Advair Diskus

0 Comments | Family Practice News, Oct 15, 2000 | by Elizabeth Mechcatie

(salmeterol and fluticasone propionate inhalation powder, Glaxo Wellcome)

A combination of a long-acting [[beta].sub.2]-agonist and corticosteroid for long-term maintenance treatment of asthma in people 12 and older. The first product to combine an inhaled corticosteroid and bronchodilator in one device.

* Recommended Dosage: One inhalation twice a day Available in three fluticasone dose strengths: 100 [micro]g, 250 [micro]g, and 500 [micro]g, all with 50 [micro]g of salmeterol per inhalation. Each breath-activated device contains 60 premeasured doses, which can be monitored with a dose counter.

* Special Considerations: Not for relief of acute bronchospasm or to transfer patients from oral corticosteroid therapy Should not be started in patients experiencing a rapidly deteriorating or potentially life-threatening asthma episode.

* Comments: The Advair Diskus is a combination of the inhaled powder formulations of salmeterol (Serevent Diskus) and fluticasone (Flovent Rotadisk). At press time, the price for Advair Diskus had not yet been set.

The three Advair strengths were compared with their individual components in three studies of 1,208 patients, aged 12 and up, whose asthma was not adequately controlled on other treatments. Overall, treatment with Advair Diskus was associated with more improvements in pulmonary function and symptom control and with further reductions in [beta]-agonist rescue therapy and exacerbations, compared with the same doses of the drugs used separately Safety was comparable.

It is now "quite clear" from studies over the past several years that the best way to treat moderate to severe persistent asthma in adults and children is with a combination of an inhaled steroid and a long-acting [beta]-agonist, said Dr. Harold Nelson, senior staff physician in the department of medicine at the National Jewish Medical and Research Center, Denver.

The availability of having the two components, which address the inflammatory and the bronchoconstrictive aspects of asthma in one device, should improve compliance, particularly in adolescents, said Dr. Nelson, a member of the National Heart, Lung, and Blood Institute's expert panels that established national asthma treatment guidelines, Dr. Nelson has done studies for Glaxo Wellcome and has been a speaker and consultant for the company.