Advair side effects: What you should know

Medical Writer

More common side effects

Mild side effects

Serious side effects

Side effects in children

FAQ

Specifics

Precautions

Talk with your doctor

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

Advair Diskus

in clinical trials:

headache

throat irritation

upper respiratory infection

nausea and vomiting

muscle pain

* Both Advair HFA and Advair Diskus are prescribed for

asthma

in adults and certain children. Advair Diskus is also prescribed for

COPD

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

Advair Diskus

Mild side effects reported by people who took

Advair HFA

Advair Diskus

for

asthma

in clinical trials included:

headache

throat irritation

upper respiratory infection

nausea and vomiting

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

sinusitis

muscle pain

strained or

hoarse voice

dizziness

fever

fatigue

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

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.

How long do side effects of Advair typically last?

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.

Does Advair cause long-term side effects?

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

Advair Diskus

use in clinical trials.*

Eye problems associated with long-term corticosteroid use can include

cataracts

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.

* These are all serious side effects of Advair. To learn more, see the “Serious side effects of Advair” section above.

Can Advair cause anxiety?

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

dry mouth

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.

What you can do

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.

Increased risk of serious infections

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.

What you can do

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.

Allergic reaction

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

Advair Diskus

Symptoms can be mild or serious and can include:

skin rash

itching

flushing

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

What you can do

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

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

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.

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