Advair Diskus

Alternative Name(s): Seretide Diskus

    Advair Diskus (fluticasone/salmeterol) Dosage and Side Effects

    ADVAIR DISKUS is an anti inflammatory steroid that 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 inhalation is a combination medicine 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 is for use in adults and children who are at least 4 years old. ADVAIR HFA is for use in adults and children who are at least 12 years old.

    Proper Use of this medication

    It is very important that you use your ADVAIR DISKUS every day, twice a day, even if you have no symptoms. This will help you to keep free of symptoms throughout the day and night. You should not use it more than twice a day. If you take more than one inhaled medicine, make sure you understand the purpose for taking each medication and when you should use them.

    Do not stop taking ADVAIR DISKUS suddenly—even if you feel better. Your doctor can provide you with information about how to slowly stop the medication if necessary. Do not change your dose unless told to by your doctor. If you have to go into hospital for an operation, take your ADVAIR DISKUS with you and tell the doctor what medicine(s) you are taking. If your doctor decides to stop the treatment, do not keep any left-over medicine unless your doctor tells you to.

    Usual Asthma Dose:

    For patients 12 years of age and older, the usual dose is:

    One inhalation ADVAIR 100 DISKUS twice daily or

    One inhalation ADVAIR 250 DISKUS twice daily or

    One inhalation ADVAIR 500 DISKUS twice daily.

    For children 4 to 11 years of age the usual dose is: One inhalation ADVAIR 100 DISKUS twice daily.

    At present, there are insufficient clinical data to recommend the use of ADVAIR DISKUS in children younger than 4 years of age.

    Usual COPD Dose:

    The usual dose for adults (18 years and older) is:

    One inhalation ADVAIR 250 DISKUS twice daily or

    One inhalation ADVAIR 500 DISKUS twice daily.

    If you are troubled with mucus, try to clear your chest as completely as possible by coughing before you use ADVAIR DISKUS. This will allow ADVAIR DISKUS to pass more deeply into your lungs.

    Overdose:

    If you accidentally take a larger dose than recommended, you may notice that your heart is beating faster than usual and that you feel shaky. Other symptoms you may experience include headache, muscle weakness and aching joints.

    Excessive use of medication can be extremely dangerous. If you have used a larger than allowed recommended dose of ADVAIR DISKUS for a long period of time (months or years), you should talk to your doctor or pharmacist for advice. A gradual reduction of your dose may be needed. Do not stop taking the medication suddenly.

    Missed dose:

    It is very important that you use ADVAIR DISKUS regularly. If you forget to inhale a dose do not worry, inhale another as soon as you remember but if it is near to the time for the next dose, wait until it is due. Do not take a double dose. Then go on as before.

    About your ADVAIR DISKUS:

    The blisters protect the powder for inhalation from effects of the atmosphere.

    When you take your DISKUS out of its box, it will be in the closed position.

    A new DISKUS contains 28 or 60 individually protected doses of your medicine, in powder form. The device has a dose counter which tells you the number of doses remaining. It counts down from 28 or 60 to 1. To show when the last five doses have been reached the numbers appear in red.

    Each dose is accurately measured and hygienically protected. The DISKUS requires no maintenance, and no refilling.

    How to use your ADVAIR DISKUS properly:

    (See package insert for illustrations.)

    It is important that you take each dose as instructed by your doctor, nurse, or pharmacist. Your doctor will decide which strength of DISKUS you should use.

    When you need a dose, just follow the six simple steps illustrated:

    1. Open,

    2. Slide,

    3. Exhale,

    4. Inhale,

    5. Close,

    6. Rinse.

    Sliding the lever of your DISKUS opens a small hole in the mouthpiece and unwraps a dose ready for you to inhale it. When you close the DISKUS, the lever automatically moves back to its original position ready for your next dose when you need it. The outer case protects your DISKUS when it is not in use.

    1. Open: To open your DISKUS hold the outer case in one hand and put the thumb of your other hand on the thumb grip. Push the thumb grip away from you, until you hear it click into place.

