Adult Dosing
Asthma
Advair HFA
- Start 2 oral INHALATIONS twice daily; 12 hours apart in the morning and evening
- Increase the dose after 2 wks , if no adequate response to the starting dosage
- Max: 920 mcg/84 mcg daily (fluticasone/salmeterol)
Advair diskus
- Start 1 oral INHALATION twice daily; 12 hours apart in the morning and evening
- Increase the dose after 2 wks , if no adequate response to the starting dosage
- Max: 500 mcg/50 mcg NH bid
COPD; maintenance treatment
Advair diskus
- Start 1 oral INHALATION of 250 mcg/50 mcg (fluticasone/salmeterol) twice daily; 12 hours apart in the morning and evening
- If shortness of breath in between the doses, an inhaled, short-acting beta2 agonist should be taken for immediate relief
Pediatric Dosing
Asthma
Advair diskus
- Child
12 yrs: Start 1 oral INHALATION twice daily; 12 hours apart in the morning and evening - Increase the dose after 2 wks , if no adequate response to the starting dosage
- Max: 500 mcg/50 mcg NH bid
- Child 4-11 yrs: Start 1 oral INHALATION twice daily (fluticasone 100 mcg/salmeterol 50 mcg), 12 hours apart in the morning and evening
[Outline]
- Long acting beta2-adrenergics, such as salmeterol may increase the risk of asthma related death [US Black Box Warnings]
- Do not initiate fluticasone/salmeterol inhaled therapy in patients during rapidly deteriorating or potentially life-threatening episodes of asthma or COPD
- Do not use fluticasone/salmeterol inhaled therapy for the relief of acute episodes of bronchospasm, instead use short-acting beta2-agonist
- Clinically significant cardiovascular effects and fatalities has been reported with excessive use of long-acting beta2-agonists use cautiously in patients with cardiovascular disorders
- Fluticasone/salmeterol inhaled therapy can cause localized infections of the mouth and pharynx with candida albicans, discontinue the therapy and provide appropriate therapy
- Fluticasone inhalation therapy causes lower respiratory tract infections, including pneumonia in patients with COPD
- Inhaled corticosteroids should be used cautiously in patients with active or quiescent tuberculosis infections of the respiratory tract; untreated systemic fungal, bacterial, viral, or parasitic infections; or ocular herpes simplex
- Deaths due to adrenal insufficiency occurs in asthmatic patients during and after transfer from systemic corticosteroids to less systemically available inhaled corticosteroids
- After withdrawal from systemic corticosteroids, a number of months are required for recovery of hypothalamic-pituitary-adrenal (HPA) function, during this period patients may exhibit signs and symptoms of adrenal insufficiency when exposed to trauma, surgery, or infection or other conditions associated with severe electrolyte loss
- Patients withdrawn from systemic corticosteroids should be instructed to resume oral corticosteroids during stress or a severe asthma attack
- Higher than recommended doses of corticosteroid over prolonged Periods of time causes suppression of HPA function
- Concomitant CYP3A4 inhibitors can significantly increase both salmeterol and fluticasone concentrations, resulting in prolongation of QT interval (salmeterol) and systemic effects, including adrenal suppression (fluticasone)
- Adverse reactions, including life threatening paradoxical bronchospasm can occur. If this occurs, discontinue this product immediately and treat with a short acting bronchodilator
- Anaphylactic reactions have been reported in patients with severe milk protein allergy, therefore do not use fluticasone/salmeterol therapy in severe milk protein allergy
