Highlights for fluticasone-salmeterol

  1. Fluticasone/salmeterol inhalation powder is available as brand-name drugs. It isn’t available as a generic drug. Brand names: Advair Diskus, AirDuo RespiClick.
  2. Fluticasone/salmeterol comes in two forms: an inhalation powder and an inhalation aerosol.
  3. Fluticasone/salmeterol inhalation powder is used to treat asthma and chronic obstructive pulmonary disease (COPD).
  • Asthma warning: Adults with asthma who take drugs such as salmeterol alone have an increased risk of death from asthma problems. Also, children and adolescents with asthma who take salmeterol alone may have an increased risk of being hospitalized due to asthma. However, in clinical trials, people who took salmeterol with drugs such as fluticasone didn’t have these effects.
  • Usage warning: This drug doesn’t relieve sudden symptoms of asthma or COPD, such as sudden shortness of breath. Always have a rescue inhaler with you to treat sudden symptoms. If you don’t have a rescue inhaler, ask your doctor to prescribe one for you.v
  • Warning to seek emergency help: If your breathing problems get worse quickly or if your rescue inhaler doesn’t relieve your breathing problems, seek emergency medical help right away.
  • Thrush warning: This drug may put you at risk of thrush (a fungal infection in your mouth or throat). To lower your risk of thrush, you should rinse your mouth out with water without swallowing after using this drug.

Fluticasone/salmeterol is a prescription drug. It comes in two forms: inhalation powder and inhalation aerosol.

Fluticasone/salmeterol inhalation powder is available as the brand-name drugs Advair Diskus and AirDuo RespiClick. It isn’t available as a generic drug.

Fluticasone/salmeterol is a combination of two drugs, fluticasone and salmeterol, in a single form. It’s important to know both drugs in the combination because each drug may affect you in a different way.

Fluticasone/salmeterol may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it’s used

Fluticasone/salmeterol contains two drugs that work in different ways to treat asthma and chronic obstructive pulmonary disease (COPD).

How it works

Fluticasone belongs to a class of drugs called inhaled corticosteroids. Salmeterol belongs to a class of drugs called long-acting beta-adrenergic agonists. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Fluticasone helps decrease inflammation in your lungs to help you breathe better.

Salmeterol helps the muscles around the airways in your lungs stay relaxed. This prevents symptoms such as wheezing, cough, chest tightness, and shortness of breath. This can help you breathe better.

When to call the doctor

  1. While using this drug, call your doctor or get medical care right away if:
  2. your breathing problems get worse
  3. you need to use your rescue inhaler more often than usual
  4. your rescue inhaler doesn’t work as well to relieve your symptoms
  5. you need to use 4 or more inhalations of your rescue inhaler in 24 hours for two or more days in a row
  6. you use one whole canister of your rescue inhaler in eight weeks
  7. your peak flow meter results decrease (your healthcare provider will tell you the numbers that are right for you)
  8. you have asthma and your symptoms don’t improve after using this drug regularly for one week
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Fluticasone/salmeterol inhalation powder doesn’t cause drowsiness, but it can cause other side effects.

More common side effects

The adult side effects for this drug are slightly different from the side effects for children. For all side effects, if they’re mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

The more common side effects in adults can include:

  • upper respiratory tract infections
  • throat irritation
  • hoarseness, voice changes, and trouble speaking
  • thrush (fungal infections in your mouth or throat)
  • bronchitis
  • cough
  • headache
  • nausea and vomiting
  • muscle and bone pain
  • dizziness
  • pneumonia

The more common side effects for the treatment of asthma in children can include:

