ADVAIR HFA
Combination product
Pronunciation: floo-TIK-a-soen and sal-ME-ter-ol (AD-vair)
Combination of Fluticasone and Salmeterol, as a metered-dose inhaler rather than the DISKUS dry-powder device.
Each component keeps its own pharmacology page; the combination itself adds no new mechanism.
Components (2)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Asthma (maintenance treatment) | Adults and adolescents aged 12 years and older | 2 inhalations BID (~12 hours apart) of 45/21, 115/21, or 230/21 mcg; starting strength based on asthma severity | Step up strength if inadequate response after 2 weeks | 2 inhalations of 230 mcg/21 mcg BID |
Titration May increase to a higher strength after 2 weeks of inadequate response
Renal Undefined
Hepatic Closely monitor; hepatic impairment may lead to accumulation of fluticasone propionate and salmeterol
Not indicated for relief of acute bronchospasm; do not use in conjunction with another LABA.
Instructions
- For oral inhalation only; rinse mouth with water without swallowing after each dose
- Prime with 4 sprays before first use, and 2 sprays if unused >4 weeks or dropped
- Not for relief of acute bronchospasm; use a short-acting beta2-agonist for acute symptoms
- Do not use with another LABA; do not exceed 2 inhalations twice daily
Available strengths
- inhaler 45/21, 115/21, 230/21 mcg/inh
- powder 0.055/0.014, 0.1/0.05, 0.113/0.014, 0.232/0.014, 0.25/0.05, 0.5/0.05 mg/inh
Contraindications
- Primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required
Cautions
- LABA monotherapy increases risk of asthma-related death (mitigated in fixed-dose ICS/LABA)
- Do not initiate in acutely deteriorating asthma
- Do not use with another LABA (overdose risk)
- Oropharyngeal candidiasis; pneumonia in COPD patients
- Immunosuppression and risk of infections (e.g., chickenpox, measles)
- HPA suppression/adrenal insufficiency when transferring from systemic corticosteroids; hypercorticism/adrenal suppression
- Paradoxical bronchospasm; hypersensitivity reactions including anaphylaxis
- Cardiovascular and CNS effects; reduced bone mineral density; growth effects in pediatrics
- Glaucoma and cataracts; eosinophilic conditions; hypokalemia and hyperglycemia
Adverse reactions
- Upper respiratory tract infection/inflammation
- Throat irritation; dysphonia/hoarseness
- Headache, dizziness
- Nausea and vomiting; musculoskeletal pain
Pregnancy Insufficient human data; poorly/moderately controlled asthma raises perinatal risk — monitor closely and adjust to maintain asthma control.
Lactation No data on presence in human milk; plasma levels after inhaled doses are low, so milk concentrations are likely correspondingly low.
Cost
Part D rank #300.