    2. Slide: Hold your DISKUS with the mouthpiece towards you. Slide the lever away until you hear another click. Your DISKUS is now ready to use. Every time the lever is pushed back a dose is made available for inhaling. This is shown by the dose counter. Do not play with the lever as this releases doses which will be wasted.

    3. Exhale: Hold the DISKUS away from your mouth. Breathe out as far as is comfortable. Remember—never exhale into your DISKUS.

    4. Inhale: Before you start to inhale the dose, read through this section carefully.

      Once you have fully exhaled, place the mouthpiece to your mouth and close your lips around it. Breathe in steadily and deeply through your mouth until a full breath is taken. Remove the DISKUS from your mouth. Hold your breath for 10 seconds or as long as is comfortable.

      Breathe out slowly.

    5. Close: To close your DISKUS, place your thumb in the thumb grip, and slide it back until you hear a click. The lever is now automatically reset for your next use. The counter on the DISKUS indicates how many doses are remaining.

    6. Rinse: Rinse out your mouth and gargle with water after each dose. Do not swallow the water.

      To get the most from your treatment, remember to take one inhalation of ADVAIR DISKUS twice a day, everyday as prescribed by your doctor.

    Side Effects

    Medicines affect different people in different ways. Just because side effects have occurred in other patients does not mean you will get them. If you experience any side effects that bother you, please contact your doctor. This includes the following side effects, which usually wear off with continued treatment:

    Effects on heart

    • faster heart beat than usual

    Effects on muscles and joints

    • pain in joints

    • muscle cramps

    Effects on nervous system

    • feeling a little shaky

    • headache

    • behavioural changes (including agitation, anxiety, and irritability)

    • disturbed sleep

    • fainting

    • spinning sensation (vertigo)

    • dizziness

    Other Effects

    • hoarseness and voice changes

    • increased bruising

    It is very important that you use your medicine regularly to control your asthma and to ask your doctor whether you need to be monitored in any special way.

    Special attention should be paid if you:

    • were previously taking another form of corticosteroids (like an injection or an oral tablet) and have switched to an inhaled corticosteroid, to look out for tiredness, weakness, nausea and vomiting, low blood pressure.

    • are being treated for diabetes as you may need more frequent blood sugar monitoring or a dosage adjustment of your diabetes medication.

    • develop a mild yeast infection of the mouth or throat (thrush, Candidiasis) or, rarely, in the esophagus. Common signs are white, slightly raised, sore patches on your tongue and inner cheeks. Remember to rinse and gargle your mouth with water and spit after using ADVAIR DISKUS. Cleaning dentures may also help.

    • are a child or adolescent with asthma, as your growth should be monitored regularly by a physician when being treated with corticosteroids. Studies have also shown that children whose asthma is not controlled do not grow as quickly as other children.

    Warnings and Precautions

    ADVAIR DISKUS is not for the treatment of acute asthma attacks or sudden increase of breathlessness and wheezing in COPD. If you get a sudden attack of wheezing and breathlessness between your doses of ADVAIR DISKUS, you should use your fast acting ‘reliever' medicine, such as salbutamol which your doctor has prescribed to you. Use the medication as directed by your doctor.

    You may need to also take steroid tablets or syrup during a severe asthma attack, during other illnesses or during times of stress. Your doctor may give you some steroid tablets or syrup to carry with you as well as a steroid warning card, which will give you advice on when and how to use them.

    Before and while you use ADVAIR DISKUS talk to your doctor or pharmacist if the following situations apply to you so that they can determine whether you should start or continue taking this medication:

    • Are suffering from any chest infection (cold, bronchitis).

    • Have ever had to stop taking another medication for your breathing problems because you were allergic to it or it caused problems.

    • Have been told you are allergic to lactose (milk sugar) or milk protein.

    • Ever had a yeast infection (thrush) in your mouth.

    • Are having treatment for a thyroid condition.

    • Have diabetes.

    • Have high blood pressure.

    • Have heart problems.

    • Have had tuberculosis (TB) infections.

    • Are taking other “steroids” by mouth or by inhalation.

    • Are pregnant, planning to become pregnant or breastfeeding.

    • Are taking a medicine called ketoconazole, used to treat fungal infection.