  • infections in the ear, nose, and throat

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Pneumonia, especially for people with COPD. Symptoms can include:
    • increase in mucus production
    • change in mucus color
    • fever
    • chills
    • increased cough
    • increased breathing problems
  • Infections. Symptoms can include:
    • runny or stuffy nose
    • sore throat
    • drainage from your ear
    • ear pain
    • fever
    • fatigue
  • Adrenal insufficiency (reduced adrenal function). This is a condition where the adrenal glands don’t make enough steroid hormones. This can happen when you stop taking oral corticosteroid drugs (such as prednisone) and start taking fluticasone/salmeterol. This condition can be serious and even fatal. Symptoms can include:
    • tiredness
    • loss of energy
    • weakness
    • nausea and vomiting
    • low blood pressure, which may make you feel dizzy or faint
  • Sudden trouble breathing right after you inhale your medication
  • Serious allergic reactions. Symptoms can include:
    • skin rash
    • hives
    • swelling of your face, mouth, and tongue
    • breathing problems
  • Heart problems. Symptoms can include:
    • high blood pressure, which can cause headache
    • fast or irregular heart rate
    • chest pain
  • Nervous system problems. Symptoms can include:
    • tremors
    • nervousness
  • Osteoporosis (bone thinning or weakness). Symptoms can include:
    • a bone break that happens more easily than expected
    • height loss or stooped posture if your spine is affected
  • Slowed growth in children. Your child’s doctor should check their growth often during treatment with this drug.
  • Eye problems, including glaucoma and cataracts. You should have regular eye exams while taking this drug. Symptoms can include:
    • eye pain
    • blurred vision
    • seeing bright circles (halos) around lights
    • loss of night vision
    • light sensitivity
    • yellow tint to your vision
  • Churg-strauss syndrome or other conditions caused by an increase in a type of white blood cell (eosinophil). Symptoms can include:
    • red, spotty rash
    • muscle or joint pain
    • chest pain
    • numbness or altered sensations due to nerve involvement
    • rapidly worsening shortness of breath or wheezing
  • Low potassium levels. Symptoms can include:
    • muscle cramps
    • muscle twitches
    • increased urination
    • increased thirst
    • irregular heart beat
  • Hyperglycemia (high blood sugar). Symptoms can include:
    • increased urination
    • increased thirst
    • fatigue

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Fluticasone/salmeterol inhalation powder can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with fluticasone/salmeterol are listed below.

Antibiotics

Taking antibiotics with fluticasone/salmeterol may increase the amount of fluticasone/salmeterol in your body. This may cause more side effects. Examples of these drugs include:

  • clarithromycin
  • telithromycin
  • chloramphenicol

Antifungal drugs

Taking certain antifungal drugs with fluticasone/salmeterol may increase the amount of fluticasone/salmeterol in your body. This may cause more side effects. Examples of these drugs include:

  • itraconazole
  • ketoconazole
  • voriconazole

Depression drugs

Taking certain depression drugs with fluticasone/salmeterol may increase the amount of fluticasone/salmeterol in your body. This may cause more side effects. Examples of these drugs include:

  • nefazodone

Taking other depression drugs with fluticasone/salmeterol may cause heart rhythm problems. This includes prolonging the QT interval. Examples of these drugs include:

  • tricyclic antidepressants, such as:
    • amitriptyline
    • clomipramine
    • doxepin
    • imipramine
    • nortriptyline
    • protriptyline
  • monoamine oxidase inhibitors (MAOIs), such as:
    • isocarboxazid
    • phenelzine
    • tranylcypromine
    • selegiline
    • rasagiline

High blood pressure and heart drugs

Taking these drugs with fluticasone/salmeterol can block the action of salmeterol and cause the vessels in your lungs to tighten or constrict. This may make it harder for you to breathe, or put you at a higher risk of lung spasms or asthma attacks.

Examples of these drugs include:

  • beta blockers, such as:
    • acebutolol
    • atenolol
    • betaxolol
    • bisoprolol
    • esmolol
    • metoprolol
    • nadolol
    • nebivolol
    • penbutolol
    • pindolol
    • propranolol
    • sotalol
    • timolol

HIV drugs

Taking certain HIV drugs with fluticasone/salmeterol may increase the amount of fluticasone/salmeterol in your body. This may cause more side effects. Examples of these drugs include:

  • ritonavir
  • atazanavir
  • indinavir
  • nelfinavir
  • saquinavir

Diuretics (water pills)

Taking diuretics with fluticasone/salmeterol may decrease the amount of potassium in your blood. Rarely, fluticasone/salmeterol can also lower potassium. Taking these drugs together puts you at increased risk of low potassium.

