Advair is a brand-name prescription medication. It comes in two forms: Advair Diskus and Advair HFA. Both forms contain two active drugs:

  • fluticasone propionate, which is a corticosteroid
  • salmeterol, which is a long-acting beta2-agonist (LABA)

The two forms of Advair have different uses. Advair Diskus is used to treat asthma and chronic obstructive pulmonary disease (COPD), while Advair HFA is only used to treat asthma.

Advair Diskus vs. Advair HFA

Advair Diskus is:

  • Approved by the Food and Drug Administration (FDA) to treat asthma in adults and children ages 4 years and older.
  • FDA-approved as a maintenance (ongoing) treatment for adults with COPD. It can reduce the number of COPD exacerbations (flare-ups) that people have.

Advair HFA is:

  • FDA-approved to treat asthma in adults and children ages 12 years and older.
  • Not approved to treat COPD.

Advair Diskus and Advair HFA contain the same active ingredients but come in different types of inhalers.

Advair Diskus is an inhalation powder. To use the Advair Diskus inhaler, you breathe in deeply to take the medication into your mouth.

Advair HFA is an inhalation aerosol. To use the Advair HFA inhaler, you press down on the top of the canister to deliver a spray of medication into your mouth.

The two products contain different strengths of fluticasone propionate and salmeterol. They also have different recommended dosages, based on the condition they’re being used to treat.

You shouldn’t switch from using one Advair product to the other unless your doctor tells you to.

Effectiveness

Advair Diskus has been found to be effective for treating asthma and COPD. Advair HFA has been found to be effective for treating asthma. For more information, see the “Advair Uses” section.

Advair HFA is available only as a brand-name medication. It’s not currently available in generic form.

Advair HFA contains two active drug ingredients: fluticasone propionate and salmeterol.

Advair Diskus is available in a generic form called Wixela Inhub. It contains the same active drugs as Advair Diskus. For more details, see the “Advair vs. Wixela” section below.

Advair can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Advair. These lists do not include all possible side effects.

For more information on the possible side effects of Advair, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

More common side effects

The more common side effects of Advair can include:

  • headache
  • dizziness
  • nausea
  • vomiting
  • throat irritation
  • strained or hoarse voice
  • muscle pain
  • bone pain

Other common side effects, explained below in “Side effect details,” include:

  • thrush (fungal infection in your mouth or throat)
  • upper respiratory infections, such as the common cold or sinus infections

These side effects may vary depending on which Advair device you use and the condition you’re using Advair to treat.

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

Serious side effects

Serious side effects from Advair aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects may vary based on which Advair device you use and the condition you’re using Advair to treat.

Serious side effects and their symptoms can include the following:

  • Reduced function of your adrenal gland (a hormone-producing gland). Symptoms can include:
    • fatigue (lack of energy)
    • weakness
    • hypoglycemia (low blood sugar)
    • nausea
    • vomiting
  • Paradoxical bronchospasm (unexpected tightening of your airways). Symptoms can include:
    • cough
    • trouble breathing that doesn’t get better with use of your inhaler
  • Decrease in bone density, which can lead to osteoporosis. Symptoms can include:
    • fractures
  • Eye problems, such as glaucoma and cataracts. Symptoms can include:
    • increased pressure in your eyes
    • blurry vision
    • changes in vision
  • Increased risk for serious infections, such as measles and chickenpox. Symptoms can include:
    • fever
    • cough
    • chills
    • fatigue (lack of energy)
    • rash
  • Serious allergic reaction. See the “Side effect details” section below.
  • Pneumonia (in people with COPD). See “Side effect details” below.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s more detail on some of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Advair. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

In clinical studies, allergic reactions occurred in 1%–3% of people who took Advair HFA. However, it’s not known if these reactions were caused by the drug. It’s also not known how many people who took Advair Diskus in clinical studies had an allergic reaction.

It’s important to note that Advair Diskus contains milk proteins in the drug powder. These milk proteins can cause serious allergic reactions in people with a severe sensitivity to them. You shouldn’t take Advair Diskus if you have a severe allergy to milk proteins.

If you’re unsure of whether you’ve had a severe reaction to milk proteins in the past, talk with your doctor. (Note: Advair HFA does not contain milk proteins.)

Call your doctor right away if you have a severe allergic reaction to Advair. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Thrush

Thrush (a fungal infection in your mouth and throat) is a possible side effect of taking Advair.

In clinical studies, 1% to 4% of people who took Advair Diskus for asthma had thrush. In comparison, 2% of people who took fluticasone propionate (one of the active drugs in Advair Diskus) on its own had thrush. No one who took salmeterol (the other active drug in Advair Diskus) on its own or a placebo (a treatment without an active drug) reported having thrush.

In clinical studies of people with chronic obstructive pulmonary disease (COPD), 10% of people who took Advair Diskus had thrush. This was compared to 6% of people who took fluticasone propionate alone, and 3% of people who took salmeterol alone. Of the people who took a placebo, 1% had thrush.

In clinical studies, 1% to 3% of people who took Advair HFA had thrush. It’s not known how many people in the comparison groups (who took another drug or a placebo) had thrush.

