chest pain
  • Nervous system problems. Symptoms can include:

    • tremors
    • nervousness
  • Bone thinning or weakness (osteoporosis). Symptoms can include:

    • a bone break that happens more easily than expected
    • height loss or stooped posture if your spine is affected
  • Slowed growth in children. Your child’s doctor should check their growth often during treatment with this drug.

  • Eye problems, including glaucoma and cataracts. You should have regular eye exams while taking this drug.

    • eye pain
    • blurred vision
    • seeing bright circles (halos) around lights
    • loss of night vision
    • light sensitivity
    • yellow tint to your vision
  • Churg-strauss syndrome or other conditions due to changes due to an increase in a type of white blood cell (eosinophil). Symptoms can include:

    • red spotty rash
    • muscle or joint pain
    • chest pain
    • numbness or altered sensations due to nerve involvement
    • rapidly worsening shortness of breath or wheezing
  • Low potassium. Symptoms can include:

    • muscle cramps
    • muscle twitches
    • increased urination
    • increased thirst
    • irregular heart beat
  • High blood sugar (hyperglycemia). Symptoms can include:

    • increased urination
    • increased thirst
    • fatigue
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug doesn’t cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

fluticasone-salmeterol May Interact with Other Medications

Inhalation powder

Fluticasone/salmeterol can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications that might interact with this drug

Antibiotics

These drugs may increase the amount of fluticasone/salmeterol in your body. This may cause more side effects.

Examples of these drugs include:

  • clarithromycin
  • telithromycin
  • chloramphenicol

Antifungal drugs

Certain antifungal drugs may increase the amount of fluticasone/salmeterol in your body. This may cause more side effects.

Examples of these drugs include:

  • itraconazole
  • ketoconazole
  • voriconazole

Also, taking other depression drugs with fluticasone/salmeterol may cause heart rhythm problems. This includes prolonging the QT interval.

Examples of these drugs include:

  • tricyclic antidepressants, such as:
    • amitriptyline
    • clomipramine
    • doxepin
    • imipramine
    • nortriptyline
    • protriptyline
  • monoamine oxidase inhibitors (MAOIs), such as:
    • isocarboxazid
    • phenelzine
    • tranylcypromine
    • selegiline
    • rasagiline

Depression drugs

Certain depression drugs may increase the amount of fluticasone/salmeterol in your body. This may cause more side effects.

Examples of these drugs include:

  • nefazodone

High blood pressure and heart drugs

These drugs can block the action of salmeterol and cause the vessels in your lung to tighten or constrict. This may make it harder for you to breathe or put you at a higher risk for lung spasms or asthma attacks.

Examples of these drugs include:

  • beta blockers, such as:
    • acebutolol
    • atenolol
    • betaxolol
    • bisoprolol
    • esmolol
    • metoprolol
    • nadolol
    • nebivolol
    • penbutolol
    • pindolol
    • propranolol
    • sotalol
    • timolol

Human immunodeficiency virus (HIV) drugs

Certain HIV drugs may increase the amount of fluticasone/salmeterol in your body. This may cause more side effects.

Examples of these drugs include:

  • ritonavir
  • atazanavir
  • indinavir
  • nelfinavir
  • saquinavir

Water pills (diuretics)

Water pills may decrease the amount of potassium in your blood. Rarely, fluticasone/salmeterol can also lower potassium. Taking these drugs puts you at increased risk for low potassium.

Examples of these drugs include:

  • furosemide
  • bumetanide
  • torsemide
  • metolazone
  • chlorthalidone
  • hydrochlorothiazide

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
heart problems
People with heart problems, including high blood pressure

This drug may cause chest pain, high or low blood pressure, fast heart rate, and irregular heart rhythms. If you have heart problems, you may be at greater risk. Let your doctor know if you have heart disease.

seizures
People with seizures

This drug may cause seizures. Let your doctor know if you have a seizure disorder.

thyroid problems
People with thyroid problems

Thyroid problems may make your body process this drug differently. Your doctor may need to change your dose.

diabetes
People with diabetes

This drug may increase your blood sugar levels.

liver problems
People with liver problems

This drug is processed by your liver. If your liver doesn’t work well, more of this medication will stay in your body longer. This puts you at risk for side effects. Your doctor will watch you closely.

osteoporosis
People with weak bones (osteoporosis)

This drug can cause decreases in bone strength. If you have risk factors for osteoporosis, your doctor will watch you closely to make sure that this medication is safe for you.

immune system problems
People with immune system problems

This drug may increase your risk for infections. Avoid contact with people who have contagious diseases, such as chicken pox or measles.

eye problems
People with eye problems

This drug can cause eye problems, such as increased pressure inside your eyes, glaucoma, and cataracts. Let your doctor know if you have a history of these eye problems. You should have your vision checked regularly.

