Advair Diskus

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Also indexed as: Fluticasone with Salmeterol, Salmeterol with Fluticasone

This drug combines two primary active ingredients: salmeterol and fluticasone.

Salmeterol is a member of the drug family known as long-acting, beta-adrenergic bronchodilators (also called beta-agonists). It is inhaled by mouth, into the lungs, to treat asthma and prevent bronchospasm. Salmeterol is also used to prevent exercise-induced bronchospasm.

Fluticasone is a type of corticosteroid that is inhaled by mouth to treat and prevent asthma, as well as other inflammatory conditions of the lungs that restrict breathing. Oral corticosteroids are inhaled into the nose to treat and prevent symptoms of hay fever and other allergies. In addition, some agents may be used to prevent recurrence of nasal polyps following surgical removal.

The information in this article pertains to inhaled corticosteroids in general, not fluticasone specifically. The interactions reported here may not apply to all the Also Indexed As terms. Talk to your doctor or chemist if you are taking any of these drugs.

Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, a herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

May Be Beneficial: Depletion or interference—The medication may deplete or interfere with the absorption or function of the nutrient. Taking these nutrients may help replenish them.	Calcium DHEA*
May Be Beneficial: Supportive interaction—Taking these supplements may support or otherwise help your medication work better.	Coleus*
Side effect reduction/prevention	None known
Reduced drug absorption/bioavailability	None known
Adverse interaction	None known
The interactions listed in this table may apply to one or more ingredient of this medication.

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Dietary Supplements

Calcium
Most of an inhaled dose of beclomethasone (a drug similar to fluticasone) is actually swallowed, which may lead to reduced absorption of calcium.¹ Health practitioners may recommend calcium supplementation to individuals using beclomethasone inhalers.

DHEA
A group of women with asthma who had been taking inhaled beclomethasone were shown to have low levels of DHEA (dehydroepiandrosterone) compared to women with asthma who were not taking beclomethasone (a drug similar to fluticasone).² The authors speculated that this effect may partially explain how corticosteroids can cause osteoporosis. However, more research is needed to confirm these suspicions and to evaluate whether supplemental DHEA is beneficial to patients taking inhaled corticosteroids.

Interactions with Herbs

Coleus (Coleus forskohlii)
A test tube study demonstrated that the bronchodilating effects of salbutamol, another beta-adrenergic bronchodilator drug, were significantly increased by the addition of forskolin, the active component of the herb Coleus forskohlii.³ The results of this preliminary research suggest that the combination of forskolin and beta-agonists might provide an alternative to raising the doses of the beta-agonist drugs as they lose effectiveness. Until more is known, coleus should not be combined with fluticasone without the supervision of a doctor.

Interactions with Foods and Other Compounds

Food
{Discussion}

Alcohol
{Discussion}

References

1. Smith BJ, Phillips PJ, Pannall PR. Effect of orally administered beclomethasone dipropionate on calcium absorption from the gut in normal subjects. Thorax 1993;48:890–3.

2. Smith BJ, Buxton JR, Dickeson J, Heller RF. Does beclomethasone dipropionate suppress dehydroepiandrosterone sulphate in postmenopausal women? Austral NZ J Med 1994;24:396–401.

3. Yousif MH, Thulesius O. Forskolin reverses tachyphylaxis to the bronchodilator effects of salbutamol: an in-vitro study on isolated guinea-pig trachea. J Pharm Pharmacol 1999;51:181–6.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or chemist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires August 2007.