After you take a dose of Advair Diskus or Advair HFA, always rinse your mouth with water. After rinsing, spit out the water (don’t swallow it). Rinsing your mouth helps remove any leftover medication that remains in your mouth, which lowers your risk of getting thrush.

If you get thrush while taking Advair, your doctor will likely prescribe an antifungal drug to treat the infection. Your doctor may advise that you stop taking Advair until the thrush goes away.

Weight gain

Weight gain is possible while taking Advair. In clinical studies, weight gain occurred in 1% to 3% of people who took Advair HFA. Weight gain also occurred in clinical studies of Advair Diskus, but it’s not known how common this side effect is.

If you’re concerned about gaining weight while taking Advair, talk with your doctor.

Blood pressure changes

Salmeterol, one of the active drugs in Advair, may increase blood pressure in some people. This side effect is more common if Advair is taken at higher doses or more frequently than your doctor prescribes.

If you have high blood pressure, talk with your doctor about whether Advair is safe for you.

Pneumonia

Pneumonia may occur in people who take Advair Diskus for COPD.

In a 3-year clinical study, 16% of people who took Advair Diskus for COPD had pneumonia. In comparison, 14% of people who took fluticasone propionate alone had pneumonia, and 11% of people who took salmeterol alone had it. Of the people who took a placebo, 9% had pneumonia. Pneumonia infections were more common in people over the age of 65 years old, compared to those under 65 years old.

In clinical studies of people with asthma, pneumonia wasn’t reported as a side effect in people using Advair Diskus. It also wasn’t reported as a side effect in Advair HFA clinical studies.

Symptoms of pneumonia can include:

  • cough
  • fever
  • sweating
  • shortness of breath
  • chest pain

If you’re concerned about your risk for pneumonia, talk with your doctor.

Upper respiratory infections

Upper respiratory infections, such as the common cold or sinus infections, are common side effects of Advair HFA and Advair Diskus.

  • With Advair HFA:
    • In 12-week clinical studies, 16% to 24% of adults and children (ages 12 to 18 years old) who took Advair HFA for asthma had upper respiratory infections. In comparison, 13% to 17% of people who took fluticasone propionate alone, salmeterol alone, or a placebo had upper respiratory infections.
  • With Advair Diskus:
    • In 12-week clinical studies, 21% to 27% of adults and children (ages 12 to 18 years old) who took Advair Diskus for asthma had upper respiratory infections. In comparison, 14% to 29% of people who took fluticasone propionate alone, salmeterol alone, or a placebo had upper respiratory infections.
    • In 1-year clinical studies, more than 5% of adults who took Advair Diskus for COPD had upper respiratory infections, including nasal congestion and sinus infections.

If you have an upper respiratory infection while taking Advair, tell your doctor. They will determine if you need treatment to clear the infection.

Side effects in children

Many side effects of Advair in children are similar to those seen in adults, with some exceptions.

Advair Diskus is approved for use in children ages 4 years and older with asthma. In a clinical study, children ages 4 to 11 years old who took Advair Diskus had more ear, nose, and throat infections and throat irritation than adults and children ages 12 years and older.

Advair HFA is approved for use in children ages 12 years and older with asthma. A clinical study of Advair HFA did not find any additional side effects in children ages 12 years and older, compared with adults.

However, the use of inhaled corticosteroids such as fluticasone propionate, a drug in Advair, may slow down the growth of children. A clinical study of fluticasone propionate use in children ages 4 to 11 years old was done to determine whether fluticasone propionate slows growth. The results of this study weren’t conclusive, though.

To reduce the risk of slowed growth, children who are still growing should take the lowest dose of Advair that controls their asthma symptoms. If you’re concerned about your child’s growth while they’re taking Advair, talk with their doctor.

The Advair dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Advair to treat
  • your age
  • the form of Advair you take

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Advair comes in two forms: Advair Diskus and Advair HFA.

Advair Diskus

Advair Diskus is an inhalation powder. To use the inhaler, you breathe in deeply to take in the medication from the device. Advair Diskus is available in the following strengths:

  • 100/50: 100 micrograms (mcg) fluticasone propionate and 50 mcg salmeterol per puff
  • 250/50: 250 mcg fluticasone propionate and 50 mcg salmeterol per puff
  • 500/50: 500 mcg fluticasone propionate and 50 mcg salmeterol per puff

Each Advair Diskus inhaler contains 60 inhalations (puffs). The Diskus has a counter that tells you how many doses are left in the device.

Advair HFA

Advair HFA is an inhalation aerosol. Its inhaler delivers a spray of medication when you press down on the top of the canister. Advair HFA is available in the following strengths:

  • 45/21: 45 mcg fluticasone propionate and 21 mcg salmeterol per puff
  • 115/21: 115 mcg fluticasone propionate and 21 mcg salmeterol per puff
  • 230/21: 230 mcg fluticasone propionate and 21 mcg salmeterol per puff

Advair HFA inhalers can contain either 60 puffs or 120 puffs. The HFA inhaler has a counter that tells you how many doses are left in the device.

Dosage for asthma

The usual dosage of Advair Diskus for adults with asthma is one puff twice a day. Your dosage strength may be 100/50, 250/50, or 500/50, depending on how severe your asthma is.

