Why is this drug prescribed?

Seretide Accuhaler (Advair Diskus) is an oral inhaler that contains two types of asthma medication. One is fluticasone propionate, a steroid that reduces inflammation in the lungs. The other, salmeterol, is a long-acting bronchodilator that opens up the airways. Together, the two ingredients provide better control of asthma than either does individually.

Most important fact about this drug

Seretide (Advair) is used for long-term control of asthma, and won't end a sudden attack. For relief of acute asthma symptoms, your doctor will prescribe a short-acting inhaler such as Proventil or Ventolin.

How should you take this medication?

Seretide Accuhaler (Advair Diskus) should be used twice a day, once in the morning and once in the evening. Follow the detailed directions that came with the inhaler. If you have any questions, ask your doctor or pharmacist. Some important points to keep in mind:

• Do not use a "spacer" with this medication.
• Never exhale into the diskus.
• Do not try to take the diskus apart.
• Always activate and use the diskus in a level, horizontal position.
• It is important to keep the diskus dry--do not wash any part of the mouthpiece or any part of the diskus.
• To reduce the risk of developing an infection in your mouth, rinse your mouth after each inhalation.

When first using this medication, you may notice some improvement within 30 minutes, but its maximum benefits may take a week or more to appear.

If you miss a dose

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule.

Storage instructions

Store the diskus at room temperature, away from heat, sunlight, and moisture. Discard the diskus one month after removing it from its moisture-protective foil overwrap pouch or after every blister has been used, whichever comes first.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Advair Diskus.

More common side effects may include:

• bronchitis
• cough
• diarrhea
• difficulty speaking
• fungal infection of the mouth
• gastrointestinal discomfort and pain
• headaches, hoarseness
• muscle pain
• nausea
• sinus problems
• sore throat
• upper respiratory infection or inflammation
• vomiting

Less common side effects may include:

• allergic reactions
• appendicitis
• blood in nasal mucus
• bone problems
• burns
• constipation
• dental discomfort and pain
• dry and scaly skin
• ear problems
• eye infection
• fractures
• heart palpitations
• hives
• joint pain
• lower respiratory infections
• mouth ulcers or rash
• mouth discomfort or pain
• muscle injuries
• muscle stiffness
• nasal irritation
• nerve problems
• red eyes
• runny nose
• pneumonia
• skin infections
• sleep disorders
• sleepiness
• sneezing
• sweating
• tremors
• wounds

Why should this drug not be prescribed?

(Seretide) Advair cannot be used for acute episodes of asthma that require intensive therapy. You'll also have to avoid it if it gives you an allergic reaction.

Special warnings about this medication

Be sure to keep track of how often you have to use your short-acting inhaler for relief of acute asthma symptoms. Your doctor will use this information to help determine how well Advair Diskus is working. Notify your doctor if you do not get relief from your short-acting inhaler or if you need more inhalations than usual to get relief. Keep track of your peak flow readings, too. Call your doctor if you notice a drop in this measurement of lung capacity.

Do not use Advair Diskus more often than your doctor has prescribed. Excessive use can cause heart irregularities. Use Advair Diskus with caution if you have any kind of heart disorder or high blood pressure. Alert your doctor immediately if you develop chest pain, heart palpitations, nervousness, or tremor.

Do not use Serevent (salmeterol), Foradil (formoterol), or other long-acting inhalers while using Advair Diskus. They contain the same type of active ingredient, and will provide no extra benefit.

Call your doctor immediately if you develop hives, rash, or swelling, or if you have an asthma attack that does not respond to your usual medication. Advair Diskus has been known to cause allergic reactions and acute asthma attacks.

Try to avoid contact with people who have measles or chickenpox, and notify your physician if you are exposed. The steroid component of Advair Diskus tends to lower your immunity and could make these infections worse.

Possible food and drug interactions when taking this medication

If Seretide Accuhaler (Advair Diskus) is used with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining this medication with the following:

• Antidepressants categorized as "tricyclics," such as Elavil and Tofranil
• Antidepressants called "monoamine oxidase inhibitors," such as Nardil and Parnate
• Beta blockers (drugs such as Inderal and Tenormin that are used to control blood pressure and treat various heart conditions)
• Ketoconazole (Nizoral)
• Long-acting inhalers such as Serevent and Foradil
• Water pills (diuretics) such as HydroDIURIL and Lasix

Special information if you are pregnant or breastfeeding

The possibility of harm to a developing baby has not been ruled out. Seretide Accuhaler (Advair Diskus) should be used during pregnancy only if the potential benefit justifies the risk.

It is possible that the ingredients of Advair Diskus may appear in breast milk, so you'll need to choose between nursing the baby or continuing your therapy.

Recommended dosage

ADULTS

The recommended dosage of Seretide Accuhaler (Advair Diskus) is one inhalation twice daily. Take the inhalations morning and evening, 12 hours apart.

The product comes in three strengths. Your doctor will select the best strength for you based on your current therapy. If this selection fails to improve your asthma after 2 weeks, the doctor may prescribe a higher strength.

CHILDREN

Seretide Accuhaler (Advair Diskus) can be used by adolescents 12 years of age and older. The dosage is the same as for adults. It is not known whether this medication is safe for children under 12. Its steroid component has been known to stunt growth.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

Symptoms of acute Seretide Accuhaler (Advair Diskus) overdose may include:

• fast or irregular heartbeat
• headache
• muscle cramps
• tremor