Advair side effects: What you should know

Advair (fluticasone propionate/salmeterol) is a brand-name inhaled drug prescribed for asthma and chronic obstructive pulmonary disease (COPD) in adults and some children. As with other drugs, Advair can cause side effects such as throat irritation.

Advair can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Side effects may vary depending on which form of Advair you’re prescribed and what condition is being treated.* However, the more common side effects reported in clinical trials are similar for both forms of the drug and conditions.

These are just a few of the more common side effects reported by people who took Advair HFA or Advair Diskus in clinical trials:

throat irritation

muscle pain

Mild side effects can occur with Advair use. They may vary depending on which form of Advair you’re prescribed and your condition. The lists below don’t include all possible mild side effects of the drug. For more information, you can refer to the prescribing information for Advair HFA or Advair Diskus.

Mild side effects reported by people who took Advair HFA or Advair Diskus for asthma in clinical trials included:

throat irritation

muscle pain

strained or hoarse voice

oral thrush (fungal infection in your mouth or throat)*

mild allergic reaction†

Advair Diskus may also be prescribed for COPD. Mild side effects reported by people who took Advair Diskus for COPD in clinical trials include:

headache

throat irritation

muscle pain

strained or hoarse voice

dizziness

oral thrush (fungal infection in your mouth or throat)*

mild allergic reaction†

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Advair and want to tell the FDA about it, visit MedWatch.

* To learn more about this side effect, see “Side effect specifics” below. † An allergic reaction is possible after inhaling Advair. To learn more, see the “Side effect specifics” section below.

Serious side effects with Advair aren’t common, but they can occur. The list below may not include all possible serious side effects of the drug. For more information, you can refer to the Advair HFA and Advair Diskus prescribing information.

If you develop serious side effects from Advair, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

Decreased bone density, which can lead to osteoporosis. Symptoms can include:

Reduced adrenal gland function (in which your body doesn’t produce enough of certain hormones). Symptoms are typically vague and can include:

Eye problems, such as cataracts or glaucoma. Symptoms can include:

Paradoxical bronchospasm.* Symptoms can include:

Increased risk of serious infections such as pneumonia.†

Severe allergic reaction.‡

* A paradoxical reaction is an effect that is the opposite of what is expected. With paradoxical bronchospasm, the airways suddenly tighten after inhaling Advair, which is expected to open the airways. † For more information about this side effect, see “Side effect specifics” below. ‡ An allergic reaction is possible after inhaling Advair. To learn more, see the “Side effect specifics” section below.

Most of the side effects seen with Advair were similar in children and adults. But some side effects were more commonly reported in children ages 4–11 years old.

Advair HFA is approved to treat asthma in children ages 12 years and older. There was no difference in the reported side effects or how often they occurred in children and adults.

Advair Diskus is approved to treat asthma in children ages 4 years and older. Side effects of ear, nose, and throat infections and throat irritation were more commonly reported in children ages 4–11 years than in older children and adults.

The use of corticosteroids, including inhaled corticosteroids such as fluticasone propionate, may cause a slower growth rate in children. (Fluticasone propionate is an active ingredient of Advair.) To reduce this risk, your child’s doctor will prescribe the lowest dose that is effective in managing their asthma symptoms. They’ll also likely monitor your child’s growth during treatment with Advair. (To learn about Advair dosages, see this article.)

Talk with your doctor if you have any concerns about your child’s growth during Advair treatment.

Advair may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Most side effects that Advair can cause are mild and typically don’t last for long. They tend to be temporary, lasting a few days to weeks, and should go away as your body adjusts to the drug.

If you have side effects that are bothersome or don’t go away, talk with your doctor.

Treatment with Advair can cause certain side effects that may be long lasting. However, the risk of serious long-term side effects is low.