The usual dosage of Advair HFA for adults with asthma is two puffs twice a day. Your dosage strength may be 45/21, 115/21, or 230/21, depending on how severe your asthma is.

Dosage for COPD

The usual dosage of Advair Diskus for adults with COPD is one puff twice a day. The recommended strength of Advair Diskus to treat COPD is 250/50.

Advair HFA is not approved by the Food and Drug Administration to treat COPD.

Pediatric dosage for asthma

The usual dosage of Advair Diskus for children ages 12 to 18 years with asthma is one puff twice a day. A child’s dosage strength may be 100/50, 250/50, or 500/50, depending on how severe their asthma is.

The usual dosage of Advair Diskus for children ages 4 to 11 years old with asthma is one puff twice a day. The recommended strength is 100/50.

The usual dosage of Advair HFA for children ages 12 to 18 years old with asthma is two puffs twice a day. A child’s dosage strength may be 45/21, 115/21, or 230/21, depending on how severe their asthma is.

What if I miss a dose?

If you miss a dose of either Advair Diskus or Advair HFA, just skip that dose. Wait and take your next dose at the usual time.

Don’t take more than one dose at a time. This can increase your risk for serious side effects.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Advair is meant to be used as a long-term treatment. If you and your doctor determine that Advair is safe and effective for you, you’ll likely take it long term.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Advair, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for asthma

Examples of other drugs that may be used to treat asthma include:

  • short-acting beta2-agonists, such as:
    • albuterol (ProAir HFA, Proventil HFA, Ventolin HFA)
    • levalbuterol (Xopenex, Xopenex HFA)
  • short-acting anticholinergics, such as ipratropium (Atrovent HFA)
  • inhaled corticosteroids, such as:
    • beclomethasone (Qvar Redihaler)
    • budesonide (Pulmicort Flexhaler, Pulmicort Respules)
    • ciclesonide (Alvesco)
    • flunisolide (Aerospan HFA)
    • fluticasone furoate (Arnuity Ellipta)
    • fluticasone propionate (Flovent Diskus)
    • mometasone (Asmanex HFA)
  • long-acting beta2-agonists (LABAs), in combination with an inhaled corticosteroid. Examples include:
    • budesonide/formoterol (Symbicort)
    • mometasone/formoterol (Dulera)
    • fluticasone furoate/vilanterol (Breo Ellipta)
    • fluticasone propionate/salmeterol (Wixela Inhub, AirDuo RespiClick)
  • mast cell stabilizers, such as:
    • cromolyn
    • nedocromil
  • antileukotrienes, such as:
    • montelukast (Singulair)
    • zafirlukast (Accolate)
    • zileuton (Zyflo)
  • xanthine derivatives, such as theophylline
  • biologic therapies (drugs made from parts of living organisms), such as:
    • omalizumab (Xolair)
    • mepolizumab (Nucala)
    • reslizumab (Cinqair)
    • benralizumab (Fasenra)
    • dupilumab (Dupixent)

Alternatives for chronic obstructive pulmonary disease

Examples of other drugs that may be used as maintenance (ongoing) treatment of chronic obstructive pulmonary disease (COPD) include:

  • Long-acting anticholinergics, such as:
    • tiotropium (Spiriva)
    • glycopyrrolate (Seebri)
    • aclidinium (Tudorza)
  • Long-acting beta2-agonists (LABAs), such as:
    • formoterol (Foradil, Perforomist)
    • arformoterol (Brovana)
    • salmeterol (Serevent)
    • indacaterol (Arcapta)
    • olodaterol (Striverdi)
  • Combination medications that contain two or more active drugs. Some of these combination medications contain an inhaled corticosteroid, like fluticasone propionate, one of the active drugs in Advair. Examples include:
    • fluticasone furoate/vilanterol (Breo Ellipta)
    • fluticasone furoate/vilanterol/umeclidinium (Trelegy)
    • tiotropium/olodaterol (Stiolto)
    • budesonide/formoterol (Symbicort)
    • glycopyrrolate/formoterol (Bevespi Aerosphere)

You may wonder how Advair compares to other medications that are prescribed for similar uses. Here we look at how Advair and Wixela are alike and different.

Wixela Inhub is the generic form of Advair Diskus.

Note: Wixela Inhub is not a generic form of Advair HFA. There is currently no generic form of Advair HFA.

Uses

Advair Diskus and Wixela Inhub are both approved by the Food and Drug Administration (FDA) to treat adults and children ages 4 years and older with asthma.

They are both also FDA-approved as maintenance (ongoing) treatments of chronic obstructive pulmonary disease (COPD).

Drug forms and administration

Advair Diskus and Wixela Inhub contain the same two active drugs: fluticasone propionate and salmeterol. They’re also both inhalation powders.

Both Advair Diskus and Wixela Inhub are available in the same micrograms (mcg) strengths:

  • 100 mcg of fluticasone propionate/50 mcg of salmeterol
  • 250 mcg of fluticasone propionate/50 mcg of salmeterol
  • 500 mcg of fluticasone propionate/50 mcg of salmeterol

Side effects and risks

Advair and Wixela Inhub contain the same drugs. Therefore, these medications can very cause similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with both Advair and Wixela Inhub (when taken individually). Side effects may differ depending on which Advair device you use and what condition you’re using Advair or Wixela Inhub to treat.

