Monograph Details
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Respiratory Tract
> Asthma/COPD
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ADVAIR HFA 45/21 |
| Manufacturer |
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GlaxoSmithKline Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Steroid + long-acting β2-agonist. |
| Generic Name |
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Fluticasone propionate 45 micrograms, salmeterol (as xinafoate) 21 micrograms; per inh; metered-dose inhaler; CFC-free. |
| Also |
• ADVAIR HFA 115/21
• ADVAIR HFA 230/21
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| Indications |
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Maintenance treatment of asthma in patients not adequately controlled on other asthma-controller medications or whose disease severity warrants initiation of 2 maintenance therapies. |
| Children |
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Not recommended. |
| Adults |
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Allow approximately 12 hours between doses. Not currently on inhaled steroid: 2 inh of Advair 45/21 or Advair 115/21 twice daily; already on inhaled steroid: see literature. If insufficient response after 2 weeks, use next higher strength. Max 2 inh of Advair 230/21 twice daily. |
| Contraindications |
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Not for treatment of acute attacks. Concomitant with other forms of salmeterol or formoterol. |
| Precautions |
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Reevaluate periodically. Do not exceed recommended dose. Not for use with other long-acting β2-agonists or for transferring from systemic steroids. Do not initiate in significantly or acutely deteriorating asthma. Cardiovascular disease (esp. coronary insufficiency, arrhythmias, hypertension). Hyperthyroidism. Convulsive disorders. Hepatic impairment. Hyperresponsiveness to sympathomimetics. Diabetes. Ketoacidosis. Immunosuppressed. If exposed to chicken pox or measles, consider anti-infective prophylactic therapy. If adrenal insufficiency exists following systemic corticosteroid therapy, replacement with inhaled corticosteroids may exacerbate symptoms of adrenal insufficiency (eg, lassitude). Prescribe a short-acting, inhaled β2-agonist for acute symptoms; monitor for increased need. Monitor potassium, intraocular pressure; bone mineral density if other osteoporosis risk factors exist; and for growth suppression in children; hypercorticism and HPA axis suppression (if occurs, discontinue gradually). Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended. |
| Interactions |
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See Contraindications. Caution with other sympathomimetics (except short-acting bronchodilators), during or within 2 weeks of MAOIs, tricyclic antidepressants (increased cardiac effects), K+-depleting diuretics. Antagonized by β-blockers. Concomitant potent CYP3A4 inhibitors (eg, ketoconazole, ritonavir): not recommended. |
| Adverse Reactions |
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Respiratory tract infection or inflammation, laryngeal spasm or swelling, headache, dizziness, hoarseness, dysphonia, sinusitis, pain, GI upset, candidiasis, paradoxical bronchospasm; rarely: serious asthma episode, asthma-related death. |
| How Supplied |
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Inhaler—12g (120 inh) |
| Additional Resources |
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• Related Prescribing Note |
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