Advair Side Effects

I have a 10 year old son who takes 2 puffs of Advair (115mcg) daily to control his Asthma and uses Albuterol (fast acting inhaler every 4-6 hours as needed).  He is currently in his second year of immunotherapy maintenance (monthly shots) for his allergies and has responded well to this treatment.  My son also was diagnosed with ADD (Attention Deficit Disorder) in the fall of last year 2008.  While my son has received therapy for controlling his emotions and anger, I further have discussed moving him off Advair and back to Flovent over the next month out of concern for side effects of the drug.  My son switched over to Advair sometime in late 2007 or early 2008.  Symptoms my son exhibits are anxiety, nervousness, restlessness, sleep problems, lack of weight gain, low appetite.  My son has weighed 64 lbs. for the last year.  He grows in height but not weight.  He swims competitively and I'm concerned about his low weight.  His well checks have always shown growth in height but little weight gain.  His father was similarly slender as a child.  I'm interested in also changing diet and removing some processed foods and food dyes from his diet, may start seeing a homeopathic physician.  While I do not have my son on all organic foods, I do limit his refined sugar intake to desserts once a day and soda occasionally.  I fear he is also sometimes dehydrated as he likes to drink his dinner instead of eat it.

Is it possible my son could be experiencing emotional side effects from Advair and have some food allergies or vitamin deficiencies contributing to his low weight as well?

I've read that Zinc supplements & Omego 3 fatty acids have helped ADD children and also removing processed
foods from their diet.  

While I have my childs Asthma under control, I'm afraid his medication and diet are contributing to his instability.

Thank you for your help.

Advair parent

[National Jewish Health]

I assume that, with the diagnosis of ADD, your son is receiving Aderall, Ritalin, or a similar drug.  Many of the symptoms he “exhibits” may be attributable to the adverse side effects of these drugs, especially the “low appetite” and “lack of weight gain”.  There are, however, other causes of failure to gain weight, some serious and many treatable and, if not already considered, his doctor should order whatever tests might be appropriate to rule/out physical disease, especially diabetes mellitus and hyperthyroidism.  These drugs also have CNS side effects including insomnia, nervousnessnes and overstimulation.  

Advair is, as you know, a combination of flovent (fluticasone) and serevent (salmeterol), the latter in a class of drugs called (long-acting) beta-agonists.  Serevent is associated with a number of adverse reactions including hyperglycemia.

Thus, both serevent and flovent can result in hyperglycemia (elevated blood sugars, the defining feature of Diabetes Mellitus)  and this can cause wt. loss or failure to gain weight.

The bottom line, here, is that your son’s signs and symptoms may be secondary to the drugs he has been using, to an occult physical problem (for example diabetes) or a combination of the two and these possibilities would best be addressed by his physicians.

It is very unlikely that food allergies or vitamin deficiencies are a part of his problems but, the information that you have provided does suggest a degree of malnutrition and this, in turn, would prompt consideration of some type of gastrointestinal disease, characterized by malabsorption.

And, finally, yes your son could be experiencing “emotional side effects” from any of the three drugs he has been using, either singly or in combination.  For this reason and those listed above, it would be wise to look to the side effects associated with each of the drugs and this could involve exclusion, from his current medical regimen, of one drug at a time, under your and his doctor’s close supervision.

Good luck