12 things to know about Advair

If you have a chronic lung condition like asthma or chronic obstructive pulmonary disorder (COPD), you may need to take medication on a daily basis to treat your disease and help you breathe easier. One common treatment is Advair. If your provider has recently prescribed this medicine, you may want to brush up on your knowledge of this drug. 

12 Advair drug facts

You may know the basics about this inhaler—it helps prevent your symptoms, and you use it twice a day. But past that, you likely didn’t read the full drug information packet. Here are some of the most interesting Advair drug facts to consider about this prescription.

1. Advair is a combination medication.

Is Advair a steroid? Yes, Advair contains two active ingredients: a steroid medication and bronchodilator. They work together to decrease inflammation and open airways. Fluticasone propionate is the corticosteroid that it contains. Fluticasone propionate is also a key ingredient in certain nasal sprays, such as Flonase, that many people with allergies use to temporarily relieve their symptoms. 

The other main ingredient is salmeterol, a beta-2 adrenergic receptor agonist drug. It works as a long-acting bronchodilator by relaxing the smooth muscles around your lungs, allowing your airways to widen and the air to flow easily through. 

2. Advair can reduce the frequency of asthma attacks.

A 2022 study published in the journal BMJ confirmed that combination inhalers are not just effective for helping people with moderate asthma—they’re also effective for managing mild asthma, which represents the type of asthma in 45%-70% of people with the condition. According to the researchers, the use of a combination inhaler sharply reduced the number of asthma attacks that necessitated emergency oral or injected steroids. But it’s important to note that Advair is not intended to be used as a rescue medication or to relieve sudden breathing problems.

RELATED: How common is asthma? Worldwide facts and statistics

3. There are two forms of Advair.

Advair comes in two forms: Advair HFA and Advair Diskus. Advair HFA is an inhalation aerosol that makes use of a traditional inhaler that looks like a small canister. The U.S. Food and Drug Administration (FDA) has only approved it for use in treating asthma in people 12 years and older. It comes in three different strengths. 

Meanwhile, Advair Diskus is an inhalation powder for use with a disc-shaped inhaler. It can be used to treat asthma in people four years and older, as well as COPD. There are also three different strengths of Advair Diskus available. 

Some patients simply have an easier time using one version than the other, according to Frank Coletta, MD, the chief of critical care medicine and the associate director of the Center for Sleep Medicine at Mount Sinai South Nassau in New York. He notes that sometimes, certain patients will have trouble with coordination between triggering an inhaler and inhaling the medicine, so he may steer them away from the HFA version and toward the Diskus version. 

4. People with a milk allergy should not take Advair Diskus.

The manufacturer also suggests steering clear of Advair Diskus if you have an allergy to milk proteins. Why? Lactose is sometimes used as an inactive ingredient in some asthma medications, such as Advair Diskus, to enhance the stability of the active ingredients. This could be a problem or a contraindication if you have a milk-protein allergy, according to research in The Journal of Pediatric Pharmacology and Therapeutics.

5. Advair can be used long-term.

If this medication works for you, your provider might suggest sticking with it. “If a patient has asthma that is controlled with a medication like Advair, it can be continued for years if needed,” says Payel Gupta, MD, a national spokesperson for the American Lung Association and an assistant clinical professor at SUNY Downstate Medical Center. It’s safe for people with more moderate to severe asthma to undergo chronic treatment with Advair.

6. It may contribute to bone loss.

Some research suggests that people may experience decreases in bone mineral density (BMD) if they use products containing inhaled corticosteroids for a long period of time. According to the American Academy of Allergy, Asthma & Immunology, this could be a concern for susceptible individuals, such as older women, if the corticosteroids are used in high doses. However, the benefits of using the medication may outweigh the risks, which is something to discuss with your physician. 

7. Withdrawal might be an issue with Advair.

You might worry what will happen if you take Advair for a while but then stop taking it (with the guidance of your provider, of course.) It is possible to experience some withdrawal symptoms after discontinuing use of a corticosteroid. The manufacturer of Advair HFA also notes: “During withdrawal from oral corticosteroids, some patients may experience symptoms of systemically active corticosteroid withdrawal (e.g., joint and/or muscular pain, lassitude, depression) despite maintenance or even improvement of respiratory function.” 