    • Are taking medicines used to treat HIV infection (e.g. ritonavir, atazanavir, indinavir, nelfinavir, or saquinavir).

    • Have liver problems or cirrhosis.

    You should avoid coming into contact with anyone who has measles or the chicken pox while taking inhaled corticosteroids. If you or your child are exposed, tell your doctor right away.

    Asthma:

    After you start taking ADVAIR DISKUS, your doctor may change the dosages of your other asthma medicines. Rarely, this may make a patient feel worse rather than better. This especially applies to oral corticosteroids (sometimes referred to as steroids), including prednisone. If your doctor decreases your oral steroid dose, and you become unwell, tell your doctor immediately.

    You should have your asthma assessed at regular intervals as agreed upon with your doctor. Once control of your asthma is achieved and maintained, your doctor may further adjust your dose of ADVAIR DISKUS. Do not stop or change the dose of your ADVAIR DISKUS unless your doctor has advised you to do so.

    If you notice the following warning signs, you should contact your doctor as soon as possible or go to the nearest hospital:

    • A sudden worsening of your shortness of breath and wheezing shortly after using your fast acting ‘reliever' medicine or after using ADVAIR DISKUS.

    • You do not feel relief within 10 minutes after using your fast acting‘reliever' medicine or the relief does not last for at least 3 hours.

    • Measurement from your peak flow meter indicates a value less than 60 percent of predicted or personal best.

    • You are breathless at rest.

    • Your pulse is more than 120 beats per minute.

    The following warning signs indicate that your asthma condition may be worsening and that your treatment needs to be reassessed by your doctor.

    • A change in your symptoms such as more coughing, attacks of wheezing, chest tightness, or an unusual increase in the severity of the breathlessness.

    • You wake up at night with chest tightness, wheezing or shortness of breath.

    • You use increasing amounts of your fast acting ‘reliever' medicine.

    • Measurement from your peak flow meter indicates a value between 60 and 80 percent of predicted or personal best.

    COPD:

    Patients with COPD have a higher chance of getting pneumonia (a lung infection). ADVAIR DISKUS may increase the chance of getting pneumonia. If you have COPD, it is very important that even mild chest infections be treated right away. If you think you have an infection, see your doctor immediately.

    You should avoid close contact with people who have colds or the flu (influenza). You should ask your doctor about flu vaccination.

    The following warning signs indicate that your COPD condition may be worsening. You should contact your doctor as soon as possible if you notice:

    • An unusual increase or decrease in the amount of phlegm.

    • An unusual increase in the consistency and stickiness of the phlegm.

    • The presence of blood in phlegm.

    • A change in the colour of the phlegm to either brown, yellow or green.

    • An unusual increase in the severity of the breathlessness, cough or wheeze.

    • Symptoms of a cold (e.g., sore throat).

    • Unexplained tiredness or fever.

    • Chest tightness.

    • Unexplained swelling.

    • The necessity to increase the number of pillows in order to sleep in comfort.

    Interactions with this medication

    As with most medicines, interactions with other drugs are possible. Tell your doctor, nurse, or pharmacist about all the medicines you take, including drugs prescribed by other doctors, vitamins, minerals, natural supplements, or alternative medicines.

    Drugs that may interact with ADVAIR DISKUS include:

    • medicines similar to ADVAIR DISKUS used for your lung disease, as it may increase the risk of experiencing possible side effects. This includes other medicines containing a long-acting beta2-agonist or a corticosteroid.

    • medicines used to treat HIV infection or AIDS (e.g. ritonavir, atazanavir, indinavir, nelfinavir, saquinavir).

    • ketoconazole (used to treat fungal infections).

    • beta-blockers used in the treatment of high blood pressure or other heart problems (e.g. propranolol) or in the treatment of glaucoma.

    • medicines used to treat depression (i.e., tricyclic antidepressants, monoamine oxidase inhibitors).

    • medicines used to decrease the level of potassium in your blood (i.e., diuretics). These are also known as “water pills” and are used to treat high blood pressure.

    • methylxanthines (such as theophylline) used to treat asthma and COPD.

    Other related products

    The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.