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III. Advair HFA vs Diskus: Finding the Right Inhaler
Advair is a commonly prescribed inhaled medication used to improve lung function for those with chronic obstructive pulmonary disease (COPD) and asthma. Advair comes in two forms:
- Advair Diskus: A dry powder inhaler (DPI).
- Advair HFA: A metered dose inhaler (MDI).
If you have COPD, Advair Diskus is your only option. However, if you have asthma, you can choose between Advair Diskus and Advair HFA based on your needs and lifestyle.
In this article, we will discuss how Advair Diskus and Advair HFA work, the proper dosage and usage for each, and provide helpful tips to determine which version of Advair is right for you.
Advair Diskus
Advair Diskus is FDA-approved to treat asthma and chronic obstructive pulmonary disease (COPD).
- Asthma: Advair Diskus is approved for long-term use in asthma patients ages four and up. By opening airways and decreasing swelling, it makes breathing easier and helps prevent asthma attacks.
- COPD: Regular use of Advair Diskus opens airways to improve airflow over time. It lowers the risk of COPD flare-ups that can worsen symptoms. [1]
Advair contains an inhaled corticosteroid and a long-acting bronchodilator that work together to improve lung function.
- Fluticasone propionate is an inhaled corticosteroid that reduces inflammation in the lungs.
- Salmeterol is a long-acting bronchodilator (LABA) that relaxes the muscles surrounding the airways to keep them open. [1]
Advair Diskus is a dry powder inhaler (DPI) that combines these medications in a powder formulation. The powder is released when you inhale through the device and can reach even the smallest airways. You likely won't taste or feel the medication due to the small particle size. [2]
It's important to note that Advair Diskus contains lactose, like other DPIs. If you have a milk allergy, talk to your healthcare provider about suitable alternatives. [2]
Advair Diskus Dosages
Advair Diskus is available in three strengths that provide set doses of the two active ingredients, fluticasone propionate and salmeterol, to treat asthma and COPD. The first number listed on your Advair Diskus inhaler indicates the amount of fluticasone, while the second number denotes the salmeterol dose. [1]
- Advair Diskus 100/50: 100 mcg of fluticasone and 50 mcg of salmeterol.
- Advair Diskus 250/50: 250 mcg of fluticasone and 50 mcg of salmeterol.
- Advair Diskus 500/50 delivers 500 mcg of fluticasone and 50 mcg of salmeterol. [1]
Your doctor will prescribe the appropriate Advair dose based on factors such as age and symptom severity.
- Adults and children over 12 with asthma: One inhalation of Advair Diskus 100/50, 250/50, or 500/50 twice daily, depending on asthma severity.
- Children aged 4 to 11 with asthma: One inhalation of Advair Diskus 100/50 twice daily.
- COPD maintenance treatment: One inhalation of Advair Diskus 250/50 twice daily. [1]
How to Use Advair Diskus
Using your inhaler properly is key to getting the most out of your medication. Follow these steps every time you use your Advair Diskus inhaler to ensure you receive the full dose:
- Hold the inhaler horizontally like a sandwich.
- Place your thumb on the grip and push away from you until you hear a click, opening the device.
- Place your thumb on the dose lever and push away from the mouthpiece until you hear another click, loading the medication.
- Breathe out fully, away from the inhaler.
- Seal your lips tightly around the mouthpiece and take a quick, deep breath in.
- Remove the inhaler and hold your breath for 10 seconds.
- Breathe out away from the device.
- Rinse your mouth with water to prevent oral thrush. [3]
Advair HFA
Advair HFA is FDA-approved for treating asthma in patients 12 years of age and older. It is not approved to treat COPD. This medication contains the same active ingredients as Advair Diskus but in a different delivery system. [4]
Unlike Advair Diskus, which is a dry powder inhaler, Advair HFA utilizes a metered-dose inhaler (MDI). The medications are suspended in a liquid propellant and kept under pressure. When you press down on the canister, a measured dose of the medication is released as a spray that you inhale. [5]
The HFA in Advair HFA stands for hydrofluoroalkane, which is the updated propellant used in place of older chlorofluorocarbon (CFC) propellants. HFA propellants are more environmentally friendly than CFC propellants. [5]
Advair HFA Dosages
Advair HFA comes in three strengths that are prescribed based on your asthma severity. Each strength contains a set amount of the two medications in Advair: fluticasone propionate and salmeterol. [1]
The first number on your Advair inhaler shows the dose of fluticasone, while the second number is the salmeterol dose.