  • Can occur with both Advair and Wixela Inhub:
    • upper respiratory infections, such as the common cold and sinus infections
    • throat irritation
    • thrush (fungal infection in your mouth or throat)
    • cough
    • headache
    • nausea
    • vomiting
    • strained or hoarse voice
    • muscle pain
    • bone pain

Serious side effects

This list contains examples of serious side effects that can occur with both Advair and Wixela Inhub (when taken individually).

  • Can occur with both Advair and Wixela Inhub:
    • reduced function of your adrenal gland (a hormone-producing gland)
    • paradoxical bronchospasm (unexpected tightening of your airways)
    • decrease in bone density, which can lead to osteoporosis
    • eye problems, such as glaucoma and cataracts
    • increased risk for serious infections, such as measles and chickenpox
    • serious allergic reaction
    • pneumonia (in people with COPD)

Effectiveness

The Food and Drug Administration (FDA) approved Wixela Inhub as a generic form of Advair Diskus. This means that Wixela Inhub contains exact copies of the original drugs in Advair Diskus.

FDA-approved generics are expected to have the same effects in your body as the original drugs. This means that Wixela Inhub is considered just as effective in treating asthma and COPD as Advair Diskus.

Costs

Advair Diskus is a brand-name drug. Wixela Inhub is the generic form of Advair Diskus. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Advair costs significantly more than Wixela Inhub. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Advair and Symbicort are prescribed for similar uses. Below are details of how these medications are alike and different.

Advair Diskus and Advair HFA each contain two active drugs: fluticasone propionate and salmeterol.

Symbicort also contains two active drugs: budesonide and formoterol.

Advair and Symbicort can help people with asthma or chronic obstructive pulmonary disease (COPD) breathe more effectively. Both contain a corticosteroid, which reduces inflammation (swelling) in your lungs. Both drugs also contain a long-acting beta2-agonist, which relaxes airway muscles.

Uses

Advair Diskus is approved by the Food and Drug Administration (FDA) to treat asthma in adults and children ages 4 years and older. Advair Diskus is also approved as a maintenance (ongoing) treatment for chronic obstructive pulmonary disease (COPD). It helps reduce the number of COPD exacerbations (flare-ups) people have.

Advair HFA is approved to treat asthma in adults and children ages 12 years and older.

Symbicort is FDA-approved to treat asthma in adults and children ages 6 years and older. It’s also approved as a maintenance treatment for COPD, to reduce the number of COPD flare-ups people have.

Drug forms and administration

Advair Diskus and Advair HFA each contain fluticasone propionate and salmeterol. Advair Diskus is a powder inhaler. Advair HFA is an aerosol inhaler. They are each used twice a day. See the “Advair dosage” section above for more information.

Symbicort contains budesonide and formoterol. It’s an aerosol inhaler that’s used twice daily.

Side effects and risks

Advair and Symbicort contain different drugs. Therefore, some of the side effects these medications can cause are similar and some are different. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Advair, with Symbicort, or with both drugs (when taken individually). Side effects may differ depending on which Advair device you use and what condition you’re using Advair or Symbicort to treat.

  • Can occur with Advair:
    • dizziness
    • nausea
    • throat irritation
    • strained or hoarse voice
    • muscle pain
    • bone pain
  • Can occur with Symbicort:
    • mouth and throat pain
    • influenza
    • back pain
    • stomach discomfort
  • Can occur with both Advair and Symbicort:
    • upper respiratory infections, such as the common cold and sinus infections
    • headache
    • vomiting
    • thrush (fungal infection in your mouth or throat)

Serious side effects

This list contains examples of serious side effects that can occur with Advair or Symbicort (when taken individually).

  • Can occur with both Advair and Symbicort:
    • pneumonia (in people with COPD)
    • reduced adrenal gland (steroid-producing gland) function
    • paradoxical bronchospasm (unexpected tightening of your airways)
    • decrease in bone density, which can lead to osteoporosis
    • eye problems, such as glaucoma and cataracts
    • increased risk for serious infections, such as measles and chickenpox
    • serious allergic reaction

Effectiveness

Advair and Symbicort have different FDA-approved uses, but they’re both used to treat the following conditions:

  • COPD in adults
  • asthma in adults and children ages 12 years and older

The use of Advair and Symbicort as maintenance treatments for COPD has been compared in a real-world effectiveness analysis of U.S. health insurance claims. A real-world effectiveness analysis tests how well the drug works in the real world (not in a controlled setting, which is where a clinical study does testing).

This study looked at health insurance claims for more than 7,000 people with COPD who were new to treatment with either Advair or Symbicort. In this analysis, there were no differences found between Advair and Symbicort in the number of COPD flare-ups.

The use of Advair and Symbicort for the treatment of asthma has also been compared in a database analysis. This analysis included more than 3,000 people with asthma, ages 12 years and older. People who took Symbicort had an 8% lower risk of asthma-related flare-ups than people who took Advair.

Many studies have indirectly and directly compared the use of Advair and Symbicort, with conflicting results. However, Symbicort and both forms of Advair have been found to be effective for treating asthma. Also, Symbicort and Advair Diskus have both been found to be effective as maintenance treatments for COPD.

