IMPORTANT ADVAIR WARNING:

Why is Advair prescribed?

The combination of fluticasone (Advair) and salmeterol (Advair) is used to prevent wheezing, shortness of breath, and breathing difficulties caused by asthma. Fluticasone (Advair) is in a class of medications called steroids. Advair works by reducing swelling in the airways. Salmeterol (Advair) is in a class of medications called long-acting beta-agonists. Advair works by relaxing and opening air passages in the lungs, making it easier to breathe.

How should Advair be used?

The combination of fluticasone (Advair) and salmeterol (Advair) comes as a powder to inhale by mouth using a special inhaler device. Advair usually is used twice a day, in the morning and evening, about 12 hours apart. To help you remember to use fluticasone (Advair) and salmeterol (Advair), use it around the same time every day. Follow the directions on your Advair prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use fluticasone (Advair) and salmeterol (Advair) exactly as directed. Do not use more or less Advair or use Advair more often than prescribed by your doctor.

Do not use fluticasone (Advair) and salmeterol (Advair) during an asthma attack. Your doctor will prescribe a short-acting inhaler to use during attacks.

Fluticasone (Advair) and salmeterol (Advair) inhalation controls asthma but does not cure it. It may take a week or longer before you feel the full benefit of fluticasone (Advair) and salmeterol (Advair) . Tell your doctor if your symptoms do not improve after 2 weeks. Continue to use fluticasone (Advair) and salmeterol (Advair) even if you feel well. Do not stop using fluticasone (Advair) and salmeterol (Advair) without talking to your doctor. If you stop taking fluticasone (Advair) and salmeterol (Advair), your symptoms may return.

Before you use fluticasone (Advair) and salmeterol (Advair) inhalation for the first time, read the Advair instructions that come with it. Ask your doctor, pharmacist, or respiratory therapist to show you how to use the Advair inhaler. Practice using your Advair inhaler while he or she watches.

To use the Advair inhaler, follow these steps:

• Hold the Advair inhalation device in one hand, and put the thumb of your other hand on the Advair thumb grip. Push your thumb away from you as far as it will go until the Advair mouthpiece appears and snaps into position.
• Hold the Advair inhalation device in a horizontal position with the Advair mouthpiece toward you. Slide the Advair lever away from you as far as it will go until it clicks.
• Every time the Advair lever is pushed back, an Advair dose is ready to inhale. You will see the number in the Advair dose counter go down. Do not waste Advair doses by closing the device, playing with the lever, or advancing the lever more than once.
• Hold the Advair inhalation device level and away from your mouth, and breathe out as far as you comfortably can.
• Put the Advair mouthpiece to your lips. Breathe in quickly and deeply though the Advair inhalation device, not through your nose.
• Remove the Advair inhalation device from your mouth, and hold your breath for 10 seconds or as long as you comfortably can. Breathe out slowly.
• Put your thumb on the Advair thumb grip and slide it back toward you as far as it will go. The Advair device will click shut.
• Rinse your mouth with water, but do not swallow.

Never exhale into the Advair inhalation device, take the Advair device apart, or wash the Advair mouthpiece or any part of the Advair device. Keep the Advair device dry. Do not use the Advair device with a spacer.

Other uses for Advair 

This Advair medication may be prescribed for other uses; ask your doctor or pharmacist for more Advair information.

What special Advair precautions should I follow?