- Monitor bone mineral density (BMD) before initiating corticosteroid therapy and periodically thereafter, as long term administration decreases the BMD. If significant reduction in BMD noticed and fluticasone/salmeterol therapy still considered important, provide standard treatment to prevent osteoporosis
- Monitor the growth of pediatric patients receiving fluticasone/salmeterol therapy as inhaled corticosteroids may cause a reduction in growth velocity
- Glaucoma, increased intraocular pressure, and cataracts have been reported in patients on long-term administration of inhaled corticosteroids
- Inhaled fluticasone propionate can cause systemic eosinophilic conditions, physician should look for any sign of eosinophilia, vasculitic rash, worsening pulmonary symptoms, cardiac complications, and/or neuropathy
Cautions: Use cautiously in
Pregnancy Category:C
Breastfeeding: Safety unknown. Inhaled corticosteroids is absorbed into the maternal bloodstream and excreted into breastmilk in probably very small amount to affect a breastfed infant. Reviewers and an expert panel consider inhaled corticosteroids safe to use during breastfeeding. No published data exist on the use of salmeterol inhaler during lactation, as per the data from the related drug, very little is expected to be excreted into breastmilk. Reviewers consider inhaled bronchodilators acceptable during breastfeeding due to its low bioavailability. This data is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 10 Jan 2011). There is no data available on the use of fluticasone/salmeterol [Inhaled] in nursing mother, manufacturer recommends a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
US Trade Name(s)
US Availability
Advair Diskus (fluticasone/salmeterol)
- Diskus (PWDR for INH): 100 mcg/50 mcg
- Diskus (PWDR for INH): 250 mcg/50 mcg
- Diskus (PWDR for INH): 500 mcg/50 mcg
Advair HFA (fluticasone/salmeterol)
- Aerosol: 45 mcg/21 mcg
- Aerosol: 115 mcg/21 mcg
- Aerosol: 230 mcg/21 mcg
Canadian Trade Name(s)
Canadian Availability
Advair (fluticasone/salmeterol)
- Aerosol: 50 mcg/25 mcg
- Aerosol: 125 mcg/25 mcg
- Aerosol: 250 mcg/25 mcg
Advair Diskus (fluticasone/salmeterol)
- Diskus (PWDR for INH): 100 mcg/50 mcg
- Diskus (PWDR for INH): 250 mcg/50 mcg
- Diskus (PWDR for INH): 500 mcg/50 mcg
UK Trade Name(s)
UK Availability
Seretide Accuhaler (fluticasone/salmeterol)
- Accuhaler (PWDR for INH): 100 mcg/50 mcg
- Accuhaler (PWDR for INH): 250 mcg/50 mcg
- Accuhaler (PWDR for INH): 500 mcg/50 mcg
Seretide Evohaler (fluticasone/salmeterol)
- Evohaler (aerosol INH): 50 mcg/25 mcg
- Evohaler (aerosol INH): 125 mcg/25 mcg
- Evohaler (aerosol INH): 250 mcg/25 mcg
Australian Trade Name(s)
Australian Availability
Seretide Accuhaler (fluticasone/salmeterol)
- Accuhaler (PWDR for INH): 100 mcg/50 mcg
- Accuhaler (PWDR for INH): 250 mcg/50 mcg
- Accuhaler (PWDR for INH): 500 mcg/50 mcg
Seretide MDI (fluticasone/salmeterol)
- MDI: 50 mcg/25 mcg
- MDI: 125 mcg/25 mcg
- MDI: 250 mcg/25 mcg
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Advair HFA 45-21 MCG/ACT AERO [Inhaler] (GLAXO SMITH KLINE)
12 act = $209
24 act = $403.96 - Advair Diskus 500-50 MCG/DOSE AEPB [Disp Pack] (GLAXO SMITH KLINE)
60 dose = $304.99
120 dose = $599.98 - Advair Diskus 250-50 MCG/DOSE AEPB [Disp Pack] (GLAXO SMITH KLINE)
60 dose = $232.99
180 dose = $679.97 - Advair Diskus 250-50 MCG/DOSE AEPB [Disp Pack] (GLAXO SMITH KLINE)
28 dose = $105.99
84 dose = $299.96 - Advair HFA 230-21 MCG/ACT AERO [Inhaler] (GLAXO SMITH KLINE)
12 act = $320.99
36 act = $929.99 - Advair Diskus 100-50 MCG/DOSE AEPB [Disp Pack] (GLAXO SMITH KLINE)
60 dose = $189.99
120 dose = $369.97 - Advair HFA 115-21 MCG/ACT AERO [Inhaler] (GLAXO SMITH KLINE)
12 act = $248.99
36 act = $719.94
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.