Indications 

Advair HFA is an aerosol inhaler that contains two active ingredients, fluticasone, and salmeterol, which work together to manage and prevent asthma symptoms, including wheezing and shortness of breath. 

Fluticasone is a corticosteroid that decreases airway irritation and swelling, while salmeterol is a long-acting beta-agonist that eases airway muscles for smoother breathing. 

Advair HFA is for patients whose breathing problems are not well controlled with a single asthma-control medication or for those who require combination treatment. It should not be used to relieve sudden asthma attacks and does not provide immediate relief.  

In the event of an asthma attack, follow your doctor’s instructions and use your prescribed quick-relief inhaler, such as albuterol (also known as salbutamol in some countries). 

Uses and Dosage 

Before using Advair HFA, and with each prescription refill, carefully read its medication guide and patient information leaflet. For any questions or clarifications, consult your doctor or pharmacist without hesitation. 

Advair HFA should only be used after receiving instruction from a healthcare provider on correct administration techniques.  

The dosage of Advair HFA varies per individual based on their medical condition and response to the treatment. Typically, it is prescribed in two inhalations, twice a day, taken at the same time every day at a 12-hour interval. 

Advair HFA requires priming before the first use to ensure accurate dosage. Follow these steps to prime the inhaler: 

1. Take off the mouthpiece cap by squeezing its sides and pulling it out. 
2. Shake the inhaler well for 5 seconds. 
3. Spray the inhaler once into the air, away from your face, avoiding spraying in the eyes. 
4. Repeat the shaking and spraying process three more times to complete the priming. The counter should read 120 or 360, depending on the inhaler size. 
5. If the inhaler has not been used for more than 4 weeks or has been dropped, repeat the priming process: shake and spray it once, then repeat the process one more time to complete priming. 

To use Advair HFA: 

1. Ensure the metal canister fits firmly in the plastic actuator and the counter is visible through the window. 
2. Remove the cap from the mouthpiece, check for foreign objects inside, and remove any if present. 
3. Hold the inhaler with the mouthpiece down and shake it for 5 seconds. 
4. Breathe out through your mouth, then put the mouthpiece in your mouth, close your lips, and press down on the canister while inhaling deeply and slowly. 
5. After the spray comes out, remove your finger from the canister, take the inhaler out of your mouth, and close your mouth. Hold your breath for 10 seconds or for a duration that feels comfortable to you then breathe out slowly. 
6. Wait 30 seconds, shake the inhaler again, and repeat steps 3-5 for the second inhalation. 
7. Gargle your mouth with water and then expel it.  
8. Replace the cap onto the mouthpiece after each use. 

Advair HFA should be cleaned at least once a week, as directed. 

To clean the inhaler:  

• Remove the mouthpiece cap. 
• Clean the spray opening with a dry cotton swab. 
• Wipe the inside of the mouthpiece with a clean, damp tissue. 
• Air-dry the plastic actuator overnight. 
• Replace the mouthpiece cap after the plastic actuator has dried. 

Use Advair HFA exactly as directed. Do not modify your dosage or frequency of use or discontinue the use of this inhaler without consulting your doctor. 

Side Effects 

Listed below are the side effects associated with the use of Advair HFA. Inform your physician promptly if any of them persist or worsen. 

Common Side Effects 

• Headache 
• Muscle pain 
• Bone pain 
• Back pain 
• Nausea 
• Vomiting 
• Thrush 
• Throat irritation 
• Ongoing cough 
• Hoarseness or deepened voice 
• Cold symptoms such: 
  • Stuffy nose 
  • Sneezing 
  • Sore throat 
• Signs of ear infection (in a child): 
  • Fever 
  • Ear pain or full feeling 
  • Trouble hearing 
  • Drainage from the ear 
  • Fussiness 

