The 10 Most Common Questions About Advair, Answered

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Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Advair Diskus and Advair HFA are popular brand-name inhalers often prescribed for asthma, COPD or a persistent cough. The same great questions are raised by my patients every week about Advair. Let me share.  

1) Is Advair a steroid?

Yes. Advair is a mixture of a steroid (fluticasone) and a long-acting bronchodilator (salmeterol). It is used to treat asthma and COPD.

2) Is Advair a rescue inhaler?

No. Albuterol (Proventil, Ventolin, Proair) and levalbuterol (Xopenex) are your rescue inhalers. They are short-acting bronchodilators that open up the airways during an asthma attack. Not Advair.

3) Are Advair HFA, Advair Diskus and AirDuo RespiClick the same thing?

Basically, yes. They vary in dosage and delivery method, but they are the same combination of inhaled medications. Advair Diskus and AirDuo RespiClick are dry powder inhalers, while Advair HFA is delivered by propellant. Advair HFA is FDA-approved for asthma, while Advair Diskus is FDA-approved for asthma and COPD.

4) Which is better, the Advair Diskus or Advair HFA?

There are few reports comparing the effects of the two devices, so it’s unknown which should be recommended for asthma patients. Advair Diskus is activated by breath—the medication is released only when you take a deep, fast breath in through the inhaler. This is different from Advair HFA, a metered-dose propellant inhaler which pushes medication into the lungs.

Some studies suggest that Advair HFA is more effective at reducing exacerbations of COPD than Advair Diskus. And similarly, they suggest the metered-dose inhaler, Advair HFA, may be preferred for patients with asthma. The bottom line is it depends on your preference, cost and what your doctor recommends.

5) Is there a generic Advair?

Yes. It’s still pricey, but get to know the new AirDuo Respiclick, which is available in low-, mid- and high-dosage formulations (55/14, 113/14 and 232/14 μg, respectively).

Is AirDuo Respiclick just as good as Advair Diskus? Yes. AirDuo Respiclick has been compared to Advair in a 26-week clinical trial, and in terms of improvements in lung function, it was just as good.

6) I’m an adult with asthma. Do I really need Advair?

While the rate of asthma deaths in the US decreased from 15 per million people in 2001 to 10 per million people in 2016, adults were nearly five times more likely than children to die from asthma. The asthma death rate was highest among the 65 years and older age group, and females had a higher death rate than men. Yes, you need it.

7) What are the most common side effects of Advair?

The two most common side effects of Advair are upper respiratory infections (16% to 27% of patients) and headaches (5% to 20% of patients).

8) Is Advair better than an inhaled steroid alone?

Yes. Every related adult clinical trial has shown that combination products like Advair reduce asthma exacerbations significantly more than inhaled corticosteroids alone. Examples of inhaled corticosteroids are fluticasone (Flovent), budesonide (Pulmicort), mometasone (Asmanex) and beclomethasone (Qvar).

9) Which is better, Symbicort or Advair?

For asthma, Symbicort (budesonide / formoterol) and Advair (fluticasone / salmeterol) are equally effective, providing similar improvements in asthma control and reduction in the risk of hospitalizations and emergency room visits.  

10) Is it true if I have a milk allergy, I can’t use Advair?

The distinction here is if you have a true cow’s milk allergy—not just lactose intolerance. The Advair HFA is lactose free, while Advair Diskus and AirDuo RespiClick contain lactose. Talk to your doctor about which asthma inhaler options are safe for you.

Dr O.

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