Advair contains a corticosteroid (fluticasone), and the use of corticosteroids can be associated with some long-term effects. Eye problems, a reduction in bone density, and, rarely, adrenal gland problems have been reported with long-term Advair HFA or Advair Diskus use in clinical trials.*

Eye problems associated with long-term corticosteroid use can include cataracts or glaucoma. Your doctor may recommend regular eye exams if you have a history of either condition and are prescribed Advair. If you experience any vision changes, talk with your doctor.

A reduction in bone density can weaken your bones and increase your risk of fractures and osteoporosis. Your doctor may monitor your bone density over time during Advair treatment. If it decreases, your doctor may recommend additional treatments to help prevent fractures.

Low adrenal gland function decreases your body’s ability to make certain hormones. Symptoms can be vague and may include weakness, loss of appetite, and fatigue. If you experience these or other nonspecific symptoms, tell your doctor.

If you have questions or concerns about the long-term effects of Advair, talk with your doctor. They can help determine whether Advair is the right treatment option for you.

It’s possible but not likely. The side effect of anxiety wasn’t reported in clinical trials of Advair. However, there have been reports of anxiety with Advair HFA after the medication became available for use.

In some people, salmeterol (an active ingredient in Advair), can cause a racing heart or feeling of nervousness. It’s also possible that too much salmeterol could cause feelings of nervousness or anxiety. Let your doctor know if you experience these side effects and they are bothersome or don’t go away. They can help determine whether salmeterol is the cause.

If you have any questions or concerns about anxiety during Advair treatment, talk with your doctor.

Learn more about some of the side effects that Advair may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Advair HFA and Advair Diskus.

Oral thrush (or, simply, thrush) is a common side effect of Advair in clinical trials. Thrush is a fungal (yeast) infection inside your mouth.

Symptoms may include:

white or yellow bumps on your tongue, throat, or mouth

redness in your mouth

a bad taste in your mouth

pain with eating or swallowing

Advair can reduce your body’s ability to fight infections. This is especially the case in the mouth and throat where the medication touches. Thrush is generally mild and is typically easy to treat.

There are a few things you can do to help prevent thrush. You should always rinse your mouth out with water after each dose of Advair. After rinsing, be sure to spit the water out (do not swallow it). Rinsing your mouth helps remove any leftover medication from your mouth.

You can also ask your doctor about using a spacer with your inhaler. You can buy a spacer at a pharmacy, or your doctor can prescribe one for you. Using a spacer will reduce the amount of medication that touches your mouth and help prevent thrush. A spacer also helps more medication reach your lungs.

Talk with your doctor if you experience symptoms of oral thrush. Your doctor will likely prescribe an antifungal medication to treat the infection. In some cases, your doctor may advise you to stop treatment with Advair until the infection goes away.

Advair treatment can increase the risk of serious infections, such as measles and chickenpox. The risk of less serious infections, such as the common cold, may also be increased. Reports of serious infections were rare in clinical trials of Advair HFA and Advair Diskus.

Symptoms of an infection can include:

chills

Advair may increase the risk of infections because it contains a corticosteroid. Drugs in the corticosteroid class can weaken your immune system. This makes it harder for your body to fight off new or existing infections.

Talk with your doctor to be sure your vaccinations are up to date. Vaccines can help reduce your risk of developing certain serious infections during treatment with Advair. Washing your hands regularly and limiting your contact with people who are sick can also help prevent infection.

Before starting Advair therapy, be sure to tell your doctor if you have an infection. Your doctor may have you wait to start Advair. They may also recommend medications or other treatments for the infection.

Contact your doctor right away if you develop signs or symptoms of an infection during Advair treatment.

As with most drugs, Advair can cause an allergic reaction in some people. However, it’s not clear how often this side effect occurred in clinical trials of Advair HFA or Advair Diskus.

Symptoms can be mild or serious and can include:

swelling under your skin, typically in your eyelids, lips, hands, or feet

swelling of your mouth, tongue, or throat, which can make it hard to breathe

Before starting Advair Diskus, it’s important to note that the drug powder contains milk proteins. These milk proteins can cause a serious allergic reaction in people who are sensitive to them. If you have a severe sensitivity to milk proteins, you should not start Advair Diskus. (Note: Advair HFA doesn’t contain milk proteins.)