Pregnant women
Pregnant women

This drug is a category C pregnancy drug. That means two things: 

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus. 

Tell your doctor if you’re pregnant or plan to become pregnant. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

breast-feeding
Women who are breast-feeding

It isn’t known if this drug passes into breast milk. If it does, it may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby.

seniors
For seniors

People ages 65 years and older who take this drug for chronic obstructive pulmonary disease (COPD) may have more severe side effects, including pneumonia.

It’s unknown if seniors who take this drug for asthma respond differently than younger people do.

children
For children

This drug hasn’t been studied in children and shouldn’t be used in children younger than 18 years for the treatment of chronic obstructive pulmonary disease (COPD).

For asthma, Advair Diskus hasn’t been studied in young children and shouldn’t be used in children younger than 4 years. AirDuo RespiClick and Advair HFA haven’t been studied in children and shouldn’t be used in children younger than 12 years.

call the doctor
When to call the doctor

Call your healthcare provider or get medical care right away if: 

  • your breathing problems get worse.
  • you need to use your rescue inhaler more often than usual.
  • your rescue inhaler doesn’t work as well to relieve your symptoms.
  • you need to use 4 or more inhalations of your recue inhaler in 24 hours for 2 or more days in a row.
  • you use 1 whole canister of your rescue inhaler in 8 weeks.
  • your peak flow meter results decrease. Your healthcare provider will tell you the numbers that are right for you.
  • you have asthma and your symptoms don’t improve after using this drug regularly for 1 week.
allergies
Allergies

This drug can cause a severe allergic reaction. Symptoms can include:

  • skin rash
  • hives
  • swelling of your face, mouth, and tongue
  • breathing problems 

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room. 

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

SECTION 4 of 4

How to Take fluticasone-salmeterol (Dosage)

Inhalation powder

All possible dosages and forms may not be included here. Your doctor will tell you what dosage is right for you. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Asthma

Brand: Advair Diskus

Form: Inhalation powder
Strengths: 100 mcg fluticasone/50 mcg salmeterol, 250 mcg fluticasone/50 mcg salmeterol, 500 mcg fluticasone/50 mcg salmeterol

Brand: Advair HFA

Form: Inhalation aerosol
Strengths: 45 mcg fluticasone/21 mcg salmeterol, 115 mcg fluticasone/21 mcg salmeterol, 230 mcg fluticasone/21 mcg salmeterol

 

Inhalation powder (Advair Diskus):

Adult dosage (ages 18–64 years)
  • 1 inhalation taken by mouth twice daily, about 12 hours apart. 
  • Your doctor will decide your inhaler strength based on how severe your asthma is.
  • If you have shortness of breath in between doses, use your rescue inhaler for relief.
Child dosage (ages 12–17 years)
  • 1 inhalation taken by mouth twice daily, about 12 hours apart.
  • Your doctor will decide your inhaler strength based on how severe your asthma is.
  • If you have shortness of breath in between doses, use your rescue inhaler for relief.
Child dosage (ages 4–11 years)

1 inhalation of 100 mcg fluticasone/50 mcg salmeterol taken by mouth twice daily, about 12 hours apart.

Child dosage (ages 0–3 years)

This drug hasn’t been studied in young children and shouldn’t be used in children younger than 4 years.

Inhalation powder (AirDuo RespiClick)

Adult dosage (ages 18–64 years)
  • 1 inhalation twice daily, about 12 hours apart.
  • Your doctor will decide your inhaler strength based on how severe your asthma is.
  • If you have shortness of breath in between doses, use your rescue inhaler for relief.
Child dosage (ages 0–11 years)

This medication hasn’t been studied in children and shouldn’t be used in children younger than 12 years.

Child dosage (ages 12–17 years)
  • 1 inhalation twice daily, about 12 hours apart.
  • Your doctor will decide your inhaler strength based on how severe your asthma is.
  • If you have shortness of breath in between doses, use your rescue inhaler for relief.