Costs

Advair and Symbicort are both brand-name drugs. There is a generic form of Advair Diskus (called Wixela Inhub), but there are no generic forms of Advair HFA or Symbicort. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Advair (either type) and Symbicort generally cost about the same. Wixela Inhub, the generic form of Advair Diskus, may cost less than either Advair (either type) or Symbicort. The actual price you’ll pay for a drug will depend on your insurance plan, your location, and the pharmacy you use.

You should take Advair according to your doctor or healthcare provider’s instructions.

You will take either Advair Diskus or Advair HFA as inhalations (puffs) of the medication. The manufacturer of both drugs provides instructions on how to use the Advair Diskus inhaler and how to use the Advair HFA inhaler.

Always rinse your mouth with water after taking a dose of Advair. After rinsing, spit out the water (don’t swallow it). Rinsing your mouth after an Advair dose will reduce your risk for thrush (a fungal infection in your mouth and throat).

When to take

Advair Diskus and Advair HFA are each taken twice a day. You should take your dose of Advair every 12 hours.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

The Food and Drug Administration (FDA) approves prescription drugs such as Advair to treat certain conditions.

Advair for asthma

Advair Diskus is FDA-approved to treat asthma in adults and children ages 4 years and older. Advair HFA is approved to treat asthma in adults and children ages 12 years and older.

Asthma is a chronic (long-term) condition that affects your breathing. Common symptoms include inflammation, muscle tightening, and mucus in your airways. These lung problems can be triggered by illness, breathing in irritants or allergens, exercise, or other causes.

Swelling, mucus, and muscle tightening around airways prevents air from moving through your lungs. When air can’t flow through your lungs effectively, less oxygen gets into your bloodstream. This reduces the amount of oxygen that can be delivered throughout your body.

The effectiveness of Advair Diskus and Advair HFA were measured by using a value called forced expiratory volume in 1 second (FEV1). This measures how much air you can force from your lungs in 1 second. An increase in FEV1 shows better airflow in your lungs.

Advair Diskus effectiveness

Advair Diskus has been found to be effective for treating asthma.

In clinical studies, adults and children ages 12 years and older used either Advair Diskus, fluticasone propionate alone, salmeterol alone, or a placebo (a treatment without an active drug) to treat asthma. At the beginning of the study, people had an FEV1 measurement that was 63% to 72% the amount of a normal FEV1.

After 12 weeks of treatment, people in each group had the following changes in FEV1:

  • FEV1 increase of 23% to 25% with Advair Diskus
  • FEV1 increase of 13% to 15% with fluticasone propionate alone
  • FEV1 increase of 4% to 5% with salmeterol alone
  • FEV1 decrease of 5% to FEV1 increase of 1% with a placebo

Advair HFA effectiveness

Advair HFA has been found effective in treating asthma in adults and children aged 12 years and older.

In 12-week clinical studies, people with asthma took either Advair HFA, fluticasone propionate alone, salmeterol alone, or a placebo. The effectiveness of Advair HFA was measured using FEV1 at the end of the study. After 12 weeks of treatment, people in each group had the following changes in FEV1.

  • FEV1 increase of 20% to 33% in people who took Advair HFA
  • FEV1 increase of 9% to 25% in people who took fluticasone propionate alone
  • FEV1 increase of 8% to 22% in people who took salmeterol alone
  • FEV1 decrease of 6% to increase of 5% in people who took a placebo

Advair for chronic obstructive pulmonary disease

Advair Diskus is FDA-approved as a maintenance (ongoing) treatment of chronic obstructive pulmonary disease (COPD). It’s approved to reduce the number of COPD exacerbations (flare-ups) that people have.

COPD is a group of conditions, including emphysema and chronic bronchitis.

Emphysema causes damage to your alveoli (small air sacs in your lungs). This makes it hard to breathe air out of your lungs. Chronic bronchitis is characterized by swelling in your airways and narrowing of the bronchial tubes (the main airways in your lungs). Both conditions make it harder for your body to get the oxygen it needs.

Advair Diskus has also been found to be effective as a maintenance treatment for COPD.

In a 3-year clinical study, the effectiveness of Advair was tested by measuring the number of COPD exacerbations (flare-ups) that people had in 1 year. Exacerbations were considered moderate to severe if they required treatment with additional steroids or antibiotics, or treatment in the hospital. People in the study took either Advair Diskus, fluticasone propionate alone, salmeterol alone, or a placebo.

The study found that people who took Advair Diskus had:

  • 12.2% fewer moderate to severe flare-ups per year than people who took salmeterol alone
  • 9% fewer moderate to severe flare-ups per year than people who took fluticasone propionate alone
  • 25.1% fewer moderate to severe flare-ups per year than people who took a placebo

Advair for children

Advair Diskus is FDA-approved to treat asthma in children ages 4 years and older.

In a clinical study, the effectiveness of Advair Diskus in children ages 4 to 11 years old with asthma was compared with taking fluticasone propionate alone. The study used a value called FEV1 to measure how much air children could force from their lungs in 1 second. FEV1 is measured in liters (L), and an increase in FEV1 shows better airflow in the lungs.