If you experience mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should continue treatment with Advair. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Be sure to talk with your doctor about your health history before you start Advair for asthma or COPD. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health. These include:

Rapidly worsening asthma or COPD. You should not start Advair if you have symptoms of asthma or COPD that are rapidly getting worse. If your asthma or COPD requires hospitalization, you should not start Advair therapy. Your doctor will determine whether your condition is stable enough to begin Advair.

Heart problems. Advair is a combination drug that contains salmeterol, which can worsen certain heart problems such as high blood pressure and irregular heart rhythm. If you have heart problems, talk with your doctor before starting Advair. They may recommend a different treatment option for you.

Diabetes. If you have diabetes, Advair may worsen it. Talk with your doctor if you have diabetes. They may monitor your diabetes more closely during Advair treatment.

Seizure disorders. Salmeterol can worsen seizure disorders in some people. If you have a seizure disorder, talk with your doctor before starting Advair. They may recommend a different medication that doesn’t contain salmeterol.

Certain hormone conditions. Advair’s active ingredients (fluticasone propionate and salmeterol) may cause or worsen certain hormone conditions. Salmeterol can worsen symptoms of hyperthyroidism (high thyroid hormone levels) in some people. And fluticasone propionate can cause a high level of cortisol in some people. (Cortisol is a hormone produced in the adrenal gland.) High levels of thyroid hormone or cortisol can cause serious side effects.

Due to this risk, talk with your doctor if you have a hormone condition. They can advise you about whether Advair therapy is right for you.

Severe allergic reaction to milk proteins. If you’ve had a serious allergic reaction to milk proteins in the past, you should not have Advair Diskus. If you’re unsure whether you’ve had an allergic reaction to milk proteins, talk with your doctor. (Note: Advair HFA doesn’t contain milk proteins.)

Allergic reaction. If you’ve had an allergic reaction to Advair or any of its ingredients, your doctor will likely not prescribe Advair. Ask your doctor what other medications may be better options for you.

Serious infections. It’s possible that Advair will decrease your body’s ability to fight infections.* If you have a serious infection such as tuberculosis (TB) or have had one in the past, talk with your doctor. They’ll evaluate your health to determine whether Advair is safe for you.

Pregnancy or breastfeeding. If you’re pregnant or breastfeeding your child, Advair should be safe for you. Advair HFA and Advair Diskus have not been clinically trialed in pregnant people or people who are breastfeeding. However, treatment guidelines from the Global Initiative for Asthma state that Advair’s active ingredients are safe for pregnant people with asthma. You should still talk with your doctor about the possible effects of Advair if you’re pregnant or planning to become pregnant.

Alcohol consumption. There are no known interactions between Advair and alcohol. However, it’s possible that drinking alcohol during Advair therapy could worsen your symptoms or increase your risk of infection.* Talk with your doctor or pharmacist if you have any questions about drinking alcohol during Advair treatment. To learn more about possible drug interactions with Advair, you can refer to this article.

* This is a serious side effect of Advair. To learn more, see the “Side effect specifics” section above.

As with most medications, Advair can cause side effects. Most are mild and typically go away on their own after a few days to weeks. Although not common, Advair can also cause some serious side effects. You should talk with your doctor if you have any side effects that last, are bothersome, or are serious.

If you’d like to learn more about Advair, talk with your doctor or pharmacist. They can help answer any questions you have about side effects of the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

More information about Advair. For details about other aspects of Advair, refer to this article.

Cost. If you’d like to learn about Advair and cost, see this article.

Drug comparison. To learn how Advair compares with Symbicort, read this article.

Dosage. For information about the dosage of Advair, view this article.

Interactions. To find out about Advair’s interactions, see this article.

A look at your condition. For details about the conditions Advair treats, see our COPD hub or asthma and allergies hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.