Examples of these drugs include:

  • furosemide
  • bumetanide
  • torsemide
  • metolazone
  • chlorthalidone
  • hydrochlorothiazide

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

This drug can cause a severe allergic reaction. Symptoms can include:

  • skin rash
  • hives
  • swelling of your face, mouth, and tongue
  • breathing problems

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Warnings for people with certain health conditions

For people with heart problems, including high blood pressure: This drug may cause chest pain, high or low blood pressure, fast heart rate, and irregular heart rhythms. If you have heart problems, you may be at greater risk. Let your doctor know if you have heart disease.

For people with seizures: This drug may cause seizures. Let your doctor know if you have a seizure disorder.

For people with thyroid problems: Thyroid problems may make your body process this drug differently. Your doctor may need to change your dosage.

For people with diabetes: This drug may increase your blood sugar levels.

For people with liver problems: This drug is processed by your liver. If your liver doesn’t work well, more of this medication will stay in your body longer. This puts you at increased risk of side effects. Your doctor will watch you closely while you take this drug.

For people with osteoporosis (weak bones): This drug can cause decreased bone strength. If you have risk factors for osteoporosis, your doctor will watch you closely to make sure that this medication is safe for you.

For people with immune system problems: This drug may increase your risk of infections. Avoid contact with people who have contagious diseases, such as chicken pox or measles.

For people with eye problems: This drug can cause eye problems, such as increased pressure inside your eyes, glaucoma, and cataracts. Let your doctor know if you have a history of these eye problems. You should have your vision checked regularly while you take this drug.

Warnings for other groups

For pregnant women: Tell your doctor if you’re pregnant or plan to become pregnant. If you become pregnant while taking this drug, call your doctor right away. Pregnant women with asthma should be closely monitored. Your doctor should adjust your medication as needed to control your asthma symptoms.

For women who are breastfeeding: It isn’t known if this drug passes into breast milk. If it does, it may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child.

For seniors: People ages 65 years and older who take this drug for COPD may have more severe side effects, including pneumonia.

It’s unknown if seniors who take this drug for asthma respond differently than younger people do.

For children: For COPD treatment, this drug hasn’t been studied in children. It shouldn’t be used in children younger than 18 years for this purpose.

For asthma treatment, Advair Diskus hasn’t been studied in young children and shouldn’t be used in children younger than 4 years. AirDuo RespiClick hasn’t been studied in children and shouldn’t be used in children younger than 12 years.

All possible dosages and forms may not be included here. Your doctor will tell you what dosage is right for you. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Dosage for asthma

Brand: Advair Diskus

  • Form: inhalation powder
  • Strengths:
    • 100 mcg fluticasone/50 mcg salmeterol
    • 250 mcg fluticasone/50 mcg salmeterol
    • 500 mcg fluticasone/50 mcg salmeterol

Brand: AirDuo RespiClick

  • Form: inhalation powder
  • Strengths:
    • 55 mcg fluticasone/14 mcg salmeterol
    • 113 mcg fluticasone/14 mcg salmeterol
    • 232 mcg fluticasone/14 mcg salmeterol

Advair Diskus

Adult dosage (ages 18–64 years)

  • Typical dosage: 1 inhalation taken twice daily, about 12 hours apart.
  • Strength: Your doctor will decide your inhaler strength based on how severe your asthma is.
  • Between doses: If you have shortness of breath in between doses, use your rescue inhaler for relief.

Child dosage (ages 12–17 years)

  • Typical dosage: 1 inhalation taken twice daily, about 12 hours apart.
  • Strength: Your doctor will decide your child’s inhaler strength based on how severe your child’s asthma is.
  • Between doses: If your child has shortness of breath in between doses, they should use their rescue inhaler for relief.

Child dosage (ages 4–11 years)

Typical dosage: 1 inhalation of 100 mcg fluticasone/50 mcg salmeterol taken twice daily, about 12 hours apart.

Child dosage (ages 0–3 years)

This drug hasn’t been studied in young children for asthma treatment. It shouldn’t be used in children younger than 4 years for this purpose.

