Advair®

What is Advair?

Advair is the branded version of Fluticasone + Salmeterol, a combination inhaler used as a preventative medication for asthma.

The effect of Advair is long-lasting, meaning you shouldn’t use it when you have acute symptoms. Instead you should take it daily every 12 hours, even if you’re not having symptoms. Advair needs to be used twice daily to prevent asthma attacks.

Advair comes as a regular HFA inhaler that you need to press down at the same time as you breathe in to deliver the medication to your lungs, and as a Diskus that is breath-activated, and arguably much easier to use.

How does Advair work?

Advair contains both a corticosteroid and a beta-2 agonist; each has a different function within your body.

Salmeterol is the beta-agonist that works on the smooth muscle of the lungs. Here it acts as a bronchodilator, to make it easier for you to breathe when an asthma attack strikes.^[1] This effect is long-lasting, so if you have an asthma attack your symptoms should be reduced, but you’ll likely still need a rescue inhaler to restore calm.

Fluticasone is a corticosteroid with a powerful anti-inflammatory effect. It acts on the activated inflammatory genes to prevent asthma symptoms from occurring and making the ones that do develop much milder.^[2]

What doses of Advair are there?

There are two versions of Advair, the Diskus and the HFA, and each comes in three different doses.

Advair Diskus comes in 100mcg, 250mcg, or 500mcg of Fluticasone, and all options contain 50mcg of Salmeterol. These quantities are the amount delivered per dose; you’re supposed to take one inhalation twice daily, roughly every 12 hours.

The twice a day regimen is the same with Advair HFA, but the doses are slightly different, so you need to inhale it twice each time. You can get the HFA in 45mcg, 115mcg, or 230mcg of Fluticasone, and all options contain 21mcg of Salmeterol.

How to use Advair

The doctor who prescribed Advair to you will direct you exactly on how to use it, and you should always follow their advice. If you have any questions or concerns, don’t hesitate to ask them.

Here are a few general guidelines to get you started with Advair, as well as specific instructions on how to use the Diskus and HFA.

• Always rinse your mouth with water after using your inhaler, and do not swallow the water
• Don’t take the inhaler apart
• Both inhalers come with a dose counter, once the display turns red you should order a refill
• If you have an asthma attack you shouldn’t use Advair, instead use your rescue inhaler

How to use Advair HFA

• Use Advair HFA twice a day, two inhalations each time
• Always hold your inhaler upright, with the mouthpiece at the bottom
• Before you use the HFA for the first time you need to prime it. To do so, squeeze the sides of the mouthpiece cap and pull it off, shake the inhaler well, and press the canister away from your face until the dose counter goes down by one. Repeat this four times and your inhaler will be ready to use
• Before each use, remove the mouthpiece cap by squeezing the sides and pulling it off
• Shake the inhaler well for about five seconds
• Breathe out as much as you can away from the inhaler
• Put your lips around the mouthpiece and breathe in deeply, synchronising your inhale with pressing down the canister, until you’ve press it all the way down
• Stop pressing the canister and remove the inhaler from your mouth
• Hold your breath for as long as you can, ideally ten seconds
• Breathe out as much as you can and repeat the process one more time

How to use Advair Diskus

• Use Advair Diskus twice a day, one inhalation in the morning and one inhalation in the evening. Even if you’re not experiencing asthma symptoms and are feeling well.
• Hold the inhaler with your left hand and uncover the mouthpiece by pushing the lever on the side with your thumb
• With the mouthpiece pointing towards you, use your thumb to slide the lever next to the mouthpiece away from you. You should hear a click when you reach the correct position
• Don’t tilt the inhaler, otherwise the powder might fall off.
• Meaning a wasted dose
• Breathe out as much as you can away from the inhaler
• Place the mouthpiece between your lips and breathe in fast and deeply
• Remove the inhaler from your mouth and hold your breath for ten seconds, or until you can’t hold it any longer
• Breathe out slowly and close the inhaler by moving the lever towards the mouthpiece until you can’t see it anymore

How long does it take Advair to work?

You might not feel anything drastic when taking Advair, since it’s a preventative medication. This means you’ll be taking it twice a day, everyday, even if you don’t have any asthma symptoms. Typically, you’ll only get the full benefits of Advair after about a week of using it. These benefits include easier breathing and less frequent or severe asthma symptoms.

What should I do if I make a mistake when using Advair?

If you forget to take a dose of Advair, you should take it as soon as you remember, as long as it doesn’t mess up your schedule too much. If it’s almost time for your next dose you can safely skip the missed one and continue taking it every 12 hours.

If you accidentally take too much Advair, contact your primary physician as soon as possible so they can advise you on how to proceed. If you get any serious side effects like shortness of breath or a faster heartbeat, call 911.