After 12 weeks of treatment, improvements of FEV1 were:

  • from 1.70 L at the beginning of the study to 1.88 L after 12 weeks of taking Advair Diskus
  • from 1.65 L at the beginning of the study to 1.77 L after 12 weeks of taking fluticasone propionate alone

Advair HFA is approved to treat asthma in children ages 12 years and older. See “Advair HFA effectiveness” above for more details about the medication’s effectiveness in adults and children 12 years and older.

Advair Diskus and Advair HFA are both used as a daily treatment to control symptoms of asthma or chronic obstructive pulmonary disease (COPD). They are not used to treat flare-ups of either condition. This is because they don’t work quickly enough to relieve your symptoms in an emergency situation.

Your doctor will likely prescribe a rescue inhaler for you, which you should keep with you at all times. A rescue inhaler works rapidly to improve your breathing. Examples of rescue inhalers include albuterol (ProAir HFA, Ventolin HFA) and levalbuterol (Xopenex, Xopenex HFA).

There is no known interaction between Advair and alcohol.

However, studies have found that chronic alcohol drinking can damage the cilia in your airways. Cilia are small, hair-like structures that help trap and remove germs from the air you breathe. Damaged cilia make it easier for germs to cause infections in your lungs. Chronic drinking can also decrease your immune system’s ability to fight off infections.

These effects can lead to a higher risk for serious infections, such as pneumonia. They can also make your symptoms of asthma or chronic obstructive pulmonary disease (COPD) worse.

If you drink alcohol, talk with your doctor about how much alcohol is safe for you to drink.

Advair can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Advair and other medications

Below is a list of medications that can interact with Advair. This list does not contain all drugs that may interact with Advair.

Before taking Advair, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Advair and certain HIV drugs

Taking Advair with certain drugs used to treat viral infections, such as HIV, can increase levels of fluticasone propionate and salmeterol in your body. This is because certain antiviral drugs prevent the breakdown of fluticasone propionate and salmeterol in your body. Higher levels of fluticasone propionate and salmeterol can increase your risk for serious side effects.

Examples of antiviral drugs that can increase fluticasone propionate levels include:

  • ritonavir (Norvir)
  • atazanavir (Reyataz)
  • indinavir (Crixivan)
  • nelfinavir (Viracept)
  • saquinavir (Invirase)

Taking Advair with these antiviral drugs is not recommended. If you are undergoing treatment for HIV while taking Advair, your doctor may prescribe a different HIV medication.

Advair and certain antibiotics or antifungal drugs

Taking Advair with certain antibiotic or antifungal drugs can increase your risk for serious side effects. This is because these antibiotics or antifungal drugs prevent the breakdown of fluticasone propionate and salmeterol in your body. This causes higher than usual levels of fluticasone propionate and salmeterol.

An example of an antibiotic drug that can increase fluticasone propionate and salmeterol levels in your body is clarithromycin (Biaxin XL).

Examples of antifungal drugs that can increase fluticasone propionate and salmeterol levels in your body include:

  • ketoconazole (Extina, Nizoral, Xolegel)
  • itraconazole (Omnel, Sporanox, Tolsura)
  • voriconazole (Vfend)

Taking Advair with these medications is not recommended. If you need treatment with one of these drugs while taking Advair, your doctor will monitor you closely for increased side effects.

Advair and certain antidepressants

Taking certain antidepressants with Advair (or within 2 weeks of taking Advair) can raise your risk of serious side effects, such as heart problems.

Examples of antidepressants that can increase your risk for heart problems if taken with Advair include:

  • selegiline (Emsam, Zelapar)
  • phenelzine (Nardil)
  • isocarboxazid (Marplan)
  • amitriptyline
  • nortriptyline (Pamelor)
  • desipramine (Norpramin)
  • imipramine (Tofranil)

If you need to take an antidepressant with Advair, talk with your doctor. They may suggest a different option than the ones listed above.

Advair and certain blood pressure or heart rate medications

Taking Advair with certain blood pressure or heart rate medications can increase your risk for serious breathing problems.

Examples of blood pressure or heart rate medications that can increase your risk for breathing problems if taken with Advair include:

  • metoprolol (Lopressor, Toprol XL)
  • atenolol (Tenormin)
  • carvedilol (Coreg)
  • propranolol (Inderal, Innopran XL)

Advair should only be taken with one of these medications in an emergency situation (such as a heart attack) or if there are no other preferred options. If you need to take Advair with one of these drugs, your doctor will monitor you closely for serious breathing problems.

Advair and certain diuretics

Taking Advair with certain diuretics (water pills) can increase your risk for hypokalemia (low potassium levels). It can also raise your risk for serious heart problems, including abnormal heart rhythms.

Examples of diuretics that can increase your risk for these serious effects if taken with Advair include:

  • furosemide (Lasix)
  • torsemide (Demadex)
  • hydrochlorothiazide (Microzide)
  • chlorthalidone

Some diuretics also come as part of a combination medication (which contains more than one active drug). Be sure to check all of your medications to see if any contain one of the diuretics listed above.

If you need to take one of these diuretics with Advair, your doctor will monitor you closely for hypokalemia and abnormal heart rhythms.

