Side Effects of Advair: what You Need to Know

Introduction

If you have asthma or chronic obstructive pulmonary disease (COPD), your doctor might suggest Advair as a treatment option.

Advair is a prescription drug used to treat asthma in adults and some children. It’s also approved to treat COPD in adults.

The drug comes in two forms: Advair Diskus and Advair HFA. With both forms, you inhale the drug by mouth.

The two active ingredients in Advair are fluticasone propionate and salmeterol. (An active ingredient is what makes a drug work.) Advair is usually a long-term treatment. For more information about Advair, including details about its uses, see this in-depth article.

Like other drugs, Advair can cause mild to serious side effects (also called adverse effects). Keep reading to learn more.

What are the more common side effects of Advair Diskus and Advair HFA?

Some people may experience mild to serious side effects during their Advair treatment. Common side effects may vary based on the form of Advair or the condition it’s used to treat.

Examples of Advair’s commonly reported side effects include:

  • dizziness
  • headache*
  • throat irritation*
  • nausea and vomiting
  • bone and muscle pain
  • cough
  • hoarseness
  • certain infections (such as oral thrush or upper respiratory infections)

This list doesn’t contain all of Advair’s side effects. Talk with your doctor to learn more about the side effects caused by this drug.

* To learn more about this side effect, see the “Side effects explained” section below.

What are the mild side effects of Advair?

Advair can cause mild side effects in some people. Examples of mild side effects that have been reported with Advair include:

  • throat irritation*
  • nausea and vomiting
  • hoarse voice
  • cough
  • muscle and bone pain
  • thrush
  • headache*
  • weight gain*
  • mild allergic reaction*

In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop using Advair unless your doctor recommends it.

Advair may cause mild side effects other than the ones listed above. For details, see the prescribing information for Advair Diskus and Advair HFA.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Advair, visit MedWatch.

* To learn more about this side effect, see the “Side effects explained” section below.

What are the serious side effects of Advair?

Serious side effects aren’t common with Advair, but they can occur. Serious side effects that have been reported with Advair include:

  • pneumonia
  • increased risk of serious infection*
  • severe allergic reaction*
  • eye problems (such as cataracts and glaucoma)
  • adrenal gland problems
  • thyroid problems
  • decreased bone density
  • paradoxical bronchospasm
  • chest pain, rapid heart rate, tremor, or nervousness
  • slowed growth rate in childrenâ€

If you develop serious side effects while using Advair, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below. †To learn more, see the “Side effects in children” section below.

Side effects in children

For the most part, Advair’s side effects are the same in adults and children. But some side effects may be more common in children.

In studies of Advair Diskus, the most commonly reported side effects in children were throat irritation, and infections of the ears, nose, and throat. In studies of Advair HFA, the side effects seen in children were similar to those seen in adults.

It’s important to note that inhaled corticosteroids may cause a slower growth rate in children. Fluticasone (one of the active ingredients in Advair) is a corticosteroid. For this reason, your child’s doctor will prescribe the lowest dose of Advair that can effectively manage their symptoms. During treatment, your child’s growth rate will likely be monitored by their doctor.

If you have questions about your child’s risk of side effects from Advair, talk with their doctor.

FAQs about Advair’s side effects

Get answers to some frequently asked questions about Advair’s side effects.

Could using Advair affect my teeth?

Yes, Advair may affect your teeth. But this isn’t a common side effect. In studies, some people reported dental pain with Advair Diskus and Advair HFA. There were also a few reports of cavities with Advair HFA use.

If you have concerns about how Advair may affect your teeth, be sure to get regular dental checkups. If you have a higher risk of dental-related side effects, let your dentist know the form of Advair you use and your dosage. They may recommend some specific tips to help keep your teeth and gums healthy while using Advair.

Does Advair cause anxiety?

It’s not likely. Anxiety wasn’t a side effect seen during studies of Advair Diskus or Advair HFA. There have been reports of this side effect in people using Advair HFA since it became available for use. But it’s unclear how often this happened or if Advair was the cause.

For some people, the active ingredient salmeterol in Advair could make their heart race or cause a feeling of nervousness. If you’re having these side effects and they don’t go away, let your doctor know.

If you have concerns about anxiety while using Advair, talk with your doctor.

