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Fluticasone is a steroid that prevents the release of substances in the body that cause inflammation. Salmeterol is a bronchodilator. It works by relaxing muscles in the airways to improve breathing.
Fluticasone and salmeterol inhalation is a combination medicine used to prevent asthma attacks. It is also used to prevent flare-ups or worsening of chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis and/or emphysema.
Advair Diskus is for use in adults and children who are at least 4 years old. Advair HFA is for use in adults and children who are at least 12 years old.
Fluticasone and salmeterol may also be used for purposes not listed in this medication guide.
Do not use fluticasone and salmeterol to treat an asthma attack that has already begun.
Salmeterol may increase the risk of asthma-related death. Use only the prescribed dose of fluticasone and salmeterol, and do not use it for longer than your doctor recommends. Follow all patient instructions for safe use. Talk with your doctor about your individual risks and benefits of using this medication.
You should not use this medicine if you are allergic to fluticasone or salmeterol (Serevent), or:

• if you have a severe allergy to milk proteins; or
• if you are having an asthma attack or severe COPD symptoms.

To make sure fluticasone and salmeterol is safe for you, tell your doctor if you have:

• a food or drug allergy;
• heart disease or high blood pressure;
• epilepsy or other seizure disorder;
• any type of infection;
• a weak immune system;
• diabetes;
• glaucoma;
• tuberculosis;
• osteoporosis;
• a thyroid disorder; or
• liver disease.

Long-term use of steroids may lead to bone loss (osteoporosis), especially if you smoke, if you do not exercise, if you do not get enough vitamin D or calcium in your diet, or if you have a family history of osteoporosis.
It is not known whether fluticasone and salmeterol is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.
It is not known whether fluticasone and salmeterol passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Fluticasone and salmeterol inhalation can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medication.
Do not give this medicine to a child without medical advice.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:

• chest pain;
• fast or uneven heart beats, restless feeling, tremors;
• severe headache, pounding in your neck or ears, nosebleed;
• fever, chills, swollen glands, mouth sores, skin sores, cold or flu symptoms;
• cough with yellow or green mucus, feeling short of breath;
• blurred vision, tunnel vision, eye pain, or seeing halos around lights;
• high blood sugar--increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin;
• low potassium--confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling; or
• signs of a hormonal disorder--worsening tiredness or muscle weakness, feeling light-headed, anxiety, feeling irritable, nausea, vomiting, loss of appetite, diarrhea, weight loss, weight gain, slow wound healing.

Common side effects may include:

• headache, muscle pain, bone pain;
• nausea, vomiting;
• throat irritation, white patches in the mouth or throat;
• cold symptoms such as stuffy nose, sneezing, sore throat;
• ongoing cough; or
• hoarseness or deepened voice.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Do not use a second form of salmeterol (such as Serevent) or use a similar inhaled bronchodilator such as formoterol (Foradil, Symbicort, Dulera), arformoterol (Brovana), or vilanterol (Bree Ellipta, Anoro Ellipta) unless your doctor has told you to.
Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medicine.
Tell your doctor about all medicines you use, and those you start or stop using during your treatment with fluticasone and salmeterol, especially:

• ritonavir (Norvir); or
• lopiinavir/ritonavir (Kaletra).

This list is not complete. Other drugs may interact with fluticasone and salmeterol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Salmeterol may increase the risk of asthma-related death. Use only the prescribed dose of fluticasone and salmeterol, and do not use it for longer than your doctor recommends. Follow all patient instructions for safe use. Talk with your doctor about your individual risks and benefits of using this medicine.
Fluticasone and salmeterol is not a rescue medicine. It will not work fast enough to treat an asthma attack. Use only a fast acting inhalation medicine for an asthma attack.
Advair Diskus is a powder form of fluticasone and salmeterol that comes with a special inhaler device pre-loaded with blister packs containing measured doses of the medicine. The device opens and loads a blister each time you use the inhaler. This device is not to be used with a spacer.
Advair HFA is an aerosol form of fluticasone and salmeterol that comes in a canister that is used with an actuator inhaler device. Use only the inhaler device provided with Advair HFA. This device is not to be used with a spacer.
Shake the Advair HFA inhaler for at least 5 seconds before each spray.
To reduce the chance of developing a yeast infection in your mouth, rinse your mouth with water after using this medicine.
Keep track of the number of sprays you have used and throw away the Advair HFA canister after 120 sprays, even if it feels like there is still medicine in it.
If you also use an oral steroid medication, do not stop using it suddenly or you may have unpleasant withdrawal symptoms. Talk with your doctor about tapering your steroid dose before stopping completely. Carry an identification card or wear a medical alert ID to let others know that you may need an oral steroid in an emergency.
Seek medical attention if you think any of your asthma medications are not working as well as usual. An increased need for medication could be an early sign of a serious asthma attack. If you use a peak flow meter at home, call your doctor if your numbers are lower than normal.
Do not change your doses or medication schedule without advice from your doctor.
Store fluticasone and salmeterol at room temperature away from moisture, heat, and direct light. Keep the Advair HFA canister away from high heat, such as open flame or in a car on a hot day. The canister may explode if it gets too hot.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include angina or chest pain, fast or irregular heartbeats, seizures, tremor, weakness, headache, nausea, and vomiting.
Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.