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 is also used to
prevent flare-ups or worsening of chronic obstructive pulmonary disease (COPD) associated with
chronic bronchitis and/or emphysema.
Fluticasone and salmeterol may also be used for other purposes not listed in this medication
guide.
What should I discuss with my healthcare provider before taking fluticasone and salmeterol (inhalation)?
Do not use this medication if you are allergic to fluticasone (Flonase, Flovent), salmeterol
(Serevent), or milk proteins, or if you are having an asthma attack or severe COPD symptoms.
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.
If you have any of these other conditions, you may need a dose adjustment or special tests to
safely use this medication:
-
a food or drug allergy;
-
heart disease or high blood pressure;
-
epilepsy or other seizure disorder;
-
an infection of any kind;
-
a weak immune system;
-
diabetes;
-
glaucoma;
-
tuberculosis;
-
osteoporosis;
-
a thyroid disorder; or
-
liver disease.
FDA pregnancy category C. It is not known whether fluticasone and
salmeterol is harmful to an unborn baby. Before using this medication, tell your doctor if you are
pregnant or plan to become pregnant during treatment.
It is not known whether fluticasone and salmeterol 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.
How should I take fluticasone and salmeterol (inhalation)?
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, and directions for
priming the inhaler device if needed. Follow these directions carefully.
Do not
use fluticasone and salmeterol inhalation to treat an asthma attack
that has already begun. It will not work fast enough. Use only a fast-acting inhalation medication.
Advair Diskus
is a powder form of fluticasone and salmeterol that comes
with a special inhaler device pre-loaded 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.
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.
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.
If you also use a steroid medication, do not stop using the steroid suddenly or you may have
unpleasant withdrawal symptoms. Talk with your doctor about using less and less of the steroid before
stopping completely.
Call your doctor right away if any of your asthma medications do not seem to work as well
in treating or preventing asthma attacks. An increased need for medication could be an early sign of a
serious asthma attack. If you use a peak flow meter, call your doctor if your numbers are lower than
normal.
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.
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 Advair
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 of fluticasone and salmeterol (inhalation)?
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.
Where can I get more information about fluticasone and salmeterol (inhalation)?
Your pharmacist has information about fluticasone and salmeterol (inhalation) written for health professionals that you may read.
What are the possible side effects of fluticasone and salmeterol (inhalation)?
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, stabbing chest pain, cough with yellow or
green mucus;
-
blurred vision, eye pain, or seeing halos around lights;
-
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;
-
dry mouth, nose, or throat;
-
stuffy nose, sinus pain, cough, sore throat; or
-
hoarseness or deepened voice.
This is not a complete list of side effects and others may occur. Call your
doctor for medical advice about side effects. You may report side effects to FDA at
1-800-FDA-1088.
What is the most important information I should know about fluticasone and salmeterol (inhalation)?
Do not
use fluticasone and salmeterol to treat an asthma attack that has
already begun.
Before using fluticasone and salmeterol, tell your doctor if you have a food or drug allergy, heart
disease, high blood pressure, a seizure disorder, an infection, a weak immune system, diabetes,
glaucoma, tuberculosis, osteoporosis, a thyroid disorder, or liver disease.
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.
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.
What should I avoid while taking fluticasone and salmeterol (inhalation)?
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.
Fluticasone and salmeterol can lower the blood cells that help your body fight infections. 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.
What other drugs will affect fluticasone and salmeterol (inhalation)?
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 atazanavir (Reyataz), ritonavir
(Norvir), indinavir (Crixivan), nelfinavir (Viracept), or saquinavir (Invirase);
-
an MAO inhibitor such as isocarboxazid (Marplan),
tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl,
Emsam);
-
an antidepressant such as amitriptyline (Elavil),
desipramine (Norpramin), fluoxetine (Prozac), nefazodone, or imipramine (Tofranil);
-
antibiotics such as clarithromycin (Biaxin) or telithromycin
(Ketek);
-
antifungal medications such as ketoconazole (Nizoral) or
itraconazole (Sporanox); or
-
a beta-blocker such as atenolol (Tenormin), carvedilol
(Coreg), metoprolol (Lopressor, Toprol), and others.
This list is not complete and there may be other drugs that can interact with
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.
What happens if I have an overdose of fluticasone and salmeterol (inhalation)?