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All about: Advair HFA

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Generic Name: fluticasone and salmeterol (floo TIK a sone, sal ME te rol)
Brand Names: Advair Diskus, Advair HFA

What is fluticasone and salmeterol inhalation?

Fluticasone is a steroid. It prevents the release of substances in the body that cause inflammation. Salmeterol is a bronchodilator. It works by relaxing muscles in the airways to improve breathing.

Fluticasone and salmeterol inhalation is used to prevent asthma attacks. It will not treat an asthma attack that has already begun. Fluticasone and salmeterol inhalation is also used to treat chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis.

Fluticasone and salmeterol may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about this medication?

Do not use this medication to treat an asthma attack that has already begun. It will not work fast enough to reverse your symptoms. Use another, faster-acting inhalation medication to treat an asthma attack.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Call your doctor right away if you feel that this medicine is not working as well as usual, or if it makes your condition worse. An increased need for medication could be an early sign of a serious asthma attack. If you use a peak flow meter at home, call your doctor if your numbers are lower than normal. Salmeterol has been shown to increase the risk of asthma-related death. It is critical that you use only the prescribed dose of this medicine and follow all patient instructions for safe use of the medication. Talk with your doctor about your individual risks and benefits in using fluticasone and salmeterol.

What should I discuss with my healthcare provider before using this medication?

Do not use this medication if you are allergic to fluticasone (Flonase, Flovent) or salmeterol (Serevent), or if you are having an asthma attack.

Before using this medication, tell your doctor if you have been sick or had an infection of any kind. You may not be able to use fluticasone and salmeterol inhalation until you are well.

Before using fluticasone and salmeterol, tell your doctor if you are allergic to any medications, or if you have:

  • a food or drug allergy;

  • heart disease or high blood pressure;

  • epilepsy or other seizure disorder;

  • diabetes;

  • glaucoma;

  • tuberculosis;

  • osteoporosis;

  • a thyroid disorder; or

  • liver disease.

If you have any of these conditions, you may not be able to use fluticasone and salmeterol, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether this medication passes into breast milk or if it could harm a nursing baby. Do not use fluticasone and salmeterol inhalation without telling your doctor if you are breast-feeding a baby.

Fluticasone and salmeterol inhalation can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medication.

Long-term use of steroids may lead to bone loss (osteoporosis), especially if you smoke, if you do not exercise, if you do not get enough vitamin D or calcium in your diet, or if you have a family history of osteoporosis. Talk with your doctor about your risk of osteoporosis.

How should I use this medication?

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label. This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Salmeterol has been shown to increase the risk of asthma-related death. It is critical that you use only the prescribed dose of this medicine and follow all patient instructions for safe use of the medication. Talk with your doctor about your individual risks and benefits in using fluticasone and salmeterol. Do not use fluticasone and salmeterol inhalation to treat an asthma attack that has already begun. It will not work fast enough to reverse your symptoms. Use another, faster-acting inhalation medication to treat an asthma attack.

Asthma is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor.

Advair Diskus is a powder form of fluticasone and salmeterol that comes with a special inhaler device preloaded with blister packs containing measured doses of the medicine. The device opens and loads a blister each time you use the inhaler. This device is not to be used with a spacer.

Do not exhale or blow into the Diskus device. Do not take the device apart or allow it to get wet. Do not reuse the Advair Diskus device. Throw it away 1 month after you have taken it out of the foil pouch, or if the dose indicator shows a zero, whichever comes first. Each Diskus device contains 60 doses.

Advair HFA is an aerosol form of fluticasone and salmeterol that comes in a canister that is used with an actuator inhaler device. Use only the inhaler device provided with Advair HFA. This device is not to be used with a spacer.

Shake the Advair HFA inhaler for at least 5 seconds before each spray. When using the inhaler for the first time, prime it by spraying 4 test sprays into the air, away from your face. Shake the canister for 5 seconds before each spray. Also prime the inhaler if you have not used it in more than 4 weeks, or if you have dropped the canister.

Keep track of the number of sprays you have used and throw away the Advair HFA canister after 120 sprays, even if it feels like there is still medicine in it.

To reduce the chance of developing a yeast infection in your mouth, rinse with water after using fluticasone and salmeterol inhalation. Do not swallow.

It is important to use fluticasone and salmeterol inhalation regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Call your doctor right away if you feel that this medicine is not working as well as usual, or if it makes your condition worse. An increased need for medication could be an early sign of a serious asthma attack. If you use a peak flow meter at home, call your doctor if your numbers are lower than normal. If you were switched from an oral (taken by mouth) steroid to fluticasone and salmeterol inhalation, you may need to go back to taking the oral medicine if you are under stress or have an asthma attack or other medical emergency. Carry an identification card or wear a medical alert ID to let others know that you may need an oral steroid in an emergency. Store this medication at room temperature away from moisture and heat. Keep the Atrovent HFA canister away from high heat, such as open flame or in a car on a hot day. The canister may explode if it gets too hot.

What happens if I miss a dose?

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include angina or chest pain, fast or irregular heartbeats, seizures, tremor, weakness, headache, nausea, and vomiting.

What should I avoid while using this medication?

Do not use a second form of salmeterol (such as Serevent) or use a similar inhaled bronchodilator such as formoterol (Foradil) unless your doctor has told you to.

This medication can lower the blood cells that help your body fight infections. This can make it easier for you to get sick. Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medicines.

This medication side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
  • bronchospasm (wheezing, chest tightness, trouble breathing);

  • fast or uneven heart beats, restless feeling, tremor;

  • fever, chills, cough with yellow or green mucus;

  • stabbing chest pain, feeling short of breath;

  • white patches or sores inside your mouth or on your lips; or

  • worsening asthma symptoms.

Less serious side effects include:

  • headache, dizziness;

  • nausea, vomiting, diarrhea;

  • dryness in your mouth, nose, or throat;

  • stuffy nose, sinus pain, cough, sore throat; or

  • hoarseness or deepened voice.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect this medication?

Before using fluticasone and salmeterol inhalation, tell your doctor if you are using any of the following drugs:

  • amiodarone (Cordarone);

  • a diuretic or "water pill";

  • HIV medicines such as ritonavir (Norvir), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept);

  • an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam);

  • antidepressants such as amitriptyline (Elavil), desipramine (Norpramin), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), or nortriptyline (Pamelor); or

  • antibiotics such as ketoconazole (Nizoral), itraconazole (Sporanox), clarithromycin (Biaxin), erythromycin (E-Mycin, Ery-Tab, E.E.S.).

If you are using any of these drugs, you may not be able to use fluticasone and salmeterol, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect fluticasone and salmeterol inhalation. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist has additional information about fluticasone and salmeterol inhalation written for health professionals that you may read.

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 5.03. Revision Date: 07/23/2007 3:28:07 PM.

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