What is the dosing regimen for Advair (fluticasone-salmeterol)?

From the Guidelines

Advair should be taken twice daily, with a dose that depends on the level of severity or control of asthma or COPD, with the most common starting dose for adults being 250/50 (250 mcg fluticasasteroid and 50 mcg salmeterol) inhaled twice daily. The medication comes in three strengths: 100/50,250/50, and as indicated in the study from the Journal of Allergy and Clinical Immunology 1.

Key Considerations

• The dose may be adjusted based on symptom control, with a maximum of two inhalations twice daily.
• It is essential to rinse the mouth with water after each use to prevent thrush.
• The medication should be used in conjunction with an inhaled corticosteroid, as indicated by the study in the European Respir 1.

Potential Adverse Effects

• Tachycardia, skeletal muscle tremor, hypokalemia, and decreased duration of protection against exercise-induced bronchospasm may occur with regular use, as noted in the study 1.
• A diminished bronchoprotective effect may occur within a week of chronic therapy, and there is a potential risk of uncommon severe life-threatening or fatal exacerbation, as discussed in the study 1.

Important Considerations for Use

• The medication should not be used for acute symptom relief or exacerbations, and it should only be used with inhaled corticosteroids, as indicated by the study 1.
• The dose for children 5-12 years of age is based on clinical trials using a dry powder inhaler with slightly different delivery characteristics, as noted in the study 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION • For oral inhalation only. (2) • Treatment of Asthma in Patients Aged 12 Years and Older: 1 inhalation of fluticasone propionate and salmeterol inhalation powder 100 mcg/50 mcg, fluticasone propionate and salmeterol inhalation powder 250 mcg/50 mcg, or fluticasone propionate and salmeterol inhalation powder 500 mcg/50 mcg twice daily. Starting dosage is based on asthma severity. (2.1) • Treatment of Asthma in Patients Aged 4 to 11 Years: 1 inhalation of fluticasone propionate and salmeterol inhalation powder 100 mcg/50 mcg twice daily. (2.1) • Maintenance Treatment of COPD: 1 inhalation of fluticasone propionate and salmeterol inhalation powder 250 mcg/50 mcg twice daily. (2.2)

The dosing regimen for Advair (fluticasone-salmeterol) is as follows:

• Asthma in patients 12 years and older: 1 inhalation of 100 mcg/50 mcg, 250 mcg/50 mcg, or 500 mcg/50 mcg twice daily, based on asthma severity.
• Asthma in patients 4 to 11 years: 1 inhalation of 100 mcg/50 mcg twice daily.
• Maintenance treatment of COPD: 1 inhalation of 250 mcg/50 mcg twice daily. 2

From the Research

Dosing Regimen for Advair (fluticasone-salmeterol)

• The dosing regimen for Advair (fluticasone-salmeterol) varies depending on the patient's condition and age 3, 4, 5, 6, 7.
• For adults with chronic obstructive pulmonary disease (COPD), the recommended dose is twice-daily salmeterol/fluticasone propionate 50/250 microg 3.
• For patients with moderate-to-severe COPD, twice-daily inhaled salmeterol/fluticasone propionate 50/250 or 50/500 microg can be used 3.
• In patients with asthma, the Advair Diskus is available in 3 strengths of fluticasone propionate (100,250, and 500 microg) and a fixed dose (50 microg) of salmeterol, administered twice daily 4, 5.
• A study also investigated the efficacy and safety of fluticasone propionate/salmeterol 250/50 mcg Diskus administered once daily, which may be a valuable treatment option for some patients 7.
• The combination of salmeterol 50 microg and fluticasone 250 microg in a single dry powder inhaler was found to be superior to twice the dose of fluticasone propionate (500 microg) for the treatment of symptomatic moderate asthma 6.