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Advair Diskus Consumer Information

ADVAIR DISKUS

Generic Name: fluticasone and salmeterol (flew TIH cah sone and sal MEE teh rall)

Brand Names: Advair Diskus

What is the most important information I should know about fluticasone and salmeterol inhalation?

• Data from a large study of people using salmeterol inhalation (Serevent) has shown a small but significant increased risk of asthma-related deaths. Discuss with your doctor the risks and benefits of using fluticasone and salmeterol inhalation before starting treatment.
• Do not use fluticasone and salmeterol to treat an asthma attack that has already begun. It will not work fast enough to reverse your symptoms. Have another, faster-acting inhalation medication--such as albuterol (Ventolin, Proventil)--on hand to relieve asthma attacks.
• Do not use more of this medication than is prescribed.
• Use fluticasone and salmeterol as directed, even when you are feeling better. Improvement in your condition may occur within 30 minutes of using a dose, however it may be one week or more before the full benefit is achieved. Talk to your doctor or other healthcare professional if your symptoms get worse or do not improve.
• It is very important that the fluticasone and salmeterol inhaler is used properly, so that the medicine gets into the lungs. Do not use a spacer with this product. Talk to your doctor about proper inhaler use.
• Seek medical attention if you notice that you require more than your usual or more than the maximum amount of a short-acting asthma medication in a 24-hour period. An increased need for medication could be an early sign of a serious asthma attack.
• Do not use an inhaled, long-acting bronchodilator such as salmeterol (Serevent) or other inhaled steroid medicines during treatment with fluticasone and salmeterol inhalation unless otherwise directed by your doctor.

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 used only to prevent asthma attacks, not to treat an attack already in progress. It will not work fast enough to give relief during an attack. Fluticasone and salmeterol inhalation is also used in the treatment of 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 should I discuss with my healthcare provider before using fluticasone and salmeterol?

• Data from a large study of people using salmeterol inhalation (Serevent) has shown a small but significant increased risk of asthma-related deaths. Discuss with your doctor the risks and benefits of using fluticasone and salmeterol inhalation before starting treatment.
• Before using fluticasone and salmeterol, tell your doctor if you have
• a viral, bacterial, or fungal infection of any kind;
• ever had an allergic reaction to fluticasone (Flovent, Flonase) or salmeterol (Serevent);
• heart disease or high blood pressure;
• epilepsy or another seizure disorder;
• diabetes;
• glaucoma;
• tuberculosis;
• an overactive thyroid (hyperthyroidism); or
• liver disease.
• You may not be able to use fluticasone and salmeterol inhalation or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Fluticasone and salmeterol inhalation is in the FDA pregnancy C. This means that it is not known whether fluticasone and salmeterol inhalation will be harmful to an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• It is not known whether fluticasone and salmeterol pass into breast milk. Do not use fluticasone and salmeterol inhalation without first talking to your doctor if you are breast-feeding a baby.

How should I use fluticasone and salmeterol inhalation?

• Use fluticasone and salmeterol inhalation exactly as directed by your doctor and read the information insert included with your inhaler.
• If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Fluticasone and salmeterol inhalation is usually used as one inhalation twice a day (morning and evening approximately 12 hours apart). Follow your doctor's instructions.
• To use the fluticasone and salmeterol (Advair Diskus) inhaler: Snap the mouthpiece into position. Hold the Diskus level and away from your mouth, breathe out fully, away from the mouthpiece. (Do not breathe out into the Diskus mouthpiece.) Put the mouthpiece to your lips. Take a steady, deep breath in through your mouth. Remove the mouthpiece from your mouth. Hold your breath for about 10 seconds. Breathe out slowly away from the mouthpiece. Close the Diskus. The Diskus is now ready for the next scheduled dose.
• To reduce the chance of developing a yeast infection in your mouth, rinse your mouth after using fluticasone and salmeterol inhalation.
• It is very important that the fluticasone and salmeterol inhaler is used properly, so that the medicine gets into the lungs. Do not use a spacer with this product. Talk to your doctor about proper inhaler use.
• Never wash the mouthpiece or any part of the Diskus device. Keep it dry at all times.
• Do not use more of this medication than is prescribed.
• Use fluticasone and salmeterol as directed, even when you are feeling better. Improvement in your condition may occur within 30 minutes of using a dose, however it may be one week or more before the full benefit is achieved. Talk to your doctor or other healthcare professional if your symptoms get worse or do not improve.
• Do not use fluticasone and salmeterol to treat an asthma attack that has already begun. It will not work fast enough to reverse your symptoms. Have another, faster-acting inhalation medication--such as albuterol (Ventolin, Proventil)--on hand to relieve asthma attacks.
• Do not use an inhaled, long-acting bronchodilator such as salmeterol (Serevent) or formoterol (Foradil) or an inhaled steroid medicine during treatment with fluticasone and salmeterol inhalation unless otherwise directed by your doctor.
• Seek medical attention if you notice that you require more than your usual or more than the maximum amount of a short-acting asthma medication in a 24-hour period. An increased need for medication could be an early sign of a serious asthma attack.
• Continue to take any oral steroid (pills or liquid) that your doctor has prescribed. Fluticasone and salmeterol inhalation is not a substitute for an oral steroid.
• If you are switching from an oral steroid (pills or liquid) to fluticasone and salmeterol inhalation, carry or wear identification that will let others know that you may require a systemic steroid during a severe asthma attack or during another traumatic situation. Discuss with your doctor the precautions necessary when stopping an oral steroid.
• Your doctor may want you to have lung function tests, eye exams, or other medical evaluations during treatment with fluticasone and salmeterol to monitor progress and side effects.
• Store this medication at room temperature away from moisture and heat. The Diskus inhalation device is not reusable. Throw away the device 1 month after removal from the moisture-protective foil overwrap pouch or after all doses have been used (when the dose indicator reads "0"), whichever comes first. There are 60 doses per Diskus. Do not attempt to take the device apart.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. If it is almost time for the next regularly scheduled dose, skip the missed dose and use the next one as directed. Do not use a double dose of this medication.

