Information About Advair Diskus

Common uses
This product is a combination "controller" medicine for long-term treatment to prevent or decrease the symptoms of asthma and chronic lung diseases such as emphysema, bronchitis, or COPD. It works to open the airways of the lungs in two ways (decreasing bronchiolar swelling and causing muscle relaxation). It may also be used to treat other breathing conditions as determined by your physician. Advair Diskus does not work immediately and should not be used for acute asthma attacks. Use other "quick-relief" medicines/inhalers for sudden shortness of breath or asthma attacks.

Prior to Use
Salmeterol may rarely be associated with serious asthma attacks (potentially fatal). African-American patients and patients prescribed salmeterol when their asthma condition is worsening may have an increased risk for this event. If you find that your fast-acting inhaler is not working as well or if you need to use it more often than usual, such as using 4 or more puffs daily or using more than 1 inhaler every 8 weeks, tell your physician or pharmacist promptly. This may be a sign of worsening asthma which is a serious condition. Do not suddenly stop using Advair Diskus. Doing so may cause your breathing condition to get worse. Discuss with your physician the benefits and risks of using Advair Diskus. Be aware that pre-existing medical conditions, or taking additional medications could interfere with the effectiveness of this one. Let your physician or pharmacist know about any other medications -- prescription or over-the-counter -- that you are using. Do not use Advair Diskus if you are taking ritonavir or lopinavir. If you are currently taking either of these medicines ask your physician for directions. Additional monitoring of your dose or condition may be needed if you are also taking other asthma medicines (e.g., quick-relief inhalers), oral corticosteroids (e.g., dexamethasone, prednisone), beta-blockers (e.g., metoprolol, propranolol), mao inhibitors (e.g., furazolidone, linezolid, moclobemide, phenelzine, procarbazine, selegiline, isocarboxazid, tranylcypromine), tricyclic antidepressants (e.g., amitriptyline, nortriptyline), "water pills" (diuretics such as furosemide, hydrochlorothiazide), hiv protease inhibitors, azole antifungals (e.g., itraconazole, ketoconazole), "adrenaline-like" stimulants (e.g., pseudoephedrine or ephedra). Use of this inhaler within 2 weeks after stopping MAO inhibitors or tricyclic antidepressants is not recommended, since these medicines may increase the serious side effects of salmeterol. Do not start or stop any medicine without physician or pharmacist approval. Inform your physician of any other medical conditions including heart disease (angina, arrhythmias), liver problems, diabetes, high blood pressure, low potassium levels (hypokalemia), eye problems (e.g., cataracts, glaucoma), depression, recent infection, seizures, thyroid problems (hyperthyroid or hypothyroid), any allergies, pregnancy, or breast-feeding. You should not take Advair Diskus if you have a history of irregular/fast heartbeat (cardiac tachyarrhythmias), untreated lung infections (bacterial, fungal, or tuberculosis), or certain lung diseases (bronchiectasis). If you have questions or concerns about Advair Diskus, be sure to let your physician or pharmacist know.

Instructions for Use
Follow your physician's instructions for taking Advair Diskus. Advair Diskus comes with a patient information leaflet. Read it carefully. Refer to the illustrated directions provided for instruction on the correct use of this device. Ask your physician, nurse, or pharmacist any questions that you may have about Advair Diskus. Always activate and use this device in a level, horizontal position. Do not breathe into the inhaler. Do not use a spacer. Your dose is based on your condition and response to treatment. Gargle and rinse your mouth after using Advair Diskus to help prevent dryness, relieve throat irritation, and to prevent mouth infections (e.g., thrush). Do not swallow the rinse solution. If you have been using a "quick-relief" beta agonist inhaler (such as salbutamol/albuterol) on a regular daily schedule, you must discontinue this schedule and only use it "as needed" for acute asthma attacks. Consult your physician. Do not use the inhaler apart or wash the mouthpiece of the inhaler. Store Advair Diskus at room temperature as directed on the package, away from heat, moisture, or light. Keep the inhaler dry at all times. Continue to use Advair Diskus even if you feel well. Make sure that you do not skip a dose of Advair Diskus. Should you skip or forget a dose of Advair Diskus, use it as soon as possible. If it is almost time for your next dose, omit the skipped dose and continue to follow your original dosing schedule. Do NOT use 2 doses at once.