AirDuo RespiClick

Adult dosage (ages 18–64 years)

  • Typical dosage: 1 inhalation twice daily, about 12 hours apart.
  • Strength: Your doctor will decide your inhaler strength based on how severe your asthma is.
  • Between doses: If you have shortness of breath in between doses, use your rescue inhaler for relief.

Child dosage (ages 12–17 years)

  • Typical dosage: 1 inhalation twice daily, about 12 hours apart.
  • Strength: Your doctor will decide your child’s inhaler strength based on how severe your child’s asthma is.
  • Between doses: If your child has shortness of breath in between doses, they should use their rescue inhaler for relief.

Child dosage (ages 0–11 years)

This drug hasn’t been studied in children for asthma treatment. It shouldn’t be used in children younger than 12 years for this purpose.

Dosage for coronary obstructive pulmonary disease (COPD)

Brand: Advair Diskus

  • Form: Inhalation powder
  • Strengths: 100 mcg fluticasone/50 mcg salmeterol, 250 mcg fluticasone/50 mcg salmeterol, 500 mcg fluticasone/50 mcg salmeterol

Adult dosage (ages 18–64 years)

  • Typical dosage: 1 inhalation of 250 mcg fluticasone/50 mcg salmeterol taken twice daily, about 12 hours apart.
  • Between doses: If you have shortness of breath in between doses, use your rescue inhaler for relief.

Child dosage (ages 0–17 years)

This medication hasn’t been studied in children for the treatment of COPD. It shouldn’t be used in children younger than 18 years for this purpose.

Senior dosage (ages 65 years and older)

The liver and kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor will monitor you closely while you take this drug.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Fluticasone/salmeterol inhalation powder is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you don’t take it at all: Your symptoms of asthma or COPD will get worse. Your lung function will decline and you’ll have more trouble breathing.

If you stop taking it suddenly: You may not feel anything right away. Eventually your asthma or COPD symptoms will get worse and you may need to use your rescue inhaler more often.

If you don’t take it on schedule: Your asthma or COPD symptoms will get worse. Be sure to take it as prescribed, with your doses about 12 hours apart.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • worsening shortness of breath
  • chest pain
  • increased hart rate
  • shakiness

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: If you miss a dose, just skip that dose. Take your next dose at your usual time. Don’t take two doses at one time to try to make up for the missed dose.

How to tell if the drug is working: Your asthma or COPD symptoms should be better controlled. You should have fewer attacks or sudden symptoms of trouble breathing.

Keep these considerations in mind if your doctor prescribes fluticasone/salmeterol for you.

General

  • You can take this drug with or without food.
  • Take your doses 12 hours apart.

Storage

  • Store this drug at room temperature between 68°F and 77°F (20°C and 25°C). Keep it away from high temperatures.
  • Keep this drug in a dry place away from heat and sunlight.
  • Don’t store this medication in moist or damp areas, such as bathrooms.
  • Store Advair Diskus in the unopened foil pouch and only open it when you’re ready to take it.
  • Safely throw away Advair Diskus in the trash one month after you open the foil pouch or when the counter reads 0, whichever comes first.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t harm your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Your doctor may have you monitor your lung function while you take this drug. You may be asked to record your symptoms or monitor how well your lungs are working with a peak flow meter. Your doctor will show you how to use a peak flow meter.

Follow the instructions that come with your inhaler carefully. Your doctor or pharmacist will show you how to use your inhaler.

Clinical monitoring

You’ll have your lung function monitored through the following tests to make sure this drug is working:

  • Pulmonary function tests (PFTs): Your doctor will do these tests to measure how well your lungs are working.
  • Peak flow results: Your doctor may have you check your lung function at home. You may be asked to record your symptoms or monitor how well your lungs are working with a peak flow meter.

Your doctor should also check the following while you take this drug:

  • Bone strength: This drug may decrease your bone strength.
  • Growth in children: This drug may lead to slowed or delayed growth problems.
  • Eyes: This drug may lead to serious eye problems, such as cataracts or glaucoma.
  • Blood: This drug can cause changes in some blood test results, such as sugar, potassium, and certain types of white blood cells.

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.