Inhalation aerosol (Advair HFA):

Adult dosage (ages 18–64 years)
  • 2 inhalations taken by mouth twice daily, about 12 hours apart. 
  • Your doctor will decide your inhaler strength based on how severe your asthma is.
  • If you have shortness of breath in between doses, use your rescue inhaler for relief. 
Child dosage (ages 12–17 years)
  • 2 inhalations taken by mouth twice daily, about 12 hours apart. 
  • Your doctor will decide your inhaler strength based on how severe your asthma is.  
  • If you have shortness of breath in between doses, use your rescue inhaler for relief.
Child dosage (ages 0–11 years)

This medicine hasn’t been studied in children and shouldn’t be used in children younger than 12 years.

Senior dosage (ages 65 years and older)

The liver and kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor will monitor you closely.

Coronary obstructive pulmonary disease (COPD)

Brand: Advair Diskus

Form: Inhalation powder
Strengths: 100 mcg fluticasone/50 mcg salmeterol, 250 mcg fluticasone/50 mcg salmeterol, 500 mcg fluticasone/50 mcg salmeterol
Adult dosage (ages 18–64 years)
  • 1 inhalation of 250 mcg fluticasone/50 mcg salmeterol taken by mouth twice daily, about 12 hours apart.
  • If you have shortness of breath in between doses, use your rescue inhaler for relief.
Child dosage (ages 0–17 years)

This medicine hasn’t been studied in children and shouldn’t be used in children younger than 18 years for the treatment of chronic obstructive pulmonary disease (COPD).

Senior dosage (ages 65 years and older)

The liver and kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor will monitor you closely.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug comes with serious risks if you don't take it as prescribed.

If you don't take it at all

Your asthma or chronic obstructive pulmonary disease (COPD) symptoms will get worse. Your lung function will decline and you’ll have more trouble breathing.

If you stop taking it suddenly

You may not feel anything right away. Eventually your asthma or COPD symptoms will get worse and you may need to use your rescue inhaler more often.

If you don't take it on schedule

Your asthma or COPD symptoms will get worse. Be sure to take it as prescribed, with your doses about 12 hours apart.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • worsening shortness of breath
  • chest pain
  • increased hart rate
  • shakiness

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

If you miss a dose, just skip that dose. Take your next dose at your usual time. Don’t take two doses at one time to try to make up for the missed dose.

How to tell if the drug is working

Your asthma or COPD symptoms will be better controlled. You’ll have fewer attacks or sudden symptoms of trouble breathing.

This drug is used for long-term treatment.

Store this drug carefully

  • Store this drug at room temperature between 68°F and 77°F (20°C and 25°C). Keep it away from high temperatures.
  • Keep this drug in a dry place away from heat and sunlight.
  • Don’t store this medication in moist or damp areas, such as bathrooms.
  • Store Advair Diskus in the unopened foil pouch and only open it when you’re ready to take it.
  • Safely throw away Advair Diskus in the trash one month after you open the foil pouch or when the counter reads 0, whichever comes first.
  • The contents of your Advair HFA are under pressure. Don’t puncture the case it comes in or store it near heat or open flame. Temperatures above 120°F may cause the canister to burst.
  • Don’t throw the container that your drug comes in into fire or an incinerator.
  • Safely throw away Advair HFA in the trash when the counter reads 000.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt this medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Your doctor may have you monitor your lung function. You may be asked to record your symptoms or monitor how well your lungs are working with a peak flow meter. Your doctor will show you how to use a peak flow meter.

Follow the instructions that come with your inhaler carefully. Your doctor or pharmacist will show you how to use your inhaler.

Clinical monitoring

You’ll have your lung function monitored through the following tests to make sure this drug is working:

  • pulmonary function tests (PFTs): Your doctor will do these tests to measure how well your lungs are working.
  • peak flow results: Your doctor may have you check your lung function at home. You may be asked to record your symptoms or monitor how well your lungs are working with a peak flow meter. 

Your doctor should also check the following while you take this drug:  

  • bone strength: This drug may lower your bone strength.
  • growth in children: This drug may lead to slowed or delayed growth problems.
  • eyes: This drug may lead to serious eye problems, such as cataracts or glaucoma.
  • blood. This drug can cause changes in some blood test results, such as sugar, potassium, and certain types of white blood cells.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other options that may work for you.

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on May 17, 2017

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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