As with all medications, the cost of Advair can vary. To find current prices for Advair in your area, check out GoodRx.com.

The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Financial and insurance assistance

If you need financial support to pay for Advair, or if you need help understanding your insurance coverage, assistance is available.

GlaxoSmithKline, the manufacturer of Advair, offers coupons that can lower the cost of Advair. For more information and to find out if you’re eligible to use these coupons, visit the program website.

The manufacturer also has a program called GSKForYOU. This program offers financial assistance to people who don’t have insurance coverage or who can’t afford Advair. For more information and to find out if you’re eligible for support, call 866-GSK-FOR-U (866-475-3678), or visit the program website.

It’s not known how safe it is to use Advair during pregnancy. In animal studies, harm to the fetus was seen when the pregnant mother received Advair. However, animal studies don’t always predict what will happen in humans.

Untreated or poorly treated asthma during pregnancy may cause serious problems for the mother and baby. These include preeclampsia (high blood pressure during pregnancy), premature birth, and low birth weight. If your asthma is well controlled, you may have a lower risk of these problems.

Treatment guidelines state that the combination of an inhaled corticosteroid and long-acting beta2-agonist is safe for pregnant women with asthma. Advair contains this combination with the active drugs fluticasone propionate and salmeterol.

If you have asthma or chronic obstructive pulmonary disease (COPD) and are pregnant or considering becoming pregnant, talk with your doctor about your treatment options.

It’s not known if Advair is safe to take during pregnancy. If you are sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Advair.

It’s not known if Advair passes into human breast milk. In animal studies, fluticasone propionate, one of the active drugs in Advair, did pass into breast milk. However, animal studies don’t always predict what will happen in humans.

You and your doctor should weigh the benefits of breastfeeding while taking Advair against the risks of untreated asthma or chronic obstructive pulmonary disease (COPD). Together you can determine if breastfeeding is a safe option for you and your child.

Using more than the recommended dosage of Advair can lead to serious side effects.

Overdose symptoms

Symptoms of an overdose can include:

  • dry mouth
  • nausea
  • fatigue (lack of energy)
  • dizziness
  • fast heart rate
  • changes in blood pressure
  • chest pain
  • shakiness
  • abnormal heart rhythm
  • muscle cramps
  • seizures

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

Chronic obstructive pulmonary disease (COPD) is a group of conditions that cause damage in your lungs that gets worse over time. COPD includes conditions such as chronic bronchitis and emphysema.

Chronic bronchitis causes inflammation (swelling) and mucus buildup in your airways. This makes it hard for air to flow through your lungs, reducing the amount of oxygen that you can take in.

Emphysema damages your alveoli, which are small air sacs in your lungs. This damage makes it hard for you to breathe carbon dioxide out of your lungs. Trapped carbon dioxide in your lungs prevents you from breathing in fresh oxygen.

These conditions prevent oxygen from entering your bloodstream and reaching your organs.

Advair contains two drugs: fluticasone propionate, a corticosteroid, and salmeterol, a long-acting beta2-agonist.

Corticosteroids like fluticasone propionate reduce the amount of inflammation in your lungs. This helps clear some of the swelling and mucus that can block airflow through your lungs. Long-acting beta2-agonists relax the muscles that line your airways. By doing this, they widen the airways and allow more air to flow through.

Both of these drugs help improve airflow in people with asthma and COPD. This helps you breathe easier and get the oxygen you need.

How long does it take to work?

In clinical studies, people’s symptoms usually started improving within 30 to 60 minutes of taking Advair HFA. People’s symptoms started improving within about 30 minutes of taking Advair Diskus. After starting Advair, it might take about a week before you see the maximum amount of improvement in your symptoms.

Here are answers to some frequently asked questions about Advair.

Will I taste anything when I take Advair?

You might taste some of the medication after you take a dose of Advair. Always rinse your mouth with water (and spit it out) after taking an Advair dose, whether you tasted anything or not. This will help reduce your risk for yeast infections in your mouth and throat.

Will Advair cure my condition? If not, how long will I have to take it?

Advair can’t cure asthma or chronic obstructive pulmonary disease (COPD). There are currently no cures for either condition.

Advair is meant for long-term use. If you and your doctor decide that Advair helps control your asthma or COPD, you’ll likely take it long term.

Should I use Advair during a COPD or asthma flare-up?

No, Advair shouldn’t be used during a COPD or asthma flare-up (sudden worsening of your symptoms). It also shouldn’t be used in an emergency (severe flare-up). Advair doesn’t work quickly enough to provide relief during these situations. You should always carry a rescue inhaler to give you immediate relief.

See the “Advair use with other drugs” section for more details about rescue inhalers. Also, talk with your doctor about what to do if your asthma or COPD symptoms suddenly get worse.

Can I take Advair to treat allergies?

No, Advair is not used to treat allergies. The causes and symptoms of allergies are different from those of asthma or COPD, so Advair won’t fully treat allergy symptoms. If you have asthma or COPD and also have allergies, talk with your doctor about ways to relieve your allergy symptoms.

Can Advair slow my child’s growth?

