Fluticasone and Salmeterol Oral Inhalation : Uses, Side Effects, Interactions & More

Why is this medication prescribed?
The combination of fluticasone and salmeterol (Advair Diskus, Advair HFA, AirDuo Respiclick) is used to treat shortness of breath, wheezing, shortness of breath, cough, and chest tightness caused by asthma. The combination of fluticasone and salmeterol (Advair Diskus) is also used to prevent and treat wheezing, shortness of breath, cough and tightness in the chest caused by chronic obstructive pulmonary disease (COPD; a group of lung diseases that includes chronic bronchitis and emphysema). The combination of fluticasone and salmeterol (Advair Diskus) is used in adults and children over 4 years of age. The combination of fluticasone and salmeterol (Advair HFA, AirDuo Respiclick) is used in children 12 years of age and older. Fluticasone belongs to a class of medications called steroids. It works by reducing swelling of the airways. Salmeterol belongs to a class of medications called long-acting beta-agonists (LABA). It works by relaxing and opening the airways of the lungs, making it easier to breathe.

How should this medicine be used?
The combination of fluticasone and salmeterol comes as a powder and as an inhalation solution to inhale by mouth using a specially designed inhaler. It is usually used twice a day, in the morning and at night, about 12 hours apart. Use fluticasone and salmeterol at around the same time every day. Follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any part you do not understand. Use fluticasone and salmeterol exactly as directed. Do not use more or less or use it more often than prescribed by your doctor.

Talk to your doctor about how you should take your other oral or inhaled asthma medications during your treatment with salmeterol and fluticasone inhalation. If you were using a short-acting beta agonist inhaler such as albuterol (Proventil, Ventolin) on a regular basis, your doctor will probably tell you to stop using it regularly but to continue using it to treat sudden attacks of asthma symptoms. Follow these instructions carefully. Do not change the way you use any of your medications or stop taking any of them without talking to your doctor.

Do not use fluticasone and salmeterol during an asthma or COPD attack. Your doctor will prescribe a short-acting inhaler to use during attacks.

Inhaling fluticasone and salmeterol controls the symptoms of certain lung diseases but does not cure these conditions. It may take a week or more before you feel the full benefit of fluticasone and salmeterol. Continue to use fluticasone and salmeterol even if you feel well. Do not stop using fluticasone and salmeterol without talking to your doctor. If you stop using fluticasone and salmeterol inhalation, your symptoms may return.

Before using fluticasone and salmeterol inhalation (Advair Diskus, Advair HFA, or AirDuo Respiclick) for the first time, read the written instructions on the package that came with it. Look at the diagrams and package instructions carefully and be sure to recognize all parts of the inhaler. Ask your doctor, pharmacist, or respiratory therapist to show you how to use the inhaler. Practice using your inhaler while they watch you, to be sure you are doing it the right way.

If your child will be using fluticasone and salmeterol inhalation, make sure they know how to use it. Watch your child every time you use the inhaler to make sure she is using it correctly.

Never breathe out into the inhaler, take the inhaler apart, or wash the mouthpiece or any part of the inhaler. Keep the inhaler dry. Do not use the inhaler with a spacer.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the inhalation of fluticasone and salmeterol (Advair Diskus, Advair HFA or AirDuo Respiclick) for the patient.

Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before using fluticasone and salmeterol oral inhalation,

  • Tell your doctor and pharmacist if you are allergic to fluticasone (Flonase, Flovent), salmeterol (Serevent), any other medications, milk protein, any foods, or any of the ingredients in fluticasone and salmeterol oral inhalation. Ask your pharmacist or check Patient Information for a list of ingredients.
  • Tell your doctor if you use another LABA such as formoterol (Perforomist, in Dulera, in Symbicort) or salmeterol (Serevent, in Advair). These medications should not be used with inhalation of fluticasone and salmeterol. Your doctor will tell you which medicine to use and which medicine to stop using.
  • Tell your doctor and pharmacist what other prescription and over-the-counter medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: certain antifungals like itraconazole (Onmel, Sporanox) and ketoconazole; beta-blockers such as atenolol (Tenormin), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard) and propranolol (Inderal); clarithromycin (Biaxin, in Prevpac); diuretics (‘water pills’); HIV protease inhibitors such as atazanavir (Reyataz), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Invirase); other medications for asthma or COPD; seizure medications; metronidazole (Flagyl); nefazodone; and telithromycin (Ketek; no longer available in the US). Also tell your doctor and pharmacist if you are taking the following medications or have stopped taking them within the past 2 weeks: antidepressants such as amitriptyline, amoxapine, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil) and trimipramine (Surmontil); and monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate). Many other medications can also interact with fluticasone and salmeterol, so be sure to tell your doctor about all the medications you are taking, even the ones not listed here. Your doctor may need to change the doses of your medications or monitor you closely for side effects.
  • Tell your doctor if you or someone in your family has or has ever had osteoporosis (a condition in which the bones become weak and brittle) and if you have or have ever had high blood pressure, irregular heartbeat, seizures, hyperthyroidism (overactive thyroid). ), diabetes, tuberculosis (TB), cataracts (clouding of the lens of the eye), glaucoma (an eye disease), any condition that affects your immune system, or liver or heart disease. Also tell your doctor if you have a herpes eye infection or any other type of infection and if you smoke or use tobacco products.
  • Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using fluticasone and salmeterol, call your doctor.
  • If you are having surgery, including dental surgery, tell your doctor or dentist that you are using fluticasone and salmeterol.
  • Tell your doctor if you have never had chickenpox or measles and have not been vaccinated against these infections. Stay away from people who are sick, especially people who have chickenpox or measles. If you are exposed to these infections or if you have symptoms of these infections, call your doctor immediately. You may need to receive a vaccine (shot) to protect yourself from these infections.

