Brand Names:

Advair Diskus, Advair HFA

What is it?

Fluticasone-Salmeterol is a two in one drug given to people with breathing problems like asthma and COPD, to help them breathe easier. It is treats inflammation and it has a long acting drug that opens airways.

What’s In It For Me?

If you need both medications this is an easy and convenient way to get them into your lungs. It is a dry powder inhaler which is very easy to use.

The Good

Using this drug daily the way your doctor prescribes it, will help stop or reduce how often you get serious breathing problems. You should not need to use the albuterol “rescue” inhaler more than once or twice per week.

The Bad

This drug does not work immediately, so do not use it if you should experience an attack from sudden serious breathing problems. It only works when taken regularly, not as needed.  There are some drugs, like albuterol, used just for attacks because they work quicker.  Some side effects may occur, but generally less than 5 per cent of people get them. These include throat irritation, headache and mouth infections (you should rinse with water and spit out after use).

The Controversial

The salmeterol half of this combination has been associated with more deaths in asthma patients. Some people think it is because people tried to use it like a rescue inhaler and did not get help in time. Perhaps a bigger concern is that many people with asthma do not need the salmeterol half of the combination and so you are getting risks without any benefit. Also many people with chronic lung disase called COPD or emphysema (usually smoking related) , don’t need the fluticasone part of the combination. Again, risks without benefits. 

Fact Box

The main benefit in chronic lung disease (not asthma) is to decrease the number of exacerbations or “bad spells”

For The Cynic

This drug is marketed like it is the only drug for lung problems. It is much better to start with single drugs rather than combinations and use the combination only in people who have proven they need both meds.

The Cost

This drug or any other ones like it are not available in generic form, so patients usually pay brand name copays. Those that pay cash, it is well over $100 per month (as of Spring 2011)

This is a very good combination medication, but it should only be used in people who are not controlled on a single drug product.

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