It’s possible. Fluticasone propionate, one of the active drugs in Advair HFA, may slow a child’s growth. If your child needs to take Advair, their doctor will monitor their growth closely. Their doctor will prescribe the lowest dosage needed to treat your child’s asthma. This can help lower the risk of slowing their growth.

Before taking Advair, talk with your doctor about your health history. Advair may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • History of allergic reaction to Advair. You shouldn’t use Advair if you’ve had an allergic reaction to it in the past. If you’re unsure of whether you’ve had an allergic reaction to Advair, talk with your doctor.
  • Severe allergic reaction to milk proteins. You shouldn’t use Advair Diskus if you’ve had a severe allergic reaction to milk proteins in the past. Talk with your doctor if you’re unsure if you’ve had a severe allergic reaction to milk protein. Note: Advair HFA does not contain milk proteins.
  • Rapidly worsening asthma or chronic obstructive pulmonary disease (COPD). You shouldn’t use Advair if you have rapidly worsening asthma or COPD. Also, don’t use Advair during situations that require intense medical treatment or hospitalization for asthma or COPD. If you’re unsure if your asthma or COPD is stable enough to start Advair, talk with your doctor.
  • Serious infections. Advair can decrease your immune system’s ability to fight infections. You might not be able to start treatment with Advair if you have a serious infection, including tuberculosis. If you currently have a serious infection (or you’ve had one in the past), talk with your doctor about whether Advair is safe for you.
  • Heart problems. Salmeterol, one of the active drugs in Advair, can worsen certain heart problems, including abnormal heart rhythms and high blood pressure. If you have heart problems, talk with your doctor about whether Advair is safe for you.
  • Seizure disorders. Salmeterol, one of the active drugs in Advair, can worsen seizure disorders in some people. If you have a seizure disorder, talk with your doctor about whether Advair is safe for you.
  • Certain hormone disorders. Salmeterol, one of the active drugs in Advair, can worsen symptoms of hyperthyroidism (high thyroid levels). Fluticasone propionate is the other active drug in Advair. It can cause high levels of cortisol (a hormone produced in the adrenal glands) in some people. Both of these issues can cause serious side effects. If you have a hormone disorder, talk with your doctor about whether Advair is safe for you.
  • Pregnancy. It’s not known how safe Advair is during pregnancy. For more information, see the “Advair and pregnancy” section above.
  • Breastfeeding. It’s not known how safe Advair is during pregnancy. For more information, see the “Advair and breastfeeding” section above.

Note: For more information about the potential negative effects of Advair, see the “Advair side effects” section above.

When you get Advair from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee the effectiveness of the medication during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Advair Diskus should be thrown away when the counter reads “0” or 1 month after the foil pouch was opened, whichever comes first.

Advair HFA should be thrown away when the counter reads “000.”

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Advair Diskus and Advair HFA should be stored at room temperature, no higher than 77°F (25°C).

They should be stored in their packaging and away from light. Advair HFA should not be stored near high temperatures because it can burst if it gets too hot. Don’t keep this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Advair and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Advair Diskus is approved by the Food and Drug Administration (FDA) to treat asthma in adults and children ages 4 years and older. It’s also FDA-approved for the maintenance treatment and reduction of exacerbations in adults with chronic obstructive pulmonary disease (COPD).

Advair HFA is approved to treat asthma in adults and children ages 12 years and older.

Mechanism of action

Advair Diskus and Advair HFA contain two active drugs: fluticasone propionate and salmeterol.

Fluticasone propionate is a corticosteroid that improves asthma and COPD symptoms by reducing inflammation. It does this by binding to glucocorticoid receptors and reducing the activation and activity of immune system cells and mediators.

Salmeterol is a long-acting beta2-agonist (LABA) that improves asthma and COPD symptoms by relaxing bronchial smooth muscle. It also inhibits mediator release from mast cells, reducing inflammation. Salmeterol works by binding to beta2-adrenoreceptors and increasing cyclic AMP levels, prompting smooth muscle relaxation in the lungs.

Pharmacokinetics and metabolism

Following inhalation, absolute bioavailability of fluticasone propionate is about 5.3% for Advair HFA and about 5.5% for Advair Diskus. Very low levels of salmeterol reach systemic circulation. Peak concentration achieved within 0.33 to 1.5 hours for fluticasone propionate and 5 to 10 minutes with salmeterol.

Plasma protein binding is approximately 99% for fluticasone propionate and 96% for salmeterol. Fluticasone propionate and salmeterol are both metabolized via the CYP3A4 pathway.

Fluticasone propionate is primarily excreted via fecal route. Salmeterol excretion is through urine (~25%) and feces (~60%). Terminal half-life for both drugs is about 5.5 hours.

Contraindications

Advair Diskus is contraindicated as primary treatment of status asthmaticus or acute episodes of asthma or COPD that require intense treatment.

Advair HFA is contraindicated as primary treatment of status asthmaticus or acute episodes of asthma that require intense treatment.

Advair Diskus and Advair HFA are both contraindicated in people with a history of hypersensitivity to their respective active and inactive ingredients (including milk proteins in Advair Diskus).

Storage

Advair Diskus and Advair HFA should be stored at room temperature (68°F to 77°F; 20°C to 25°C). Protect Advair HFA from extreme heat, as the device can burst.

Disclaimer: Medical News Today 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.