What is the generic version of Advair (Fluticasone-Salmeterol)?

From the Guidelines

Generic Advair is a suitable and cost-effective option for patients with asthma and COPD, as it contains the same active ingredients as the brand-name version, fluticasone propionate and salmeterol, and has been shown to reduce exacerbations and improve health status in patients with COPD 1.

Key Points to Consider

• The generic version of Advair works by reducing airway inflammation with fluticasone, a corticosteroid, and relaxing airway muscles with salmeterol, a long-acting beta-agonist.
• The typical dosage is one inhalation twice daily, approximately 12 hours apart, and it comes in three strengths: 100/50 mcg, 250/50 mcg, and 500/50 mcg.
• Common side effects include throat irritation, hoarseness, and oral thrush, which can be minimized by rinsing your mouth after use.
• Unlike rescue inhalers, generic Advair is for maintenance therapy and won't provide immediate relief during an acute attack.
• Patients should continue using it regularly even when feeling well to maintain control of their respiratory condition.

Evidence-Based Recommendations

• A systematic review for a clinical practice guideline found that combination therapy with a long-acting β2-agonist and inhaled corticosteroids reduced the relative annual rate of severe exacerbations requiring hospitalizations by 18% versus placebo 1.
• Another study found that combination therapy with salmeterol–fluticasone reduced hospitalizations for acute COPD exacerbations and all-cause hospitalizations versus tiotropium alone 1.
• The evidence suggests that generic Advair is a viable option for patients with asthma and COPD, as it has been shown to reduce exacerbations and improve health status, and is a cost-effective alternative to the brand-name version.

From the Research

Generic Advair Overview

• Generic Advair, also known as Wixela Inhub, is a substitutable version of the dry powder inhaler Advair Diskus, which contains the combination of fluticasone propionate and salmeterol 2.
• The US Food and Drug Administration (FDA) approved Wixela Inhub in 2019 for the treatment of asthma and chronic obstructive pulmonary disease (COPD) 3.

Efficacy and Safety of Generic Advair

• A study published in 2021 found that Wixela Inhub was bioequivalent to Advair Diskus, suggesting that it may provide an alternative option for patients with asthma or COPD requiring intervention with an ICS/LABA 2.
• A 2023 study compared the effectiveness and safety of generic (Wixela Inhub) and brand-name (Advair Diskus) fluticasone-salmeterol among patients with COPD and found that they were associated with similar outcomes 3.
• Another study published in 2011 compared the combination of fluticasone and salmeterol with fixed-dose combination budesonide and formoterol for chronic asthma in adults and children, and found that the odds of exacerbations requiring oral steroids were lower with fluticasone/salmeterol, but did not reach statistical significance 4.

Comparison with Other Treatments

• A 2011 study compared the effectiveness of budesonide/formoterol and fluticasone/salmeterol for COPD management and found that they showed comparable real-world effectiveness 5.
• A 2020 study evaluated the quality, real-world comparative effectiveness of budesonide/formoterol combination maintenance therapy and found that it was effective and appropriate for use in asthma and COPD 6.

Key Findings

• Generic Advair (Wixela Inhub) is a bioequivalent and substitutable version of Advair Diskus 2.
• Generic and brand-name fluticasone-salmeterol have similar effectiveness and safety outcomes in patients with COPD 3.
• The combination of fluticasone and salmeterol may have a lower risk of exacerbations requiring oral steroids compared to budesonide/formoterol, but more research is needed to confirm this finding 4.