Featured Product: Advair Diskus (Fluticasone / Salmeterol)

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.

Advair Diskus (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.

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What is Advair Diskus (fluticasone and salmeterol)? 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. Advair Diskus (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. Advair Diskus (fluticasone and salmeterol) may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about fluticasone and salmeterol? 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 discuss with my healthcare provider before using this medication? 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. Advair Diskus (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 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, 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.

Synonyms: Cutivate, Flixonase, Flixotide, Flonase, Flovent Diskus, Flunase, Seretide

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. Advair Diskus (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.

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, 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.

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 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.

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