In some studies, people taking salmeterol (one of the components of fluticasone and salmeterol) were more likely to have very severe asthma attacks. Some of these severe asthma attacks have resulted in deaths. It is not entirely clear if salmeterol caused these problems or not, or whether fluticasone and salmeterol will show similar problems. Fluticasone and salmeterol should not be started in people whose asthma is becoming significantly worse (or in emergency situations), as this may increase the risk of death. Let your healthcare provider know immediately if your asthma symptoms become worse during treatment with fluticasone and salmeterol.
Fluticasone and salmeterol is not a fast-acting asthma medication and cannot replace fast-acting rescue inhalers. Do not use fluticasone and salmeterol to treat an asthma attack. Everyone taking fluticasone and salmeterol should also have a rescue medication available at all times. Let your healthcare provider know if you need to use your rescue inhaler more frequently than usual, as this may be a sign of worsening asthma.
Do not take fluticasone and salmeterol more frequently than prescribed, as this may increase your risk of side effects.
Fluticasone and salmeterol can have a stimulatory effect on the heart and blood pressure. A fast heart rate (tachycardia), high blood pressure (hypertension), and an irregular heart rhythm (arrhythmia) may occur -- though low blood pressure (hypotension) is also possible. If you have heart disease or high blood pressure, make sure your healthcare provider is aware of it. He or she may wish to use particular caution if he or she recommends fluticasone and salmeterol in your case.
People with an overactive thyroid (hyperthyroidism), diabetes, or epilepsy should use caution when using fluticasone and salmeterol, as fluticasone and salmeterol may worsen these conditions or increase the risk of side effects.
Fluticasone and salmeterol contains a steroid and may suppress the immune system. Although this is more likely to occur with oral steroids, it is still possible with inhaled steroids (such as fluticasone and salmeterol). This may cause you to be at a higher risk of infections. Certain infections (such as chickenpox or the measles) may be more dangerous if you are taking fluticasone and salmeterol. Let your healthcare provider know right away if you are exposed to chickenpox or the measles (if you have not had these infections and have not been vaccinated against them).
Fluticasone and salmeterol should not be used to switch from oral to inhaled steroids.
Fluticasone and salmeterol is considered a pregnancy Category C medication. This means that fluticasone and salmeterol may not be safe to use during pregnancy. Talk with your healthcare provider about the risks and benefits of using fluticasone and salmeterol during pregnancy (see Advair and Pregnancy for more information).
It is not known if fluticasone and salmeterol passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about using fluticasone and salmeterol (see Advair and Breastfeeding for more information).
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