 Serious Side Effects 

• Wheezing, choking, or other breathing problems after administration of Advair HFA  
• Fever, chills, cough with mucus, feeling short of breath 
• Chest pain, severe headache, fast or irregular heartbeats, pounding in your neck or ears 
• Tremors, nervousness 
• Blurred vision, tunnel vision, seeing halos around lights, or eye pain 
• Signs of thrush (a fungal infection) such as: 
  • Sores or white patches in your mouth or throat 
  • Trouble swallowing 
• Signs of high blood sugar: 
  • Increased thirst 
  • Increased urination 
  • Dry mouth 
  • Fruity breath odor 
• Indication of low potassium level:  
  • Leg cramps 
  • Constipation 
  • Irregular heartbeats 
  • Fluttering in your chest 
  • Increased thirst or urination 
  • Numbness or tingling 
  • Muscle weakness 
  • Limp feeling 
• Signs of hormonal disorder: 
  • Worsening tiredness or weakness 
  • Feeling light-headed 
  • Nausea 
  • Vomiting 

Call your doctor immediately if you experience any of the severe symptoms listed above. 

Allergic Reactions 

Advair HFA rarely causes severe allergic reactions. However, seek prompt medical assistance if you observe the following: 

• Rash 
• Itching or swelling, especially of the face, tongue, or throat 
• Severe dizziness 
• Trouble breathing 

This list does not contain all potential side effects of Advair HFA. Tell your doctor if you experience any unlisted effects. 

Cautions 

Before using Advair HFA, inform your doctor or pharmacist if you have any known allergies, especially to fluticasone or salmeterol, any medications, or any ingredients present in Advair HFA inhaler. 

To ensure Advair HFA is safe for you, disclose to your physician your medical background, specifically regarding any history of: 

• Infections like tuberculosis or herpes, whether current or in the past 
• High blood pressure 
• Osteoporosis (bone loss) 
• Heart diseases such as irregular heartbeat, chest pain, or heart attack 
• Hyperthyroidism (overactive thyroid) 
• Diabetes 
• Eye problems such as cataracts or glaucoma 
• Seizures 
• Liver disease 

Many drugs may interact with Advair HFA, including aldesleukin. To reduce the risk of drug interactions, inform your healthcare provider about all your current medications, including prescription and over-the-counter drugs, vitamins, and herbal products. 

Certain medications may interfere with the removal of fluticasone and salmeterol from the body, thereby impacting the effectiveness of this inhaler. These medications include: 

• Azole antifungals such as ketoconazole 
• Cobicistat 
• Macrolide antibiotics such as clarithromycin 
• HIV protease inhibitors such as lopinavir 
• Nefazodone 
• Ritonavir 
• Telithromycin 
• Others 

Unless advised by your doctor, refrain from using a second inhaled bronchodilator. 

This includes: 

• Formoterol (Perforomist, Symbicort, Bevespi, Dulera) 
• Arformoterol (Brovana) 
• Indacaterol (Arcapta) 
• Olodaterol (Striverdi, Stiolto Respimat) 
• Salmeterol (Serevent) 
• Vilanterol (Anoro, Breo, or Trelegy Ellipta) 

Long-term use of Advair HFA may result in temporary growth retardation in children, but uncontrolled asthma can also lead to growth issues. Regular check-ups with the doctor to monitor your child’s height are recommended. 

Advair HFA can raise the risk of developing glaucoma or cataracts. Regular eye exams may be necessary during your treatment. Tell your doctor immediately if you experience eye pain, redness, blurred vision, or other vision changes. Discuss the risks of using this medication with your doctor. 

Advair HFA may increase the risk of osteoporosis in adults if used for a long time. Talk to your doctor about available treatments and lifestyle changes to reduce this risk, such as weight-bearing exercise, calcium, and vitamin D intake, quitting smoking, and limiting alcohol consumption.  

Advair HFA can mask signs of infection and increase the risk of new or worsening infections. Avoid contact with people who have contagious infections like chickenpox, measles, or flu. In case of exposure to an infection or for further information, consult your doctor. 

The flu virus can exacerbate breathing problems; inquire about getting a yearly flu shot with your doctor or pharmacist. 

Minimize exposure to allergens/irritants like smoke, pollen, pet dander, dust, or molds that can aggravate asthma and other respiratory issues. 

Consult with your doctor to weigh the advantages and disadvantages of using Advair HFA while pregnant, and only use it if deemed necessary. 

It is uncertain whether fluticasone or salmeterol can pass into breast milk. Consult your doctor before nursing an infant.