“Inhalers—like Advair—are not addictive,” explains Dr. Gupta. But when you stop using an inhaled medication like Advair, it’s possible that you may start feeling worsening symptoms of your asthma, she adds.

8. Advair is similar to Symbicort…but not the same.

Advair and Symbicort are both combination medications, and you use an inhaler to take both medications. But they aren’t the same combination of medications. While Advair combines fluticasone with salmeterol, Symbicort combines a different steroid, budesonide, with a different long-acting bronchodilator, formoterol. 

According to Dr. Coletta, there’s not a body of research that shows that one is superior to the other. “The unfortunate reality is that sometimes, you pick one based on what the patient’s insurance carrier is,” he says. If you’re not sure which combination medication is covered by your health insurance, talk to your pharmacist.

RELATED: Symbicort vs. Advair

9. There are cheaper alternatives to Advair.

Advair is available in both brand name and generic forms. The brand name versions, which are manufactured by GlaxoSmithKline, or GSK, tend to be pricier. On average, Advair Diskus costs about $528, while Advair HFA runs about $542 without insurance. But you might consider a generic, because one of the big advantages of using a generic version of the fluticasone propionate and salmeterol combination is cost savings. 

You may be able to save some money by opting for the branded generic version of Advair Diskus called Wixela Inhub, which is made by Mylan. Several other manufacturers make generic versions of Advair Diskus, too. (There’s currently not a generic version of Advair HFA.)

You can also use a SingleCare discount card to drop the price of the name brand versions of Advair, taking the price of Advair Diskus down to about $71. You can also use SingleCare as a copay option to reduce the price of Advair HFA to about $256.

RELATED: Asthma inhalers price list: How much do inhalers cost?

10. You should brush your teeth after using Advair.

If you’re the kind of person who likes to take their medicine right before they dash out the door, you might want to rework your routine—and make time to brush your teeth right after you use your Advair inhaler. 

One of the more serious possible side effects of using this medication is developing a fungal infection in your mouth or throat. To reduce your chances of developing thrush, you should at least rinse your mouth thoroughly with water without swallowing any of the water after using Advair. 

“Every time they use an inhaler that has a steroid in it, they should brush their teeth or rinse their mouth or gargle so that the steroid component is removed from their mucosa,” says Dr. Coletta. “When you put a steroid on your mucosa, that dampens your immune system, and that can lead to an overgrowth of fungus, and that leads to thrush.” 

If a patient does develop thrush, your doctor will prescribe an antifungal medicine. 

11. Advair probably won’t make you gain weight.

Steroids are notorious for increasing people’s appetites, which can lead to weight gain. Weight gain is listed as one of many adverse reactions “whether drug-related or not” that occurred in 1%-3% of patients in clinical trials involving Advair HFA. But Dr. Gupta says that systemic side effects like this are “uncommon for inhaled steroids.”

12. It could affect your sleep.

Another common belief is that anything containing a steroid may interfere with your sleep. 

“Inhaled corticosteroids generally don’t have this type of side effect because there is limited systemic absorption of the drug, but some people are more sensitive to drug side effects and may experience these effects,” says Dr. Gupta.

Some research suggests that inhaled fluticasone/salmeterol might actually help people with disordered breathing sleep better. A study in the Journal of Allergy and Clinical Immunology found that this medication helped improve sleep quality in patients with COPD, perhaps by improving their lung function. 

If Advair doesn’t work well for you, you have options. Your provider might suggest that you give another inhaled combination drug a try. Breo Ellipta incorporates the steroid fluticasone furoate and the long-acting bronchodilator vilanterol. Unlike Advair, which is a twice-daily medication, you only have to use Breo Ellipta once a day. “It’s got the same efficacy; it’s just longer lasting,” says Dr. Coletta. And that can be a real advantage for some people.