Advair HFA (combination), Serevent Diskus

Name: Advair HFA (combination), Serevent Diskus

Introduction

Bronchodilator; a relatively selective, long-acting β2-adrenergic agonist.1 2 3 5 188

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

Salmeterol Xinafoate

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral Inhalation

Powder

50 mcg (of salmeterol) per inhalation

Serevent Diskus

GlaxoSmithKline

Salmeterol Xinafoate Combinations

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral Inhalation

Aerosol

21 mcg (of salmeterol) with Fluticasone Propionate 45 mcg per metered spray (from the actuator)

Advair HFA (with hydrofluoroalkane propellant)

GlaxoSmithKline

21 mcg (of salmeterol) with Fluticasone Propionate 115 mcg per metered spray (from the actuator)

Advair HFA (with hydrofluoroalkane propellant)

GlaxoSmithKline

21 mcg (of salmeterol) with Fluticasone Propionate 230 mcg per metered spray (from the actuator)

Advair HFA (with hydrofluoroalkane propellant)

GlaxoSmithKline

Powder

50 mcg (of salmeterol) with Fluticasone Propionate 100 mcg per inhalation

Advair Diskus

GlaxoSmithKline

50 mcg (of salmeterol) with Fluticasone Propionate 250 mcg per inhalation

Advair Diskus

GlaxoSmithKline

50 mcg (of salmeterol) with Fluticasone Propionate 500 mcg per inhalation

Advair Diskus

GlaxoSmithKline

Usual Adult Dose for Asthma - Maintenance

50 mcg (1 inhalation) orally twice a day, approximately 12 hours apart.

Comments:
-Reevaluate the therapeutic regimen if a previously effective dosage fails to provide the usual response, as this is often a sign of destabilization of asthma.
-If symptoms arise in the period between doses, an inhaled, short-acting beta2-­agonist should be taken for immediate relief.

Uses:
-Treatment of asthma and prevention of bronchospasm only as concomitant therapy with a long-term asthma control medication, such as an inhaled corticosteroid, in patients with reversible obstructive airway disease, including patients with symptoms of nocturnal asthma.

Usual Adult Dose for Bronchospasm Prophylaxis

Prevention of Exercise Induced Bronchospasm (EIB):
-50 mcg (1 inhalation) orally at least 30 minutes before exercise

Comments:
-Protection may last up to 9 hours when used intermittently as needed for prevention.
-Additional doses should not be taken for 12 hours.
-Patients receiving twice daily doses for the treatment of asthma should not use additional doses for the prevention of EIB.

Uses:
-For the prevention of EIB, as a single agent, in patients with no persistent asthma.
-In patients with persistent asthma use of this drug for the prevention of EIB may be clinically indicated, but the treatment of asthma should include a long-term asthma control medication, such as an inhaled corticosteroid.

Precautions

US BOXED WARNINGS:
ASTHMA-RELATED DEATH:
Long-acting beta2-adrenergic agonists (LABA), such as this drug, increase the risk of asthma-related death. A U.S. trial showed an increase in asthma-related deaths in subjects receiving this drug (13 deaths out of 13,176 subjects treated for 28 weeks on salmeterol versus 3 out of 13,179 subjects on placebo). Currently available data are inadequate to determine whether concurrent use of inhaled corticosteroids or other long-term asthma control drugs mitigates the increased risk of asthma-related death from LABA.
This drug should be prescribed only as additional therapy for patients with asthma who are currently taking but are inadequately controlled on a long-term asthma control medication, such as an inhaled corticosteroid. Once asthma control is achieved and maintained, assess the patient at regular intervals and step down therapy (e.g., gradually discontinue this drug) if possible without loss of asthma control and maintain the patient on a long-term asthma control medication, such as an inhaled corticosteroid. Do not use this drug for patients whose asthma is adequately controlled on low- or medium-dose inhaled corticosteroids.
Available data from controlled clinical trials suggest that LABA increase the risk of asthma-related hospitalization in pediatric and adolescent patients.

ASTHMA: Safety and efficacy have not been established in patients younger than 4 years.
COPD: Safety and efficacy have not been established in patients younger than 18 years

Consult WARNINGS section for additional precautions.

Salmeterol Identification

Substance Name

Salmeterol

CAS Registry Number

89365-50-4

Drug Class

Anti-Asthmatic Agents

Bronchodilators

Beta Adrenergic Agonists

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