Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Advair Diskus. If you are concerned about side effects, discuss the risks and benefits of Advair Diskus with your doctor.

The following side effects have been reported by at least 1% of people taking Advair Diskus. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• body aches or pains
• cough
• disturbed sleep
• dizziness
• fatigue
• headache
• hoarseness
• mouth, tongue, or throat irritation
• muscle cramps or pain
• nausea
• spinning sensation
• tremor
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• behavior changes (e.g., agitation, anxiety, or irritability)
• fainting
• fast or irregular heartbeat
• increased bruising
• increased frequency of infections
• persistent pain and/or limited motion of joints or limbs
• pins and needles or numbness of arms or legs, sinus pain and congestion, worsening breathing problems (Churg-Strauss Syndrome)
• rounded face
• signs of low potassium levels in the blood (e.g., weakness, fatigue, muscle cramps, irregular heartbeat)
• slowed growth (children and adolescents)
• sores, ulcer, or white patches in the mouth or throat (thrush)
• symptoms of adrenal insufficiency (tiredness, headache, nausea, vomiting, muscle or joint pain)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of increased pressure in the eyes (e.g., decreased or blurred vision, eye pain, red eye, swelling of the eye)
• symptoms of pneumonia (e.g.,  Fever or chills, shortness of breath, fatigue, chest pain, cough)
• vision changes (blurred vision)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• a Anaphylaxis (severe allergic reaction) (e.g., Hives; difficulty breathing; or swelling of the face, mouth, or tongue; difficulty swallowing, breathing, or speaking)
• skin rash or hives all over the body
• wheezing or difficulty breathing immediately after inhaling the medication
• worsening asthma symptoms even after using your reliever medication

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Advair Diskus.

Advair Diskus

Advair 100 Diskus
A plastic inhaler device containing a foil strip with 28 or 60 blisters. Each blister contains 50 µg of salmeterol (as the xinafoate salt) and 100 µg of fluticasone propionate. Nonmedicinal ingredient: lactose (milk sugar), including milk protein, which acts as the "carrier".

Advair 250 Diskus
A plastic inhaler device containing a foil strip with 28 or 60 blisters. Each blister contains 50 µg of salmeterol (as the xinafoate salt) and 250 µg of fluticasone propionate. Nonmedicinal ingredient: lactose (milk sugar), including milk protein, which acts as the "carrier".

Do not use Advair Diskus if you:

• are allergic to salmeterol, fluticasone, or any ingredients of the medication
• are allergic to lactose or milk (Diskus only)
• have abnormal rapid heart rhythms known as tachyarrhythmias
• have status asthmaticus or are experiencing an asthma attack
• have untreated fungal, bacterial, or tuberculous infections of the lungs

There may be an interaction between salmeterol - fluticasone and any of the following:

• Aldesleukin
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• anti-psychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, olanzepine, Quetiapine, Risperidone)
• Atomoxetine
• "azole" antifungals (e.g., fluconazole, itraconazole, ketoconazole, Voriconazole)
• BCG
• beta-blocker medications (e.g., Propranolol, Metoprolol, Atenolol, Labetalol)
• beta2-agonists (e.g., salbutamol, terbutaline, formoterol, Indacaterol)
• Betahistine
• caffeine
• cannabis
• chloroquine
• Cobicistat
• conivaptan
• Cyclosporine
• decongestant cold medications (e.g., phenylephrine, Pseudoephedrine)
• decongestant eye drops and nose sprays (e.g., naphazoline, oxymetazoline, xylometazoline)
• Deferasirox
• Degarelix
• Desmopressin
• Digoxin
• Diltiazem
• dipivefrin
• Disopyramide
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• dofetilide
• Domperidone
• Dronedarone
• echinacea
• Epinephrine
• Fingolimod
• Flecainide
• grapefruit juice
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delaviridine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• Leflunomide
• Linezolid
• Lomitapide
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Methadone
• Methylphenidate
• mifepristone
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• Nabilone
• Natalizumab
• nefazodone
• Nivolumab
• Pimecrolimus
• Primaquine
• procainamide
• protein kinase inhibitors (e.g., Lapatinib, Pazopanib, Sunitinib)
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin, Ofloxacin, sparfloxacin)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• serotonin antagonists (anti-emetics; Granisetron, Ondansetron)
• simeprevir
• Stiripentol
• Tacrolimus
• Tetrabenazine
• theophyllines (e.g., Aminophylline, Oxtriphylline, Theophylline)
• Tofacitinib
• tricylic antidepressants (e.g. Amitriptyline, Clomipramine, Desipramine)
• vaccines
• Verapamil

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Advair Diskus. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Advair Diskus.

