Can Advair (fluticasone propionate/salmeterol) and Qvar (beclomethasone dipropionate) be taken together?

No, Advair and Qvar Should Not Be Taken Together

Taking Advair (fluticasone/salmeterol) and Qvar (beclomethasone) together is not recommended because this would result in unnecessary duplication of inhaled corticosteroid therapy without additional benefit, while increasing the risk of corticosteroid-related side effects.

Why This Combination Doesn't Make Sense

Advair already contains an inhaled corticosteroid (fluticasone) combined with a long-acting beta-agonist (salmeterol). Adding Qvar would mean you're taking two different inhaled corticosteroids simultaneously, which:

• Provides no additional therapeutic benefit - Guidelines consistently show that combining two inhaled corticosteroids offers no advantage over using an appropriate dose of a single agent 1
• Increases systemic corticosteroid exposure - This raises the risk of side effects including adrenal suppression, bone density loss, and growth suppression in children 2
• Is not supported by any clinical evidence - No studies demonstrate benefit from dual inhaled corticosteroid therapy

What the Guidelines Actually Recommend

When asthma control is inadequate on a single inhaled corticosteroid, the evidence-based approach is 1:

Preferred strategy: Add a long-acting beta-agonist (LABA) to the inhaled corticosteroid - which is exactly what Advair already provides

Alternative strategies if Advair isn't working:

• Increase the dose of Advair itself (higher strength formulation)
• Add a leukotriene modifier (like montelukast) to Advair
• Add theophylline to Advair
• Consider stepping up to high-dose inhaled corticosteroid/LABA combination

The Right Approach If Asthma Isn't Controlled

If your asthma remains poorly controlled on Advair, the appropriate steps are 3, 1:

1. First verify: Are you using the inhaler correctly? Is adherence adequate? Are environmental triggers being addressed?

2. If truly inadequate control on low-medium dose Advair:

   • Step up to a higher dose of Advair (e.g., from 100/50 to 250/50 or 500/50)
   • Consider adding a leukotriene receptor antagonist like montelukast

3. For severe persistent asthma:

   • Use high-dose Advair (500/50 twice daily)
   • Add additional controller medications (leukotriene modifiers, theophylline)
   • Consider biologics like omalizumab for allergic asthma 3

Common Pitfall to Avoid

The mistake here is thinking "more inhaled steroids = better control." The evidence clearly shows that adding a LABA to an inhaled corticosteroid is more effective than doubling the corticosteroid dose 1, 4. Since Advair already contains both components, adding Qvar would only duplicate the steroid component without the proven benefit of combination therapy.

What You Should Do Instead

If you're currently prescribed both medications, contact your prescriber to clarify the treatment plan. The likely scenarios are:

• Transitioning: You may be switching from Qvar to Advair (use one, then the other - not both)
• Error: This may be a prescribing error that needs correction
• Step-down: If well-controlled on both, you may be able to discontinue Qvar and continue Advair alone

The evidence consistently supports using a single inhaled corticosteroid/LABA combination product like Advair rather than multiple separate inhaled corticosteroids 1.