Advair alternatives for asthma and COPD

Advair is an FDA-approved brand-name medication manufactured by GSK (GlaxoSmithKline). It contains an anti-inflammatory medicine (fluticasone propionate) and a long-acting bronchodilator (salmeterol) and is used to prevent asthma attacks and flare-ups or worsening of chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis or emphysema.

Advair is an expensive brand-name medication with several alternatives available, including medications with lower-cost generic alternatives. Learn more about what Advair Diskus is, how it works, its side effects, and alternatives for Advair.

What is Advair (fluticasone/salmeterol)?

Advair is a prescription medication used for the maintenance treatment of asthma in adults and children 12 years of age and older. Advair HFA is a metered-dose inhaler that contains the fluticasone propionate/salmeterol combination. When inhaled, these ingredients work together to open up your lungs and airways. Fluticasone propionate is a type of corticosteroid. When you inhale Advair, molecules of fluticasone propionate attach to areas on the surface of the cells in your airways and lungs called glucocorticoid receptors. This stimulates the receptors, producing lower amounts of the substances that trigger inflammation and greater amounts of anti-inflammatory proteins. This helps to reduce inflammation throughout your lungs and airways.

Salmeterol is classed as a long-acting beta 2-adrenergic agonist (LABA). It attaches to areas outside of muscle tissue in your airways and lungs called beta-2 receptors. This stimulates the receptors, causing them to relax the muscle tissue, opening up your lungs and airways, and allowing you to breathe more easily.

What are the most common side effects of Advair?

The most common side effects of Advair in clinical trials include:

• Headaches, dizziness, nausea, vomiting
• Sore throat, hoarseness and changes to your voice
• An increase in upper respiratory tract infections
• Sinus and throat infections

More serious side effects of Advair include

• A weakened immune system, makes you more vulnerable to infections, including serious infections like tuberculosis
• Adrenal insufficiency
• Life-threatening allergic reactions, such as hives, swelling in your face, mouth, and throat, can make it difficult to breathe and cause shortness of breath
• A sudden worsening of your asthma symptoms, including asthma attacks (paradoxical bronchospasm)
• Fungal infections (candida/thrush) in your mouth and throat – this is less likely if you rinse your mouth out with water after taking your Advair Diskus
• Increased blood pressure
• A fast and/or irregular heartbeat
• A thinning and weakening of bones (osteoporosis)
• An increased risk of eye problems, including glaucoma, cataracts, and blurred vision
• An increased risk of developing pneumonia if you also have chronic obstructive pulmonary disease (COPD)
• Slowed rates of growth in children

These aren’t all the possible side effects Advair can cause. You can find more details in the patient leaflet that comes with your medication. If you have any concerns about side effects, talk to a healthcare professional. You are encouraged to report the negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Alternative to Advair Diskus

Alternatives to Advair Diskus inhalation powder include a range of alternative aerosol asthma inhalers and oral medications. Oral tablets include tablets such as Singulair (montelukast). Alternative inhalers include:

• Wixela Inhub (generic version of Advair Diskus)
• ProAir HFA
• Xolair
• Ventolin HFA (a short-acting beta agonist commonly prescribed as a rescue inhaler for acute symptoms)
• Dupixent
• Spiriva
• Combivent
• Albuterol

What inhaler is comparable to Advair?

Symbicort (budesonide/formoterol), Dulera (mometasone/formoterol), and Breo (fluticasone/vilanterol) are combination inhalers similar to Advair. These medications all contain an inhaled corticosteroid (ICS) and a long-acting beta-agonist (LABA).

What is the generic equivalent of Advair?

Wixela Inhub is the first approved generic version of Advair in the United States. It is a therapeutically equivalent medication to Advair Diskus that is manufactured by Mylan Pharmaceuticals.

RELATED: Wixela vs Advair

What are the problems with generic Advair?

A generic version of Advair Diskus has recently become available. It is marketed under the name Wixela Inhub. This generic version is similar to Advair. A generic drug must, by law, contain the same active ingredients as the branded version and work in the same way. In this case, the generic versions’ design and doses are different from Advair, meaning that those with a prescription for Advair must obtain a new prescription for the generic inhaler if they wish to switch to the generic.

What are the cheapest steroid inhalers?

Steroid inhalers will vary in cost depending on how many you buy and where you buy them from. The cheapest steroid inhaler, Breo Ellipta (budesonide/glycopyrrolate/formoterol fumarate) will cost around $180 for 1 inhaler of 28 blisters of 100 mcg/25 mcg. Arnuity Ellipta (fluticasone furoate) and Asmanex HFA (mometasone furoate) will cost around $260 for 1 inhaler. Qvar Redihaler (beclomethasone/dipropionate HFA) and Flovent HFA (fluticasone) will cost around $360 for 1 inhaler, and the most expensive, Symbicort (budesonide/formoterol) and Advair HFA (fluticasone propionate/salmeterol) will cost over $500 for 1 inhaler.

Natural alternatives to Advair

Natural alternatives for asthma treatment are sometimes used by patients to help protect themselves from the causes of asthma attacks. However, it is important to understand that natural alternative remedies are not as effective as using asthma medication.

• Herbs and supplements may help with some of the symptoms of asthma, but research in this area is ongoing and not conclusive. Natural herbs may include ginkgo, dried ivy, black seed, choline, and French maritime pine bark extract. Some natural alternatives and over-the-counter treatments have been found to cause serious side effects
• Magnesium and fish oil in combination with Vitamin C may reduce inflammation and reduce asthma symptoms
• Caffeine, a natural bronchodilator
• Reducing stress can reduce the symptoms of asthma. In children, this may involve breathing exercises and relaxation
• Yoga and relaxation to help properly control breathing and reduce stress
• Acupuncture – placing very thin needles at specific points on the body to ease the symptoms of asthma

Speak to your healthcare provider for medical advice before trying any new alternative treatments for asthma.