Asthma is a chronic respiratory condition that has no cure, though the symptoms can be treated. The symptoms of asthma include difficulty breathing, wheezing, coughing and tightness in the chest. One medication prescribed to treat asthma is Advair, which is actually a combination of two drugs: salmeterol and fluticasone. MedlinePlus, an online medical encyclopedia, reports that though Advair has been shown to be effective at preventing the onset of asthma symptoms, there are warnings associated with its use.
Risk of Death
MedlinePlus reports that a large clinical study has been conducted to measure the safety and efficacy of using salmeterol, one of the ingredients of Advair, for control of asthma symptoms. This study found that more people died of asthma-related death than those people not using salmeterol. The pharmaceutical company that makes Advair, GlaxoSmithKline, the Federal Drug Administration (FDA) and MedlinePlus, all report this "black box warning;" it's called a black box warning because the information must be enclosed in a black box on the prescribing information document. Because of the risk of asthma-related death, the FDA advises that medications such as salmeterol be given only when asthma is not adequately controlled using other medications. The FDA states that the use of salmeterol alone is contraindicated, meaning should it should not be prescribed alone; the agency requires salmeterol to be prescribed in combination with another medication, such as fluticasone, which is the other ingredient in Advair.
Infections
There is a risk of infection due to the corticosteroid fluticasone, which is an immunosupressant. This medication works in the treatment of asthma because the primary cause of asthma is inflammation, and immunosuppressive drugs help to reduce inflammation. However, immunosuppresive drugs may also make the patient susceptible to certain infections. Clinical trials showed that there is a risk of localized infection with Candida albicans in the mouth and throat. Thus, GlaxoSmithKline advises patients to rinse their mouth and throat with water after inhaling the medication. Advair may also worsen certain existing infections, such as tuberculosis, fungal, bacterial, viral or parasitic infections.
Risk of Overdose
Another warning that should be considered when using Advair is about the risk of overdose. Salmeterol is a beta-adrenergic agonist, which means that it is a stimulant. If too much of Advair is taken, the patient may experience symptoms of an overdose, which may be serious. According to MedlinePlus, these symptoms include chest pain, dizziness, fainting, blurred vision, seizures, headache, shaking, dry mouth, nausea, extreme fatigue, and difficulty falling and/or staying asleep. If these symptoms become severe, MedlinPlus advises calling poison control or 911.
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