Warnings
Do not stop using Advair Diskus without first checking with your physician. Some conditions may become worse when the medicine is suddenly stopped. Your dose may need to be gradually decreased. Do not exceed the recommended dose or use Advair Diskus more often than prescribed without checking with your physician. Doing so would decrease the effectiveness of the medicine and increase the risk of side effects. Advair Diskus may cause dizziness do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Advair Diskus. Using Advair Diskus alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. Limit alcoholic beverages. Before you begin taking any new medicine, either prescription or over-the-counter, consult your pharmacist or physician . Check the labels on all your medicines (e.g., cough-and-cold products, diet aids) because they may contain ingredients that could increase your heart rate and blood pressure. Ask your pharmacist about the safe use of those products. If you have switched from an oral corticosteroid (e.g., prednisone tablets) to this inhaler within the past 12 months, or if you have been using this product in higher-than-usual doses and suddenly stop using it, your body may not produce enough natural steroids. You may need to start taking additional corticosteroids, especially if your body is stressed due to a major infection, surgery, or injury. Consult your physician or pharmacist for more details, and inform them that you use (or have used) any type of corticosteroid. Carry a warning card stating that you may need supplemental corticosteroids (e.g., prednisone) during stress periods (such as trauma or major surgery). Contact your physician if you experience any symptoms of low steroid levels including unusual weakness, weight loss, fainting, or dizziness. Caution is advised when using Advair Diskus in the elderly because they may be more sensitive to the effects of the medicine, especially the effects on the heart (cardiovascular). Caution is advised when using Advair Diskus in children. Though it is very unlikely to occur with inhaled steroids (fluticasone), Advair Diskus may decrease a child's growth rate, but not necessarily their final adult height. Though it is very unlikely with inhaled steroid use, children using Advair Diskus might be prone to serious cases of common infections, such as chickenpox or measles. Avoid exposing the child to such diseases. Consult the physician or pharmacist for more details. Women, if you plan on becoming pregnant, discuss with your physician the benefits and risks of using Advair Diskus during pregnancy. One of the medicines in this product (SALMETEROL) is excreted in breast milk; it is unknown if the other medicine (fluticasone) passes into breast milk. Do not breast-feed while using Advair Diskus.

Potential Side Effects
Side effects you may experience while using Advair Diskus include hoarseness (dysphonia), throat irritation, headache, cough, or dry mouth or throat. Consult your physician if they do not go away or if they bring you difficulties. Check with your physician immediately if you experience white patches on tongue or mouth, or if your mouth/tongue becomes swollen and painful. Contact your physician immediately if you experience any of the following unlikely but serious side effects: weight gain, vision changes, trouble sleeping, tremors, seizures, severe muscle weakness or cramping, fast/irregular heartbeat, numbness or tingling in hands or feet, chest pain, or worsening of asthma symptoms (e.g., increased difficulty breathing, wheezing, coughing). An allergic reaction to Advair Diskus is unlikely but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, dizziness, or trouble breathing. Rarely, your wheezing might actually increase immediately after using Advair Diskus (paradoxical bronchospasm). If this occurs, use your "quick-relief" inhaler (such as albuterol). Seek immediate medical attention if your breathing does not improve at that time. Let your physician, pharmacist, or nurse know if you experience any side-effects not listed here.

Drug interactions
Drug interactions can result in unwanted side effects or prevent a medicine from doing its job.

In Case of Overdose
Contact a poison control center or visit an emergency room immediately, if you think you have overdosed. Indications of an overdose are seizures, chest pain, unusually fast/irregular heartbeat, severe muscle weakness, muscle cramping, and fainting.

Additional information
Carry an identification card at all times that states you are taking Advair Diskus. It is important that you keep all physician and laboratory appointments while you are using Advair Diskus. Laboratory and/or medical tests (e.g. , iop, children's rate of growth) should be performed periodically to monitor your progress or check for side effects. Consult your physician for more information. Learn to use a peak flow meter, use it daily, and promptly report worsening asthma (such as readings in the yellow or red range or increased use of quick-relief inhalers). Try to avoid irritants that may trigger an asthma attack such as smoke, pollen, pet dander, dust, or molds. Do not let anyone else use Advair Diskus. Store this and all medication away from the reach of children and pets. If using Advair Diskus for an extended period of time, obtain refills before your supply runs out.