Are there any long-term side effects of Advair?

Yes, long-term side effects are possible with Advair because it contains a corticosteroid. (Fluticasone, one of the active drugs in Advair, is a corticosteroid.) Use of corticosteroids can cause lasting and serious side effects in some people. For example, long-term use or very high doses of corticosteroids may:

  • slow the growth rate of children
  • contribute to the development of glaucoma and cataracts
  • decrease bone mineral density, which can cause weak bones and a higher risk of fractures and osteoporosis
  • decrease the function of adrenal glands, which can make them less able to produce certain hormones.

If you have concerns about long-term side effects from Advair, talk with your doctor.

Will I experience withdrawal symptoms if I stop using Advair?

Advair is not known to cause withdrawal symptoms. (Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on.) In studies, withdrawal symptoms were not reported in people using Advair.

If you’re concerned about having side effects when ending your Advair treatment, talk with your doctor.

Side effects explained

Weight gain

Advair may cause weight gain in some people. This side effect was reported in studies of Advair HFA, but it wasn’t a common side effect. There were no reports of weight gain in studies of Advair Diskus. But after Advair Diskus became available for use, some people reported weight gain with this drug.

What might help

If you have concerns about weight gain with Advair, talk with your doctor. They can discuss ways to manage your weight during your treatment.

Throat irritation

Throat irritation is possible with Advair use. In studies, this was a common side effect of both Advair Diskus and Advair HFA. Symptoms may include a sore throat that’s scratchy and painful.

What might help

You can reduce throat irritation with Advair by rinsing your mouth or gargling with water right after you take your dose of Advair.

If you have throat irritation from Advair, talk with your doctor or pharmacist. They can help make sure you’re using the inhaler correctly and suggest ways to ease your symptoms.

Increased risk of serious infection

Advair can raise the risk of serious infection during treatment. Advair contains the corticosteroid fluticasone, which may decrease your immune system’s ability to protect against new or existing infections. Examples of these infections include chickenpox and measles.

Advair can also worsen existing infections such as tuberculosis or other viral, bacterial, fungal, or parasitic infections. Serious infections can even be fatal in some cases. Tell your doctor about any existing infections you may have before starting Advair treatment. They may treat your infection before you start using the drug.

Symptoms of an infection may include:

  • fever
  • fatigue (low energy)
  • headache
  • swollen lymph nodes
  • nausea and vomiting

What might help

Before starting your Advair treatment, talk with your doctor to make sure your vaccinations are up to date. Vaccines help prevent deadly diseases and can reduce your risk of developing a serious illness during your treatment.

Limiting your exposure to illness can also help prevent you from getting sick while using Advair. Wash your hands regularly and try to avoid coming into contact with people who are sick.

If you develop an infection while using Advair, tell your doctor right away.

Headache

Using Advair may cause headache in some people. In studies, this was a common side effect of both forms of Advair.

What might help

If you have headaches while using Advair, talk with your doctor. They can recommend ways to ease your symptoms. For example, they might suggest that you drink plenty of water, get enough sleep, and eat meals on a consistent schedule.

Certain over-the-counter (OTC) medications can help ease headache symptoms. Some examples include acetaminophen, ibuprofen and aspirin. But some OTC drugs may interact with your other medications or conditions. Your doctor or pharmacist can recommend an OTC pain reliever that’s safe for you to take.

Allergic reaction

Like most drugs, Advair can cause an allergic reaction in some people.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe
  • bronchospasm (tightening of the muscles that line the airways)

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an antihistamine you take by mouth, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Advair, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Advair, they may have you switch to a different treatment.

Tell your doctor if you have a milk protein allergy. Advair Diskus contains lactose. There have been reports of allergic reactions in people using Advair Diskus who have a severe milk protein allergy.

During your Advair treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor can help them learn more about how Advair affects you. They can then use this information to adjust your treatment plan if needed.

Warnings for Advair

Advair may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether Advair is a good treatment option for you.

Talk with your doctor about your health history before starting Advair. The list below includes factors to consider.

Worsening asthma or COPD. If you have worsening symptoms of asthma or COPD, you may have a higher risk of serious lung problems or even death from using Advair. Due to this risk, your doctor likely will not prescribe Advair if you have worsening symptoms of asthma or COPD. Talk with your doctor to see if Advair is right for you.