- Advair HFA 45/21: 45 mcg of fluticasone propionate and 21 mcg of salmeterol.
- Advair HFA 115/21: 115 mcg of fluticasone propionate and 21 mcg of salmeterol.
- Advair HFA 230/21: 230 mcg of fluticasone propionate and 21 mcg of salmeterol. [1]
When your doctor prescribes Advair HFA, they will select the strength based on the severity of your asthma symptoms. Regardless of which strength you are given, the recommended dosage is two inhalations twice per day. [1]
How to Use Advair HFA
To get the maximum benefit from your Advair HFA inhaler, it’s critical to use it properly. Incorrect use can lead to some of the medication being deposited in your mouth instead of making it to your lungs where it’s needed. The biggest downside of metered dose inhalers like Advair HFA is improper usage and dosage. By following the right technique, you can avoid this issue and gain the full effects of the medication. [5]
Before using a new Advair HFA, or if you haven’t used your inhaler in over four weeks, you need to prime it. Priming the inhaler ensures you get an accurate dose of the medication with each use. [6] Here are the priming steps:
- Remove the cap from the Advair HFA inhaler.
- Shake the inhaler for 5 seconds.
- Point the inhaler away from you and press down on the canister once to release one spray.
- Repeat these steps two more times for a total of three sprays. [6]
Once primed, your Advair HFA inhaler is ready to use. Follow these steps each time you take a dose:
- Take the cap off the inhaler.
- Place your middle or index finger on top of the canister and your thumb under the mouthpiece.
- Shake the inhaler for 5 seconds.
- Breathe out fully.
- Seal your lips tightly around the mouthpiece. Don't block it with your teeth or tongue.
- Push down on the canister all the way while breathing in slowly through your mouth.
- Hold your breath for 10 seconds.
- Breathe out away from the inhaler.
- Rinse out your mouth to lower the risk of oral infection. [6]
Advair HFA vs Diskus: Finding the Right Inhaler
Both Advair HFA and Advair Diskus contain the same active ingredients to control asthma and COPD symptoms. The key difference lies in the delivery method. Advair HFA uses a metered dose inhaler, while Advair Diskus utilizes a dry powder inhaler.
If you have COPD, Advair Diskus is currently the only approved option. However, if you have asthma, you have the flexibility to choose between HFA and Diskus. We’ve outlined some benefits and considerations of each to help determine the best fit based on your needs and preferences.
- Ease of use: Many find the Diskus easier to use properly. With the HFA inhaler, you need to press down on the canister and inhale at the right time to get the full dose into your lungs. Not synchronizing the canister press and inhalation properly could lead to medication just landing in your mouth. The Diskus eliminates this issue by automatically releasing medication when you inhale through the device. [5]
- Hand strength: Advair HFA delivers the medication through a pressurized canister that requires coordinating pressing down on the canister while inhaling. This can be difficult for some, especially those with arthritis or low grip strength. Advair Diskus is breath-actuated, meaning it releases the dose when you inhale without needing to press anything. [2]
- Inhalation strength: Advair Diskus requires a strong inhalation to receive the full dose. This could be challenging for elderly individuals or during flare-ups when generating significant respiratory force may be difficult. Remember, Advair is a long-term controller medication that is not intended for sudden asthma attacks, so it’s important to have a rescue inhaler on hand for emergencies. [2]
- Allergies: Advair Diskus contains lactose, a common component in dry powder inhalers. If you have a milk allergy, you may want to opt for Advair HFA, which does not contain lactose. [2]
- Humidity: Advair Diskus is sensitive to humid conditions. High humidity can affect the medication particles, potentially reducing the amount of medication reaching your lungs. If you reside in a humid environment, Advair HFA might be a more suitable choice. [7]
Conclusion
The right inhaler can make a big difference in how effectively you manage your respiratory condition. With the variety of inhalers available today, you have options to find one that fits your needs and lifestyle.
When deciding between Advair HFA vs Diskus, have an open discussion with your doctor. Explain your symptoms and medical history. Do you need an inhaler without lactose? Or one that's easier to handle with arthritis? Your doctor can help weigh the pros and cons.
The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.