Asthma: When used for alone for asthma treatment, salmeterol has been linked to an increase in asthma-related deaths. Salmeterol - fluticasone should only be used when a regular inhaled corticosteroid (e.g., fluticasone) and a fast acting "reliever" medication (e.g., salbutamol) do not adequately control your symptoms.

If you start developing asthma symptoms, be sure to use your reliever medication for rapid relief of your asthma symptoms. It is very important that you have your reliever medication with you at all times. If you experience worsening symptoms or your reliever medications are not as effective as usual, contact your doctor or seek medical attention immediately.

Blood Pressure: Salmeterol can cause blood pressure to increase, particularly at higher doses. If you have high blood pressure, discuss with your doctor how Advair Diskus may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Advair Diskus, and whether any special monitoring is needed.

Diabetes: Both fluticasone and salmeterol may cause an increase in blood sugar levels. If you have diabetes, you may find it necessary to monitor your blood sugar more frequently while using Advair Diskus. If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Advair Diskus may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Advair Diskus, and whether any special monitoring is needed.

Eye problems: If you are at risk of developing Glaucoma or Cataracts, have your eyes checked by your doctor before starting long-term treatment with Advair Diskus. You should have your eyes monitored at regular intervals while using Advair Diskus.

Growth effects: Long-term use of corticosteroids, including inhaled forms such as Advair Diskus, may slow the growth of children and adolescents. It is important to use the lowest effective dose for managing asthma symptoms. Talk to your doctor if you have any concerns.

Heart rhythm: Beta-agonists such as salmeterol can cause changes to the normal rhythm of the heart, including an irregular heartbeat called QT prolongation. QT prolongation is a serious life-threatening condition that can cause fainting, seizures, and sudden death.

Salmeterol can cause a fluttering of the heartbeat (atrial fibrillation) or rapid heart beat, increased blood pressure, chest pain and decreased oxygen reaching the heart muscle.

If you are at risk for heart rhythm problems (e.g., people with heart failure, Angina, low potassium or magnesium levels), discuss with your doctor how Advair Diskus may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Advair Diskus, and whether any special monitoring is needed.

Infections: Corticosteroids, such as fluticasone, can reduce your body's ability to fight infections and may hide signs of infection that is developing. Infections such as Chickenpox and Measles can be more serious in people taking medications such as fluticasone. If you are exposed to someone with chickenpox or measles, contact your doctor.

Inhalation-induced bronchospasm: Inhaled forms of medications may cause spasms of the airways, which make breathing difficult. If you experience this problem when using salmeterol - fluticasone, stop using Advair Diskus immediately. Speak to your doctor if you experience any problems with breathing while taking this or other inhaled medication.

Oral hygiene: Adequate oral hygiene, such as rinsing your mouth with water after using Advair Diskus, helps reduce the chances of developing a yeast infection of the mouth or throat (thrush). If you develop symptoms of thrush, such as white patches in your mouth, contact your doctor.

Osteoporosis: Long-term use of corticosteroids, including inhaled corticosteroids such as fluticasone, may increase the risk of bone loss and osteoporosis. If your doctor recommends that you use Advair Diskus for a lengthy period of time, talk to your doctor about supplements and strategies to slow down and reduce bone loss.

Steroid medication use: If you have taken oral steroid medications over the last several months or are still taking oral corticosteroids, consult with your doctor before using Advair Diskus. In times of stress or during a severe asthma attack, your doctor may want you to start your oral steroid medication again.

Stopping medication: Do not stop Advair Diskus abruptly, as this may cause your condition to get worse. When Advair Diskus is stopped, it should be stopped gradually as directed by your doctor.

Thyroid disease: People who have an over-active thyroid gland may be more sensitive to the effects of salmeterol - fluticasone. If you have thyroid disease, discuss with your doctor how Advair Diskus may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Advair Diskus, and whether any special monitoring is needed.

Worsening symptoms: If you find you need to use your short-acting "rescue" inhaler more often or if your condition seems to worsen, call your doctor. If you have not been given instructions beforehand, contact your doctor immediately about what to do if any of the following situations occur (they may be signs of seriously worsening asthma):

• decreased effectiveness of short-acting, inhaled bronchodilators such as salbutamol, terbutaline, or fenoterol (less than 4 hours of relief)
• need for more inhalations than usual of short-acting, inhaled bronchodilators
• peak flow meter showing results in the below-normal range

Pregnancy: Advair Diskus should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Advair Diskus, contact your doctor immediately.

Breast-feeding: Advair Diskus passes into breast milk. If you are a breast-feeding mother and are taking salmeterol - fluticasone, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of the Diskus form of Advair Diskus have not been established for children less than 4 years of age. The safety and effectiveness of the inhaler form of Advair Diskus have not been established for children less than 12 years of age.