Advair Diskus

The usual recommended dose for adults and children 4 years of age and older is one inhalation of the appropriate strength (as recommended by your doctor) twice daily.

Gargle with water after each use to prevent hoarseness and thrush of the mouth and throat.

Read the package insert or speak with your pharmacist forinstructions on using the dispenser properly.

To make sure the medication remains effective, it is very important to use it regularly twice a day, exactly as prescribed by your doctor, even when you are not experiencing symptoms of asthma or COPD. To prevent side effects, do not use Advair Diskus more often than prescribed.

Many things can affect the dose of medication that a person needs, such as the severity of the condition, body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

If you miss a dose of Advair Diskus, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Advair Diskus at room temperature, in a dry place, and keep it out of the reach of children. Keep the device closed when not in use.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause an infection of the mouth or throat, known as thrush; it may cause headaches; it may cause hoarseness; it may cause palpitations (rapid and strong heart beat); it may irritate your throat; it may cause shakiness. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Advair Diskus

Advair 100 Diskus
A plastic inhaler device containing a foil strip with 28 or 60 blisters. Each blister contains 50 µg of salmeterol (as the xinafoate salt) and 100 µg of fluticasone propionate. Nonmedicinal ingredient: lactose (milk sugar), including milk protein, which acts as the "carrier".

Advair 250 Diskus
A plastic inhaler device containing a foil strip with 28 or 60 blisters. Each blister contains 50 µg of salmeterol (as the xinafoate salt) and 250 µg of fluticasone propionate. Nonmedicinal ingredient: lactose (milk sugar), including milk protein, which acts as the "carrier".

Advair 500 Diskus
A plastic inhaler device containing a foil strip with 28 or 60 blisters. Each blister contains 50 µg of salmeterol (as the xinafoate salt) and 500 µg of fluticasone propionate. Nonmedicinal ingredient: lactose (milk sugar), including milk protein, which acts as the "carrier".

Do not use Advair Diskus if you:

• are allergic to salmeterol, fluticasone, or any ingredients of the medication
• are allergic to lactose or milk (Diskus only)
• have abnormal rapid heart rhythms known as tachyarrhythmias
• have status asthmaticus or are experiencing an asthma attack
• have untreated fungal, bacterial, or tuberculous infections of the lungs

There may be an interaction between salmeterol - fluticasone and any of the following:

• Aldesleukin
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• anti-psychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, olanzepine, Quetiapine, Risperidone)
• Atomoxetine
• "azole" antifungals (e.g., fluconazole, itraconazole, ketoconazole, Voriconazole)
• BCG
• beta-blocker medications (e.g., Propranolol, Metoprolol, Atenolol, Labetalol)
• beta2-agonists (e.g., salbutamol, terbutaline, formoterol, Indacaterol)
• Betahistine
• caffeine
• cannabis
• chloroquine
• Cobicistat
• conivaptan
• Cyclosporine
• decongestant cold medications (e.g., phenylephrine, Pseudoephedrine)
• decongestant eye drops and nose sprays (e.g., naphazoline, oxymetazoline, xylometazoline)
• Deferasirox
• Degarelix
• Desmopressin
• Digoxin
• Diltiazem
• dipivefrin
• Disopyramide
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• dofetilide
• Domperidone
• Dronedarone
• echinacea
• Epinephrine
• Fingolimod
• Flecainide
• grapefruit juice
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delaviridine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• Leflunomide
• Linezolid
• Lomitapide
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Methadone
• Methylphenidate
• mifepristone
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• Nabilone
• Natalizumab
• nefazodone
• Nivolumab
• Pimecrolimus
• Primaquine
• procainamide
• protein kinase inhibitors (e.g., Lapatinib, Pazopanib, Sunitinib)
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin, Ofloxacin, sparfloxacin)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• serotonin antagonists (anti-emetics; Granisetron, Ondansetron)
• simeprevir
• Stiripentol
• Tacrolimus
• Tetrabenazine
• theophyllines (e.g., Aminophylline, Oxtriphylline, Theophylline)
• Tofacitinib
• tricylic antidepressants (e.g. Amitriptyline, Clomipramine, Desipramine)
• vaccines
• Verapamil

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Advair Diskus. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Advair Diskus.

Asthma: When used for alone for asthma treatment, salmeterol has been linked to an increase in asthma-related deaths. Salmeterol - fluticasone should only be used when a regular inhaled corticosteroid (e.g., fluticasone) and a fast acting "reliever" medication (e.g., salbutamol) do not adequately control your symptoms.

If you start developing asthma symptoms, be sure to use your reliever medication for rapid relief of your asthma symptoms. It is very important that you have your reliever medication with you at all times. If you experience worsening symptoms or your reliever medications are not as effective as usual, contact your doctor or seek medical attention immediately.