What special dietary instructions should I follow?
Talk to your doctor about eating grapefruit or drinking grapefruit juice while taking this medication.

What should I do if I forget a dose?
Skip the missed dose and continue your regular dosing schedule. Do not inhale a double dose to make up for a missed one.

What side effects can this medication cause?

Fluticasone and salmeterol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • runny nose
  • sneezing
  • sore throat
  • throat irritation
  • sinus pain
  • headache
  • nausea
  • vomiting
  • diarrhea
  • stomach pain
  • muscle and bone pain
  • dizziness
  • weakness
  • tiredness
  • sweating
  • tooth pain
  • shaking of a part of your body that you cannot control
  • sleep problems

Some side effects can be serious. If you experience any of the following side effects, call your doctor immediately:

  • coughing, wheezing, or chest tightness that begins soon after you inhale fluticasone and salmeterol
  • hives
  • rash
  • swelling of the face, throat, tongue, lips, hands, feet, ankles, or lower legs
  • choking or difficulty swallowing
  • hoarseness
  • noisy, high-pitched breathing
  • pounding fast, or irregular heartbeat
  • fainting
  • chest pain
  • cough
  • burning or tingling in the hands or feet
  • white patches in the mouth
  • fever, chills, and other signs of infection

Fluticasone and salmeterol can cause children to grow more slowly. Your child’s doctor will carefully monitor your child’s growth. Talk to your child’s doctor about the risks of giving this medicine to your child.

Fluticasone and salmeterol can increase the risk of developing glaucoma or cataracts. You will probably need to have regular eye exams during your treatment with fluticasone and salmeterol. Tell your doctor if you have any of the following symptoms: eye pain, redness, or discomfort; blurred vision, seeing halos or bright colors around lights; or any other change in vision. Talk to your doctor about the risks of using this medication.

Fluticasone and salmeterol may increase your risk of developing osteoporosis. Talk to your doctor about the risks of using this medicine.

Fluticasone and salmeterol can cause other side effects. Call your doctor if you have any unusual problems while using this medicine.

If you experience a serious side effect, you or your doctor can submit an online report to the Food and Drug Administration (FDA) MedWatch Adverse Event Reporting Program (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?
Keep this medicine in its container, tightly closed and out of the reach of children. Store it at room temperature and away from sunlight, excess heat, and humidity (not in the bathroom). Talk to your pharmacist about the proper disposal of your medicine.

It is important to keep all medicines out of the sight and reach of children, as many containers (such as those for weekly pills and those for eye drops, creams, patches and inhalers) are not resistant to children and young children can easily open them. To protect young children from poisoning, always close the safety caps and immediately put the medicine in a safe place, one that is up and away and out of their sight and reach. http://www.upandaway.org

Unnecessary medications must be disposed of in special ways to ensure that pets, children, and others cannot consume them. However, you should not flush this medicine down the toilet. Instead, the best way to dispose of your medication is through a medication take-back program. Talk to your pharmacist or contact your local recycling / trash department to find out about return programs in your community. Check out the FDA drug safe disposal website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim collapsed, had a seizure, is having trouble breathing, or is unable to wake up, immediately call 911 for emergency services.

Symptoms of overdose may include the following:

  • seizures
  • chest pain
  • dizziness
  • fainting
  • blurred vision
  • fast, pounding, or irregular heartbeat
  • nervousness
  • headache
  • shaking of a part of your body that you cannot control
  • muscle cramps or weakness
  • dry mouth
  • nausea
  • excessive tiredness
  • lack of energy
  • difficulty falling asleep or staying asleep

What other information should I know?
Keep all appointments with your doctor and your ophthalmologist.

Do not allow anyone to use your medicine. Ask your pharmacist any questions you have about refilling your prescription.

It is important to keep a written list of all prescription and over-the-counter (non-prescription) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should take this list with you every time you visit a doctor or if you go into hospital. It is also important information to carry with you in emergencies.

Brand Names

  • Advair® Diskus
  • Advair® HFA
  • AirDuo® Respiclick

Disclaimer: We have made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.

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