Advair / Seretide

Advair/Seretide has specific FDA and regulatory approvals for treating asthma and COPD in carefully selected patients, based on extensive clinical research demonstrating significant improvements in lung function, symptom control, and quality of life:

Primary Indications:

Asthma (Reversible Obstructive Airways Disease):

• Adults and adolescents 12 years and older: Regular treatment when combination therapy is appropriate
• Children 4 years and older: Maintenance treatment with appropriate dosing
• Patients not controlled on corticosteroids alone: Those requiring additional bronchodilator therapy
• Patients already using both components separately: Simplification to single inhaler
• Patients not controlled with short-acting rescue inhalers: Step-up therapy alternative

Chronic Obstructive Pulmonary Disease (COPD):

• Moderate to severe COPD: Pre-bronchodilator FEV1 <60% predicted normal
• Symptomatic patients: Significant symptoms despite bronchodilator therapy
• History of repeated exacerbations: Patients experiencing frequent flare-ups
• Adult patients only: Not approved for pediatric COPD (rare condition in children)

Patient Selection Criteria:

Ideal Candidates for Asthma:

• Inadequate control with ICS alone: Persistent symptoms despite appropriate corticosteroid dose
• Already using both medications: Patients taking separate LABA and ICS inhalers
• Step 3-5 asthma severity: Moderate to severe persistent asthma
• Frequent symptoms: Daily or nightly asthma symptoms
• Impaired lung function: Reduced FEV1 or peak flow measurements
• Regular rescue inhaler use: Needing short-acting bronchodilators frequently

Ideal Candidates for COPD:

• FEV1 <60% predicted: Moderate to severe airflow limitation
• Chronic symptoms: Persistent breathlessness, cough, or sputum production
• Exacerbation history: Two or more exacerbations in past year
• Despite bronchodilator use: Symptoms persisting with regular bronchodilator therapy
• Significant disability: Symptoms affecting daily activities and quality of life

Contraindications and Precautions:

Absolute Contraindications:

• Hypersensitivity to salmeterol xinafoate, fluticasone propionate, or any excipients
• Primary treatment of acute asthma symptoms or status asthmaticus
• Acute deteriorating or unstable asthma requiring emergency treatment

Relative Contraindications and Cautions:

• Active or quiescent tuberculosis: Risk of disease activation with corticosteroids
• Thyrotoxicosis: Sensitivity to sympathomimetic effects
• Cardiovascular disease: Pre-existing heart conditions, arrhythmias
• Diabetes mellitus: Blood glucose monitoring required
• Hypokalemia susceptibility: Risk of low potassium levels
• Concurrent ritonavir use: Strong drug interaction increasing systemic steroid effects

Does Advair strengthen your lungs?

Advair doesn't actually strengthen lung tissue, but it does improve lung function by reducing inflammation and keeping airways open. The fluticasone component decreases swelling and irritation in the airways, while salmeterol relaxes the muscles around airways to make breathing easier. With consistent daily use, most patients experience improved lung function measurements, fewer symptoms, and better exercise tolerance. These improvements happen because the medication addresses the underlying inflammation and bronchospasm that restrict airflow in asthma and COPD.

How should I use Advair/Seretide for best results?

Use Advair exactly as prescribed, typically two inhalations twice daily (morning and evening), even when you feel well. The medication works best with regular use and won't provide immediate relief during an acute attack. Take it at the same times each day to maintain consistent levels in your system. After each use, rinse your mouth thoroughly with water and spit it out to prevent thrush. Never stop taking Advair suddenly without consulting your doctor, as this can cause your symptoms to worsen dramatically.

What should I do if I miss a dose?

If you forget a dose, take it as soon as you remember unless its almost time for your next scheduled dose. In that case, just skip the missed dose and continue with your normal schedule. Never take extra doses to make up for missed ones, as this increases your risk of side effects without providing additional benefit. If you frequently forget doses, try setting phone alarms or linking medication use to daily activities like brushing your teeth.

Can Advair cause weight gain?

Weight gain is possible but not common with Advair use. Clinical trials showed that only 1-3% of people taking Advair HFA experienced some weight gain. This is much less frequent than with oral corticosteroids because inhaled steroids are absorbed primarily in the lungs with minimal systemic exposure. If you're concerned about weight changes while taking Advair, discuss this with your doctor, but dont stop the medication without medical guidance.

Is Advair safe for long-term use?

