Fluticasone and salmeterol is a combination medication that doctors use to treat the symptoms of asthma and chronic obstructive pulmonary disease (COPD). The medication is available as both a powder and an aerosol that people take via an inhaler.
In this article, we describe what fluticasone and salmeterol is, how it works, and how to use it. We also discuss the safety of this combination medication, including its possible side effects and drug interactions.
Fluticasone and salmeterol belong to two separate classes of drugs. Fluticasone is a corticosteroid that helps reduce inflammation of the airways. Salmeterol is a long acting bronchodilator called a beta-2 agonist that relaxes the muscles around the airways. Together, the two drugs help open up the airways and alleviate breathing difficulties.
As a combination medication, fluticasone and salmeterol work together to help manage symptoms of asthma or COPD. The medication is available as either a powder or an aerosol that a person breathes in through an inhaler.
The fluticasone and salmeterol combination is available in both generic and branded forms. Brand names include Advair Diskus and AirDuo RespiClick.
The Food and Drug Administration (FDA) recommend that doctors only prescribe fluticasone and salmeterol if other medications are ineffective in controlling a person’s symptoms.
A person should take fluticasone and salmeterol according to their doctor’s instructions.
The FDA state that a person should inhale the medication twice a day and not exceed two doses in 24 hours. They also state that people should not take the medication to treat sudden, or acute, exacerbations of asthma or COPD.
If a person is not sure how to use their inhaler, they should ask their doctor or pharmacist to provide a demonstration. Parents or caregivers of children taking the medication should help the child until they are able to take the medication on their own.
After taking a dose of fluticasone and salmeterol, a person should gargle with a small amount of water and spit it out. A person may notice an improvement in their symptoms within 30 minutes.
People should store the inhaler in a cool, dry area and keep the mouthpiece clean to limit the possibility of infections.
The appropriate dosage of fluticasone and salmeterol will depend on the severity of a person’s asthma or COPD symptoms and which medications, if any, they have previously taken for either of these conditions.
For AirDuo RespiClick, the starting dosage for a person who is not using an inhaled corticosteroid is 55/14 micrograms (mcg) — 55 mcg of fluticasone propionate and 14 mcg of salmeterol — twice daily. If a person is switching medications, the doctor will recommend that they start taking the medication at a dosage similar to that of their previous medication.
For Advair Diskus, the FDA recommend a starting dose of 100/50 mcg or 250/50 mcg twice daily. They also state that doses should not exceed 500/50 mcg twice daily. Once a person’s symptoms have stabilized, their doctor will identify the lowest effective dosage.
When receiving a prescription for fluticasone and salmeterol, a person should talk to their doctor to make sure that they understand the dosing instructions and how often to take the medication.
For the most effective treatment, a person should take the medication doses 12 hours apart. If a person misses a dose, they should skip it and take the next dose at the regular time. People should not take two doses at one time, as doing so can result in an overdose.
People can use fluticasone and salmeterol if they have asthma or COPD, and other medications do not effectively regulate their symptoms.
Fluticasone and salmeterol is not suitable for the following people:
- children younger than 12 years of age, for AirDuo RespiClick
- children younger than 4 years of age, for Advair Diskus
- people with a severe milk protein allergy
- people who are allergic to fluticasone, salmeterol, or any of the ingredients that the medication label lists
According to the FDA, it is essential to talk to a doctor about the possible benefits and risks of taking fluticasone and salmeterol before doing so during pregnancy or when breastfeeding.
People with any of the following health conditions should also make their doctor aware of them before taking this combination medication:
- eye problems
- heart problems
- thyroid problems
- liver problems
- issues with the immune system
The FDA point out that fluticasone and salmeterol may interact with the following medications:
- certain heart or blood pressure medications, such as beta-blockers and diuretics
- certain antifungal medications, such as ketoconazole
- tricyclic antidepressants
- a class of antidepressants called monoamine oxidase inhibitors (MAOIs)
- certain antiretroviral medications, such as ritonavir
Before they receive a prescription for fluticasone and salmeterol, a person should tell their doctor about any medications or supplements that they are currently taking, including any:
- prescription or over-the-counter medications
- dietary or herbal supplements
- vitamin or mineral supplements
Unless a person’s healthcare provider recommends dietary changes, a person does not need to make changes to their diet while taking fluticasone and salmeterol.
Fluticasone and salmeterol can cause side effects in some people. Possible side effects depend on the specific brand of medication. They may also vary according to the condition that the person is treating.
Side effects of AirDuo RespiClick
Common side effects of AirDuo RespiClick include:
Side effects of Advair Diskus
When treating asthma, common side effects of Advair Diskus include:
- oral thrush
- changes in the voice
- nausea and vomiting
- upper respiratory tract inflammation
- upper respiratory tract infection
When treating COPD, common side effects of Advair Diskus include:
- oral thrush
- throat irritation
- changes in the voice
- musculoskeletal pain
- viral respiratory infections
Experts generally consider fluticasone and salmeterol safe and effective as long as a person takes the medication according to their doctor’s instructions.
To reduce the risk of side effects, a doctor will establish the lowest effective dosage for a person.
People living with other underlying medical conditions should talk to their doctor about the potential benefits and risks of taking this combination medication.
A person should see their doctor if they experience mild or moderate side effects while taking fluticasone and salmeterol. The doctor may recommend adjusting the dosage or changing to an alternative medication, where possible.
A person should not stop taking a medication unless their doctor says that it is safe for them to do so. Taking fluticasone and salmeterol incorrectly can worsen preexisting symptoms of asthma and COPD.
People should also see a doctor if their current medications are not effectively managing their asthma or COPD.
A person should seek emergency medical attention if they experience a severe allergic reaction after taking fluticasone and salmeterol.
Possible symptoms of a severe allergic reaction, known as anaphylaxis, include:
- skin rash or hives
- swelling of the lips, tongue, or throat
- shortness of breath or difficulty breathing
- dizziness or fainting
- stomach pain or bloating
- uterine cramps
- an impending sense of doom
Anyone who experiences symptoms of anaphylaxis after taking the medication should phone the emergency services immediately.
A person should also seek emergency care if they or their child takes too much of the medication.
Fluticasone and salmeterol is a combination medication for the management of asthma and COPD symptoms.
This medication is available via prescription only. When taking the medication, a person should follow their doctor’s instructions. They should also work closely with their doctor to establish the lowest effective dosage.
People with underlying health conditions should talk to their doctor before taking the medication. People should also notify their doctor if they are already taking a medication or supplement, as fluticasone and salmeterol can interact with certain substances.
Anyone who experiences an allergic reaction or any other severe side effect while taking this medication should seek emergency medical attention.