Allergic reaction. If you’ve had an allergic reaction to Advair or any of its ingredients, your doctor will likely not prescribe Advair. Ask them what other medications are better options for you. Bronchospasm can occur with Advair use. If you experience this type of reaction, follow your doctor’s recommendation for using your short-acting bronchodilator medication. Tell your doctor right away if you experience bronchospasm.

Severe allergic reaction to milk proteins. Advair Diskus contains milk proteins, which can cause an allergic reaction in some people. Due to this risk, doctors usually will not prescribe Advair if you’ve had a severe allergic reaction to milk proteins before. Note: Advair HFA does not contain milk proteins.

Serious infections. Advair can decrease your immune system’s ability to fight infections. This could raise your risk of developing an infection during your Advair treatment. If you already have certain infections before starting treatment (such as tuberculosis), Advair could make them worse. In some cases, serious infections can be fatal. Due to this risk, doctors usually will not prescribe Advair if you have a serious infection.

If you have a serious infection (or have had one in the past), talk with your doctor before using Advair.

Adrenal gland problems. Advair can affect the adrenal glands in some people. This can happen if you are switching from steroids taken by mouth to using Advair. Or it can occur if you’re taking a very high dose of Advair. Your body’s production of certain hormones such as cortisol may be reduced in these cases.

If you’ve had adrenal gland problems, talk with your doctor before using Advair. And if you’re switching from a steroid taken by mouth to Advair, your doctor can help you do so safely.

Other conditions that affect hormones. For some people with certain hormone disorders (such as thyroid problems), using Advair could make symptoms of their condition worse. If you have a condition that affects your hormones, talk with your doctor before using Advair.

Weakened bones. Long-term use of inhaled corticosteroids can weaken your bones. (Advair contains a corticosteroid). Weakened bones may lead to bone fractures and other bone problems. If you currently have any bone problems (or have had them in the past) talk with your doctor before using Advair. Your doctor may want to monitor you more closely during your treatment.

Seizure conditions. If you have a seizure disorder, using Advair could make your condition worse. Talk with your doctor about whether this drug is right for you.

Glaucoma and cataracts. Glaucoma and cataracts from long term use of inhaled corticosteroids have been reported. Advair contains a corticosteroid. If you have symptoms of eye problems during your Advair treatment, your doctor may refer you to an ophthalmologist.

Serious heart problems. If you have certain heart problems such as high blood pressure, palpitations, or abnormal heart rhythm, Advair could make them worse. If you have a heart condition, talk with your doctor about whether Advair is right for you.

Diabetes. If you have diabetes, using Advair could make your condition worse. If you have diabetes, talk with your doctor about whether Advair is right for you.

Churg-Strauss syndrome and conditions related to increased white blood cells. In rare cases, conditions related to high levels of eosinophils (a kind of white blood cell) have been reported when taking inhaled corticosteroids. (Advair contains a corticosteroid.)

If you have asthma, you may have a higher risk of developing Churg-Strauss syndrome. For some people, switching from long-term oral steroids for asthma control to Advair could trigger or reveal this condition. Talk with your doctor if your lung problems worsen, or if you have a rash, heart problems, or nerve pain during your treatment.

Alcohol and Advair

There are no known interactions between alcohol and Advair. But it’s important to note that long-term or excessive alcohol use can damage parts of your lungs. This type of damage can worsen your symptoms of asthma or COPD. It can also increase your risk of certain infections, such as pneumonia.

If you drink alcohol, talk with your doctor about how much (if any) may be safe to drink with your condition and treatment plan.

Pregnancy and breastfeeding while using Advair

It’s not known if it’s safe to use Advair while pregnant. But it’s important to note that asthma that’s not well managed can be harmful to a pregnant person or a fetus. For example, it could cause preeclampsia (high blood pressure during pregnancy), low birth weight, and premature birth.

It’s also not known if it’s safe to use Advair while breastfeeding. If you’re pregnant or breastfeeding, or planning to become pregnant or to breastfeed, talk with your doctor before using Advair.

What to ask your doctor

If you have questions or concerns about possible side effects of Advair, talk with your doctor. This can help you feel more confident in your treatment plan. Below are examples of some questions you may want to ask your doctor.