Examples of LABA/ICS Combination Medications
The most commonly used LABA/ICS combinations are salmeterol/fluticasone propionate (brand names: Advair, Seretide, Wixela Inhub) and formoterol/budesonide (brand name: Symbicort). 1, 2
Specific LABA/ICS Combination Products
Salmeterol/Fluticasone Propionate
- Available as Advair Diskus, Seretide, or the generic Wixela Inhub 2, 3
- Combines the LABA salmeterol (50 mcg per dose) with the ICS fluticasone propionate in varying strengths: 100/50,250/50, or 500/50 mcg 2
- Available as both dry powder inhaler (DPI) and metered-dose inhaler (MDI) formulations 3
- Dosed twice daily, approximately 12 hours apart 2
Formoterol/Budesonide
- Available as Symbicort 1, 4
- Combines the LABA formoterol with the ICS budesonide 1, 4
- Can be used as fixed maintenance dosing or as maintenance and reliever therapy (SMART regimen) 4
- The rapid onset of formoterol allows for both maintenance and as-needed symptom relief 5
Beclomethasone/Formoterol
Clinical Context and Usage
These combinations are indicated for patients with moderate to severe persistent asthma requiring step 3 care or higher, or for COPD patients with frequent exacerbations. 1
- For asthma in adults and children ≥4 years: LABA is the preferred adjunctive therapy to combine with ICS 1
- For COPD: The 250/50 strength of salmeterol/fluticasone is specifically indicated 2
- LABAs must never be used as monotherapy without an ICS due to increased risk of asthma-related deaths and hospitalizations 1, 2
Key Safety Considerations
- When LABA and ICS are used together in fixed-dose combinations, there is not a significant increased risk of hospitalizations and death from asthma problems compared to ICS alone 2
- The fixed-combination inhaler ensures appropriate use of a LABA in combination with an ICS 3
- All ICS/LABA combinations have proven efficacy in controlling symptoms, improving lung function, and reducing exacerbation rates 4, 5