Blood Pressure: Salmeterol can cause blood pressure to increase, particularly at higher doses. If you have high blood pressure, discuss with your doctor how Advair Diskus may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Advair Diskus, and whether any special monitoring is needed.

Diabetes: Both fluticasone and salmeterol may cause an increase in blood sugar levels. If you have diabetes, you may find it necessary to monitor your blood sugar more frequently while using Advair Diskus. If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Advair Diskus may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Advair Diskus, and whether any special monitoring is needed.

Eye problems: If you are at risk of developing Glaucoma or Cataracts, have your eyes checked by your doctor before starting long-term treatment with Advair Diskus. You should have your eyes monitored at regular intervals while using Advair Diskus.

Growth effects: Long-term use of corticosteroids, including inhaled forms such as Advair Diskus, may slow the growth of children and adolescents. It is important to use the lowest effective dose for managing asthma symptoms. Talk to your doctor if you have any concerns.

Heart rhythm: Beta-agonists such as salmeterol can cause changes to the normal rhythm of the heart, including an irregular heartbeat called QT prolongation. QT prolongation is a serious life-threatening condition that can cause fainting, seizures, and sudden death.

Salmeterol can cause a fluttering of the heartbeat (atrial fibrillation) or rapid heart beat, increased blood pressure, chest pain and decreased oxygen reaching the heart muscle.

If you are at risk for heart rhythm problems (e.g., people with heart failure, Angina, low potassium or magnesium levels), discuss with your doctor how Advair Diskus may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Advair Diskus, and whether any special monitoring is needed.

Infections: Corticosteroids, such as fluticasone, can reduce your body's ability to fight infections and may hide signs of infection that is developing. Infections such as Chickenpox and Measles can be more serious in people taking medications such as fluticasone. If you are exposed to someone with chickenpox or measles, contact your doctor.

Inhalation-induced bronchospasm: Inhaled forms of medications may cause spasms of the airways, which make breathing difficult. If you experience this problem when using salmeterol - fluticasone, stop using Advair Diskus immediately. Speak to your doctor if you experience any problems with breathing while taking this or other inhaled medication.

Oral hygiene: Adequate oral hygiene, such as rinsing your mouth with water after using Advair Diskus, helps reduce the chances of developing a yeast infection of the mouth or throat (thrush). If you develop symptoms of thrush, such as white patches in your mouth, contact your doctor.

Osteoporosis: Long-term use of corticosteroids, including inhaled corticosteroids such as fluticasone, may increase the risk of bone loss and osteoporosis. If your doctor recommends that you use Advair Diskus for a lengthy period of time, talk to your doctor about supplements and strategies to slow down and reduce bone loss.

Steroid medication use: If you have taken oral steroid medications over the last several months or are still taking oral corticosteroids, consult with your doctor before using Advair Diskus. In times of stress or during a severe asthma attack, your doctor may want you to start your oral steroid medication again.

Stopping medication: Do not stop Advair Diskus abruptly, as this may cause your condition to get worse. When Advair Diskus is stopped, it should be stopped gradually as directed by your doctor.

Thyroid disease: People who have an over-active thyroid gland may be more sensitive to the effects of salmeterol - fluticasone. If you have thyroid disease, discuss with your doctor how Advair Diskus may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Advair Diskus, and whether any special monitoring is needed.

Worsening symptoms: If you find you need to use your short-acting "rescue" inhaler more often or if your condition seems to worsen, call your doctor. If you have not been given instructions beforehand, contact your doctor immediately about what to do if any of the following situations occur (they may be signs of seriously worsening asthma):

• decreased effectiveness of short-acting, inhaled bronchodilators such as salbutamol, terbutaline, or fenoterol (less than 4 hours of relief)
• need for more inhalations than usual of short-acting, inhaled bronchodilators
• peak flow meter showing results in the below-normal range

Pregnancy: Advair Diskus should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Advair Diskus, contact your doctor immediately.

Breast-feeding: Advair Diskus passes into breast milk. If you are a breast-feeding mother and are taking salmeterol - fluticasone, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of the Diskus form of Advair Diskus have not been established for children less than 4 years of age. The safety and effectiveness of the inhaler form of Advair Diskus have not been established for children less than 12 years of age.

To use this inhaler, follow these steps: Remove the cap and shake the inhaler well with the mouthpiece down. Tilt your head back slightly. Slowly breathe all the way out. Place the mouthpiece in your mouth between your teeth and close your lips around it -- do not bite it. Start to breathe in, then press down on the canister once, while continuing to breathe in slowly and deeply. Hold your breath for 10 seconds then breathe out slowly. If you have been instructed to use more than one puff, wait 30 seconds before repeating the above steps. If you find it difficult to use this technique, ask your pharmacist for a spacer device; these devices make using an inhaler much easier. Clean your inhaler once a week. This medication is typically used twice a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. Using this product may cause throat irritation and coughing. You can avoid these problems by thoroughly rinsing your mouth and gargling after each dose. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up.