Before using fluticasone (Advair)and salmeterol (Advair),

• tell your doctor and pharmacist if you are allergic to Advair/ fluticasone (Flonase, Flovent), salmeterol (Serevent), any other medications, or milk protein.
• do not use formoterol (Foradil) or salmeterol (Serevent) while using fluticasone (Advair) and salmeterol (Advair).
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral); beta-blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); cimetidine (Tagamet); clarithromycin (Biaxin); cyclosporine (Neoral, Sandimmune); danazol (Danocrine); delavirdine (Rescriptor); diltiazem (Cardizem, Dilacor, Tiazac); diuretics (water pills); erythromycin (E.E.S., E-Mycin, Erythrocin); fluoxetine (Prozac, Sarafem); fluvoxamine (Luvox); HIV protease inhibitors such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir); isoniazid (INH, Nydrazid); metronidazole (Flagyl); nefazodone (Serzone); oral contraceptives (birth control pills); troleandomycin (TAO); verapamil (Calan, Covera, Isoptin, Verelan); and zafirlukast (Accolate). Also tell your doctor and pharmacist if you are taking the following medications or have stopped taking them during the past 2 weeks: antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); and monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), and tranylcypromine (Parnate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had high blood pressure, irregular heartbeat, seizures, hyperthyroidism (overactive thyroid), diabetes, tuberculosis, glaucoma, or liver or heart disease, and if you have a herpes eye infection or a fungal, viral, or bacterial infection (except an infection of the skin).
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using fluticasone (Advair) and salmeterol (Advair), call your doctor.
• if you are having surgery, including dental surgery, tell your doctor or dentist that you are using fluticasone (Advair) and salmeterol (Advair).
• if you have been using a short-acting beta-agonist inhaler such as albuterol (Proventil, Ventolin) on a regular basis (for example, four times a day), your doctor will probably tell you to stop using it regularly when you start using fluticasone (Advair) and salmeterol (Advair). Keep your other inhaler to use during an asthma attack.
• avoid exposure to chickenpox or measles. If you are exposed to these diseases or if you develop symptoms of these diseases, call your doctor immediately. You may need to get a vaccine to protect you from these infections.

What special dietary instructions should I follow when taking Advair?

Talk to your doctor about drinking grapefruit juice while taking Advair.

What should I do if I forget an Advair dose?

Inhale the missed Advair dose as soon as you remember it. However, if it is almost time for the next Advair dose, skip the missed Advair dose and continue your regular Advair dosing schedule. Do not inhale a double Advair dose to make up for a missed one.

What side effects can Advair cause?

Fluticasone (Advair) and salmeterol (Advair) may cause side effects. Tell your doctor if any of these Advair symptoms are severe or do not go away:

• runny nose
• sneezing
• sore throat
• hoarseness
• sinus pain
• cough
• headache
• upset stomach
• vomiting
• diarrhea
• stomach pain
• muscle and bone pain
• throat irritation

Some Advair side effects can be serious. The following Advair symptoms are uncommon, but if you experience any of them, call your doctor immediately:

• shaking hands that you cannot control
• hives
• skin rash
• swelling of the face, throat, tongue, lips, hands, feet, ankles, or lower legs
• choking or difficulty swallowing
• increased difficulty breathing
• noisy, high-pitched breathing
• pounding or fast heartbeat
• chest pain
• nervousness
• blurred vision
• white patches in the mouth
• fever, chills, and other signs of infection

Fluticasone (Advair) and salmeterol (Advair) may cause children to grow more slowly. If your child is using fluticasone (Advair) and salmeterol (Advair) and does not seem to be growing properly, talk to your childs doctor.

Fluticasone (Advair) and salmeterol (Advair) may cause other side effects. Call your doctor if you have any unusual problems while using Advair.

What storage conditions are needed for Advair?

Keep Advair in the container it came in, tightly closed, and out of reach of children. Store Advair at room temperature and away from excess heat and moisture (not in the bathroom). Throw away the Advair inhalation device 1 month after you remove it from the foil overwrap or after every Advair blister has been used (when the Advair dose indicator reads 0), whichever comes first. Talk to your pharmacist about the proper disposal of Advair.

In case of Advair emergency/overdose

In case of Advair overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of Advair overdose may include:

• seizures
• chest pain
• dizziness
• fainting
• blurred vision
• fast, pounding, or irregular heartbeat
• nervousness
• headache
• shaking hands that you cannot control
• muscle cramps or weakness
• dry mouth
• upset stomach
• dizziness
• excessive tiredness
• lack of energy
• difficulty falling asleep or staying asleep
• thirst
• flushing
• dry skin
• frequent urination
• loss of appetite
• trouble breathing

What other Advair information should I know?

Keep all appointments with your doctor.

Do not let anyone else take your Advair. Ask your pharmacist any questions you have about refilling your Advair prescription.