What is Advair (Fluticasone-Salmeterol)?

From the Guidelines

Advair is a prescription medication that combines fluticasone, an inhaled corticosteroid (ICS), and salmeterol, a long-acting beta-agonist (LABA), to treat asthma and chronic obstructive pulmonary disease (COPD) by reducing inflammation and improving lung function. According to the Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 report 1, an ICS combined with a LABA, such as Advair, is more effective than the individual components in improving lung function and health status and reducing exacerbations in patients with exacerbations and moderate to very severe COPD. The medication works by reducing airway inflammation and relaxing muscles in the airways to improve breathing.

Key points to consider when using Advair include:

• It is used for long-term control and prevention of symptoms, not for sudden relief of breathing problems 1
• Common side effects may include throat irritation, hoarseness, and oral thrush, which can be minimized by rinsing the mouth with water after each use without swallowing
• Patients should always have a quick-relief inhaler available for emergencies
• Regular treatment with ICSs, like fluticasone in Advair, increases the risk of pneumonia, especially in those with severe disease 1

In terms of dosing and administration, Advair comes in different strengths and is typically administered twice daily using either a diskus inhaler or an HFA inhaler. It's essential to use Advair regularly as prescribed, even when feeling well, to help prevent symptoms and improve lung function. As stated in the 2017 report, the combination of an ICS and a LABA, like Advair, can improve lung function, symptoms, and health status, and reduce exacerbations in patients with COPD 1.

From the FDA Drug Label

In 15 healthy subjects, systemic exposure to fluticasone propionate from 4 inhalations of ADVAIR HFA 230/21 (fluticasone propionate 230 mcg and salmeterol 21 mcg) Inhalation Aerosol (920/84 mcg) and 2 inhalations of fluticasone propionate and salmeterol inhalation powder 500 mcg/50 mcg (1,000 mcg/100 mcg) was similar between the 2 inhalers ADVAIR HFA, fluticasone propionate and salmeterol inhalation powder, and fluticasone propionate CFC inhalation aerosol were similar and averaged 5.6 hours. The population pharmacokinetic analysis included 160 subjects with asthma aged 4 to 11 years who received fluticasone propionate and salmeterol inhalation powder 100 mcg/50 mcg or FLOVENT DISKUS 100 mcg Advair is a combination medication that contains fluticasone propionate and salmeterol.

• It is available in different formulations, including ADVAIR HFA and fluticasone propionate and salmeterol inhalation powder.
• The medication is used to treat asthma and COPD.
• The pharmacokinetics of fluticasone propionate and salmeterol have been studied in various populations, including healthy subjects and patients with asthma and COPD 2 2.

From the Research

What is Advair

• Advair is a combination inhaler that contains the long-acting beta2-adrenoceptor agonist salmeterol and the inhaled corticosteroid fluticasone propionate 3, 4, 5.
• It is used to treat chronic obstructive pulmonary disease (COPD) and asthma, and is available in different strengths of fluticasone propionate and a fixed dose of salmeterol 3, 5.
• The combination of salmeterol and fluticasone propionate in Advair provides benefits over monotherapy, including improved lung function, reduced exacerbations, and improved health-related quality of life 3, 4.

Mechanism of Action

• Salmeterol is a long-acting beta2-adrenoceptor agonist that helps to relax the airway muscles and improve breathing 3, 4.
• Fluticasone propionate is an inhaled corticosteroid that helps to reduce inflammation in the airways 3, 4.
• The combination of salmeterol and fluticasone propionate in Advair provides a complementary action, with salmeterol helping to activate the glucocorticoid receptor and enhance the anti-inflammatory effects of fluticasone propionate 5.

Clinical Evidence

• Studies have shown that Advair is effective in improving lung function, reducing exacerbations, and improving health-related quality of life in patients with COPD and asthma 3, 4, 5.
• A study comparing the effectiveness and safety of generic and brand-name fluticasone-salmeterol found that the two were associated with similar outcomes in patients with COPD 6.
• Another study found that the combination of salmeterol and fluticasone propionate was associated with a reduced risk of exacerbations and improved cardiovascular safety in patients with COPD and asthma 7.