Yes, Advair is designed for long-term daily use and has been studied extensively in trials lasting several years. However, its important to use the lowest effective dose that controls your symptoms. Your doctor should regularly reassess your condition and consider stepping down the dose if your asthma or COPD remains well-controlled. Children using inhaled corticosteroids should have their height monitored regularly, as prolonged high-dose use can affect growth velocity.

Why can't I use Advair as a rescue inhaler?

Advair contains salmeterol, a long-acting bronchodilator that takes 30-60 minutes to start working and is designed to prevent symptoms over 12 hours. During an acute asthma attack, you need immediate relief that only short-acting bronchodilators like albuterol can provide. Using Advair during an attack won't help quickly enough and could delay appropriate treatment. Always keep a fast-acting rescue inhaler available and use it for sudden breathing problems.

What's the proper inhaler technique for Advair?

For the HFA inhaler: (1) Shake well before each use, (2) Breathe out completely, (3) Place the mouthpiece in your mouth and close your lips around it, (4) Start breathing in slowly and press down on the canister simultaneously, (5) Continue breathing in slowly and deeply, (6) Hold your breath for about 10 seconds, (7) Breathe out slowly, (8) Wait 30 seconds before the second inhalation. For the Diskus, the technique is different - you dont shake it, and its breath-activated. Ask your pharmacist or doctor to demonstrate proper technique.

Should I use a spacer with Advair HFA?

Using a spacer device with Advair HFA can be beneficial, especially if you have difficulty coordinating breathing and pressing the inhaler. Spacers improve drug delivery to the lungs and reduce medication deposition in the mouth and throat, which decreases the risk of thrush and hoarseness. If you use a spacer, wash it monthly in warm soapy water and let it air dry without rinsing or towel-drying, as this reduces static that can affect drug delivery.

How long does it take for Advair to start working?

The bronchodilator effect from salmeterol typically begins within 30-60 minutes and lasts more than 12 hours. However, the full anti-inflammatory benefits from fluticasone may take 1-2 weeks of regular use to become apparent. Most patients notice gradual improvement in symptoms, reduced need for rescue inhalers, and better lung function over the first few weeks of treatment. Don't get discouraged if you don't feel immediate dramatic improvement.

Can I use Advair if I have a heart condition?

Advair should be used with caution in patients with cardiovascular disorders, as the salmeterol component can affect heart rate and rhythm. Beta-agonists can cause increases in heart rate, blood pressure, and occasionally cardiac arrhythmias. If you have heart disease, inform your doctor before starting Advair, and report any chest pain, palpitations, or irregular heartbeat immediately. Your doctor may need to monitor you more closely or adjust your treatment.

What medications interact with Advair?

Several medications can interact with Advair. Beta-blockers can reduce the bronchodilator effectiveness and should generally be avoided. Strong CYP3A4 inhibitors like ritonavir, ketoconazole, and clarithromycin can increase fluticasone levels, leading to systemic corticosteroid effects. These combinations should be avoided when possible. Inform your doctor about all medications you're taking, including prescriptions, over-the-counter drugs, and supplements, as multiple interactions are possible.

Is Advair safe during pregnancy and breastfeeding?

Advair should only be used during pregnancy if the expected benefits outweigh potential risks to the baby. Studies haven't shown increased risk of major birth defects, but data is limited. Uncontrolled asthma during pregnancy poses significant risks to both mother and baby, so continuing asthma treatment is usually important. For breastfeeding, small amounts of the medication may pass into breast milk, but concentrations are likely very low. Discuss the risks and benefits with your doctor if you're pregnant or breastfeeding.

Why do I need to rinse my mouth after using Advair?

Rinsing your mouth with water and spitting it out after each use removes medication that deposits in your mouth and throat. This significantly reduces your risk of developing oral thrush (candidiasis), a fungal infection that causes white patches in the mouth. It also decreases absorption of corticosteroids through the mouth and throat, reducing systemic exposure. Make this a habit after every dose to prevent these preventable side effects.

Can I buy Advair online safely?

Advair requires a prescription and should only be purchased from licensed pharmacies that require valid prescriptions. Be extremely cautious about online sources, as counterfeit inhalers are a significant problem and may contain incorrect doses, contaminants, or no active ingredient. Work with reputable pharmacies that provide genuine medications with proper storage and handling. Respiratory medications require ongoing medical monitoring, so maintain regular contact with your doctor regardless of where you obtain the medication.