Advair Diskus
(Fluticasone Propionate and Salmeterol)

Other Names
(ADD-vair) Diskus®

What is this drug?
Advair is a combination medicine, it contains two medications;

• Fluticasone, an inhaled corticoidsteroid, used to control the symptoms of asthma caused by airway inflammation.
• Salmeterol is a long-acting bronchodilator, used to to control/prevent bronchospasm (narrowing of the airways) by relaxing airway muscles (see the muscle of breathing***normal anatomy).

Why is it prescribed?
Advair Diskus is used to control the symptoms (up to 12 hours at a time) of asthma and improve lung function. It is used to prevent asthma attacks.

In order for this medicine to help prevent asthma attacks, it must be used every day in regularly spaced doses, as ordered by your doctor. Do not stop taking this medicine without telling your doctor, to do so may increase the chance of side effects.

Use this medicine only as directed, do not use it more often than your doctor ordered.

**Warning ADVAIR is NOT a Fast-Acting/Rescue Inhaler

• This drug is NOT used to relieve an asthma attack that has already started. ADVAIR won't replace fast-acting/rescue inhalers for sudden symptoms.
• For relief of an asthma attack that has already started, you should use another medicine such as a “fast-acting/rescue’ inhaler.
• Taking extra doses of Advair will not relieve acute asthma symptoms.
• People switching from an oral steroid like prednisone, to Advair Diskus, need to be sure to follow their doctor’s instructions closely.

How should I take this drug?
Advair Diskus should be used twice daily:

• One inhalation/puff in the morning
• One inhalation/puff in the evening.

**To avoid mouth infections (thrush a yeast infection), be sure to rinse your mouth with water, spit the water out, do not swallow the water.

**If you miss a dose of Advair Diskus, take it as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue with your regular dosing schedule.

Instruction for using the DISKUS
(Video demonstration)

1. OPEN
Hold the DISKUS in one hand and put the thumb of your other hand on the thumbgrip. Push your thumb away from you as far as it will go, until the mouthpiece appears and snaps into position.

2. CLICK
Hold the DISKUS in a level, horizontal position with the mouthpiece toward you. Slide the lever away from you as far as it will go, until it clicks. The DISKUS is now ready to use.

**Every time the lever is pushed back, a dose is ready to be inhaled. This is shown by a decrease in numbers on the dose counter.

3. INHALE
**Before inhaling your dose of ADVAIR DISKUS, breathe out as far as is comfortable, holding the DISKUS level and away from your mouth. Remember, never breathe out into the DISKUS mouthpiece.

Put the mouthpiece to your lips. Breathe in quickly and deeply through the ADVAIR DISKUS, not through your nose.

Remove the DISKUS from your mouth. Hold your breath for about 10 seconds, or for as long as is comfortable. Breathe out slowly.

**CLOSE the DISKUS when you are finished taking a dose so that the DISKUS will be ready for you to take your next dose.

Put your thumb on the thumbgrip and slide the thumbgrip back toward you as far as it will go. The DISKUS will click shut. The lever will automatically return to its original position.

The DISKUS is now ready for you to take your next scheduled dose, due in approximately 12 hours.

To avoid releasing or wasting doses:

• Do not close the DISKUS.
• Do not tilt the DISKUS.
• Do not play with the lever.
• Do not advance the lever more than once.
• Use within one month of opening, or when the counter reads zero.

When do I need to call the doctor?

• If it is an emergency, call 911.
• In case of overdose, call your local poison control center at 1-800-222-1222.
• If the condition is worsens.
• If you are having to increase the number of your normal puffs and/or if you are not getting relief for your shortness of breath after using your rescue inhalers.
• Always consult your doctor before making changes to your prescribed medication routine.
• If you experience any of these side-effects of the medication:
  • heart palpitations
  • increased difficulty breathing
  • swollen face, lower legs, or ankles

Typical dosing and age-specific information:

Advair Diskus is a dry powder inhaler that comes in three strengths. The strength your doctor recommends for you depends on the severity of your asthma.

• For Asthma
  Adults and children 4 years of age and older: One inhalation twice a
  day, about 12 hours apart.
  
  Children up to 4 years of age: Use and dose must be determined by
  your doctor.
  
• For COPD
  Adults: One inhalation (250/50) twice a day, about 12 hour apart.

What side effects can this medication cause?

• Increased blood pressure
• Increased heart rate
• Changes in heart rhythm
• Respiratory tract infections
• Sore throat
• Hoarseness
• Sinusitis
• Oral thrush (yeast)
• Cough
• Headache
• Upset stomach

How should I store this medication?

Advair Diskus should be stored at room temperature (68-77 degrees F) in its foil overwrap until you are ready to begin using it. Avoid exposure to heat i.e. leaving in car or car trunk during warm weather.