This medication is an inhaled corticosteroid (ICS, fluticasone propionate (FP)) and a long-acting beta2-adrenergic agonist (LABA, salmeterol xinafoate). Fluticasone is a steroid, and salmeterol is a long-acting bronchodilator that relaxes the muscles in the airways to improve breathing. It is used to treat two main causes of asthma symptoms—airway constriction and airway inflammation—to help prevent symptoms. Results may vary. It also helps prevent asthma attacks, flare-ups, or worsening of chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis and/or emphysema. However, it is not meant to relieve sudden breathing problems and will not replace a rescue inhaler.

The VESTRI trial (2016), a landmark 26-week study involving over 6,000 children aged 4 to 11, provided definitive evidence about the safety of combination therapy in pediatric patients. The study found that adding salmeterol to fluticasone propionate does not significantly increase the risk of serious asthma-related events compared with fluticasone alone.

Manufacturer Information

We currently have the brand-name product from GSK (also called Seretide) in Canada, India, Turkey, and the United Kingdom.

The generic fluticasone/salmeterol is manufactured by Cipla, and it is also available from other suppliers in the countries listed above.

Advair is available in Diskus form with strengths of 100/50, 250/50, and 500/50 mcg per 60-dose inhaler.

The information below lists potential side effects and risks. It is crucial to discuss these with your doctor or pharmacist.

Common Side Effects – The following are common side effects. Contact your doctor if you experience these side effects and they are severe or bothersome.
• Dizziness
• Headache
• Hoarseness or voice changes (Dysphonia)
• Nausea and vomiting
• Sore throat (Pharyngitis)
• Stomach upset.
• Upper respiratory tract infection

Other Potential Side Effects: (less common) – These effects are reported less frequently but can still occur:
• Bronchitis
• Cough
• Musculoskeletal pain
• Oral Candidiasis (thrush/yeast infection in the mouth)
• Palpitations (fast or irregular heartbeat)
• Sinusitis
• Tremors or nervousness

Serious Side Effects - These are rare but potentially severe. Seek your doctor or call medical emergency services immediately if any of the following occur:
• Adrenal Suppression: Symptoms include extreme fatigue, lack of energy, and low blood pressure (hypotension).
• Hypokalemia: Low blood potassium levels, which can cause muscle weakness or heart rhythm issues.
• Immunosuppression: Increased susceptibility to infections, such as pneumonia (particularly in COPD patients) or worsening of existing infections like tuberculosis.
• Ocular Effects: Increased risk of developing cataracts or glaucoma (increased intraocular pressure).
• Paradoxical Bronchospasm: Sudden, life-threatening wheezing and difficulty breathing immediately after using the inhaler.
• Reduced Bone Mineral Density: Potential for weakened bones or osteoporosis with long-term use.

The primary clinical concern with Advair therapy is Paradoxical Bronchospasm, a rare, life-threatening reaction where the airways constrict immediately after inhaling the dose. If this occurs, this medication must be stopped immediately, and a fast-acting rescue bronchodilator should be given. Since salmeterol is a long-acting beta-agonist (LABA), it is strictly intended for maintenance therapy and should never be used to treat status asthmaticus or acute respiratory distress. Chronic systemic absorption of the corticosteroid fluticasone may lead to Adrenal Suppression or Reduced Bone Mineral Density, especially in patients with existing metabolic or immobility risk factors. In children, clinicians should regularly monitor growth to check for potential systemic corticosteroid effects.

The CYP3A4 enzymatic pathway significantly influences the pharmacological profile of Advair. Co-administration with strong CYP3A4 inhibitors (e.g., ritonavir, ketoconazole) can result in dangerously high systemic fluticasone levels, potentially causing Cushing’s syndrome or an acute adrenal crisis.

Moreover, using non-potassium-sparing diuretics may worsen salmeterol-induced hypokalemia. Beta-blockers (used for high blood pressure or heart conditions) should generally be avoided during treatment, as these medications can block the effects of salmeterol and may trigger severe, life-threatening airway narrowing that does not respond to standard rescue treatments.

Dietary and Lifestyle Factors

Achieving therapeutic stability with this medication requires specific routine adjustments to manage potential side effects and environmental triggers. To reduce the risk of localized immunosuppression and subsequent oral thrush, rinse your mouth with water and spit it out after each dose. While there are no direct dietary restrictions, a diet high in Calcium and Vitamin D is generally recommended to support long-term bone health during inhaled corticosteroid therapy.

Since it is a maintenance-only medication, it is crucial to always have a separate, fast-acting rescue inhaler on hand for sudden, severe bronchospasms. Proactively managing the environment—including avoiding tobacco smoke, known allergens, and extreme cold—is vital for controlling underlying airway inflammation. Additionally, because some patients might experience temporary tremors or dizziness, you should avoid driving or operating heavy machinery until you're sure the medication does not affect your coordination or alertness.

How do I order?

You can order this medication from our website, or by email (CustomerService@canadianpharmacyking.com), by phone (1-877-745-9217), or by fax or mail.

Is a prescription required?

Yes, a prescription is required when purchasing this medication.

Can I get a prescription in the USA and use it to buy medication from Canada?

Yes, you can get a prescription from your physician in the USA and use it to buy from a Canadian pharmacy.

Are there any discounts or coupons available?

Unfortunately, no discounts or coupons are available. However, we are proud to offer high-quality prescription medications at affordable prices.

Can I have this medication shipped from Canada to my address in the USA?

Yes, you can get this medication shipped to your address (or home) in the USA from Canada.

How long does delivery take from Canada to the USA?

Delivery times depend on your location. Please check our shipping information for estimated timelines.

How can I tell if an online pharmacy is legitimate?

Any CIPA-certified pharmacy is licensed, reputable, and must follow strict safety protocols. CanadianPharmacyKing.com is verified by the Canadian International Pharmacy Association (CIPA).

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