What happens if I overdose?

• Seek emergency medical attention if an overdose is suspected.
• Symptoms of a salmeterol and fluticasone overdose may include angina or chest pain, irregular or rapid heartbeats, seizures, tremor, weakness, headache, nausea, and vomiting.

What should I avoid while using fluticasone and salmeterol inhalation?

• Avoid known items or activities that may worsen symptoms of asthma or bronchitis. Clean areas where dust or pet fur may aggravate your condition.
• Avoid exposing yourself to known sources of infection. Stay away from people with chicken pox, measles, or any other type of infection. Your immune system may not be strong enough to fight off an infection while using fluticasone and salmeterol inhalation.

What are the possible side effects of fluticasone and salmeterol inhalation?

• Serious side effects from fluticasone and salmeterol inhalation are not likely to occur.
• If you experience any of the following serious side effects, stop using fluticasone and salmeterol inhalation and seek emergency medical attention or notify your doctor immediately:
• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
• chest pain or irregular heartbeats;
• numbness, tingling, or pain;
• a rash or unexplained open sores or bruising; or
• worsening breathing or asthma symptoms.
• Other, less serious side effects may be more likely to occur. Continue to take fluticasone and salmeterol inhalation and talk to your doctor if you experience
• dry mouth, nose, or throat after use;
• yeast (or another) infection in the mouth or throat (white patches);
• hoarseness or deepening of the voice, cough, or sore throat;
• nausea, vomiting, or diarrhea;
• dizziness, headache, tremor, or nervousness.
• 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 fluticasone and salmeterol inhalation?

• Before using fluticasone and salmeterol inhalation, tell your doctor and pharmacist if you are taking any of the following medications:
• another oral, nasal, or inhaled steroid;
• a beta-blocker such as atenolol (Tenormin), metoprolol (Lopressor), propranolol (Inderal), and others;
• a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate);
• a tricyclic antidepressant such as amitriptyline (Elavil), doxepin (Sinequan), nortriptyline (Pamelor), and others;
• a diuretic (water pill) such as hydrochlorothiazide (HydroDiuril, Esidrix, Oretic, Microzide), chlorothiazide (Diuril), furosemide (Lasix), and others;
• caffeine (in food or medicines), a diet medicine, or a decongestant such as pseudoephedrine or phenylephrine;
• a protease inhibitor such as ritonavir (Norvir); or
• an antifungal medicine such as ketoconazole (Nizoral) or itraconazole (Sporanox).
• You may not be able to use fluticasone and salmeterol, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
• Drugs other than those listed here may also interact with fluticasone and salmeterol inhalation or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

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.

Limitations of This Canadian Pharmacy Information

Efforts have been made to ensure that the information provided here is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information does not endorse drugs, diagnose patients or recommend therapy. This is an educational resource only intended to supplement but not to replace 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. 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, please check with your doctor, nurse or local pharmacist. This site does not assume any responsibility for any aspect of healthcare administered with the aid of information provided here.

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Version: 3.01. Revision date: 12/11/03.