Salmeterol, Fluticasone Propionate

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Indications and Usage

Long-term maintenance treatment of asthma in patients 4 yr of age and older; maintenance treatment of airflow obstruction in patients with COPD associated with chronic bronchitis (250/50 strength only). tajdrug_Asthma

Contraindications

Primary treatment of status asthmaticus or other acute episodes of asthma or COPD in which intensive measures are required; hypersensitivity to any component of the product; severe hypersensitivity to milk proteins ( Advair Diskus ).

Dosage and Administration

Asthma Adults and Adolescents 12 yr of age and older

Inhalation 1 inhalation twice daily (morning and evening, approximately 12 h apart). For patients not currently on inhaled corticosteroids whose disease severity clearly warrants initiation of treatment with 2 maintenance therapies, or patients inadequately controlled on an inhaled corticosteroid, the recommended starting dosage is fluticasone/salmeterol 100/50 or 250/50 twice daily (max, 500/50 twice daily). For patients who do not respond adequately to the starting dosage after 2 wk of therapy, a higher strength may provide additional improvement in asthma control. If a previously effective dosage regimen fails to provide adequate improvement in asthma control, the therapeutic regimen should be reevaluated and additional options (eg, replacing current strength with a higher strength, initiating oral corticosteroids, or adding additional inhaled corticosteroids) should be considered.

Children 4 to 11 yr of age (symptomatic on inhaled corticosteroids)

Inhalation 1 inhalation of fluticasone/salmeterol 100/50 twice daily (morning and evening, approximately 12 h apart).

COPD Adults

Inhalation 1 inhalation (250/50 mcg) twice daily (morning and evening, approximately 12 h apart).

Asthma Adults and Adolescents 12 yr of age and older

Inhalation 2 inhalations twice daily (morning and evening, approximately 12 h apart). For patients not currently on inhaled corticosteroids, the recommended starting dosage is 2 inhalations of fluticasone/salmeterol 45/21 mcg or 115/21 mcg twice daily (max, 2 inhalations of fluticasone/salmeterol 230/21 mcg twice daily). For patients on an inhaled corticosteroid, the recommended starting dose of fluticasone/salmeterol varies from 45/21 mcg to 230/21 mcg, 2 inhalations twice daily, depending on the current daily dose of the concomitant inhaled corticosteroid (consult the Advair HFA package insert).

General Advice

If patient is also receiving short-acting bronchodilator by inhalation, administer bronchodilator 5 min before fluticasone/salmeterol to enhance penetration of latter drugs into bronchial tree.
Titrate to the lowest effective strength after adequate stability is achieved.
Rinse mouth with water without swallowing after inhalation is complete.

Prime aerosol inhalation before using the first time by releasing 4 test sprays into the air away from face, shaking canister well for 5 sec before each spray.
If inhaler has not been used for more than 4 wk or if it is dropped, prime inhaler again by shaking well before each spray and releasing 2 test sprays away from the face.
Shake inhaler well for 5 sec before use.

Storage/Stability

Store at 68° to 77°F in a dry place away from direct heat or sunlight. Discard delivery device 30 days after removing from foil pouch or after every blister has been used and dose indicator reads “0.”

Store at 59° to 86°F. Store with mouthpiece down. Use at room temperature. Do not puncture. Do not store near heat or open flame.

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