Learn which medications, supplements, and foods interact with Advair. Know the major drug interactions to avoid and what to tell your doctor.
If you take Advair (fluticasone propionate and salmeterol) for asthma or COPD, it's important to know which medications, supplements, and foods can interact with it. Drug interactions can reduce Advair's effectiveness, increase your risk of side effects, or create potentially dangerous combinations.
This guide covers the interactions you should know about and the information your doctor and pharmacist need from you. For background on what Advair is and how it works, see What Is Advair? and How Does Advair Work?
A drug interaction happens when one substance changes how another medication works in your body. With Advair, interactions can happen in several ways:
The severity of an interaction depends on the specific drugs involved, the doses, and your individual health profile. That's why it's critical to keep your doctor and pharmacist informed about everything you take.
These medications should generally not be taken with Advair. If you're currently taking any of them, talk to your doctor immediately — do not stop any medication on your own.
These medications block the liver enzyme that breaks down fluticasone, causing it to accumulate in your body. This can lead to systemic corticosteroid effects including Cushing syndrome (weight gain, moon face, high blood sugar) and adrenal suppression.
If you need treatment with any of these drugs, your doctor may switch you to a different inhaler or choose an alternative medication for the other condition.
These medications can potentiate (amplify) the cardiovascular effects of salmeterol, increasing the risk of rapid heart rate, high blood pressure, and irregular heartbeat.
If you take an MAO inhibitor or tricyclic antidepressant, use Advair with extreme caution and only under close medical supervision. Your doctor may recommend additional cardiac monitoring.
Beta-blockers block the same receptors that salmeterol activates. Non-selective beta-blockers can completely negate salmeterol's bronchodilating effect and may trigger severe bronchospasm in asthma patients.
Important: Even beta-blocker eye drops for glaucoma (like timolol) can interact with Advair. If you need a beta-blocker, your doctor may prescribe a cardioselective (beta-1 selective) version like metoprolol or atenolol, which are less likely to affect the airways — though they should still be used with caution.
These interactions may require dose adjustments or closer monitoring but aren't necessarily dealbreakers:
Loop diuretics (furosemide/Lasix, bumetanide) and thiazide diuretics (hydrochlorothiazide) can lower potassium levels. Since salmeterol can also lower potassium, the combination may increase the risk of hypokalemia — which can cause muscle cramps, weakness, and abnormal heart rhythms.
If you take both Advair and a diuretic, your doctor may monitor your potassium levels periodically.
Do not use another LABA (such as formoterol, vilanterol, or olodaterol) while taking Advair. Salmeterol in Advair is already a LABA, and doubling up increases the risk of cardiovascular side effects like tremor, palpitations, and dangerous heart rhythms.
This includes other combination inhalers that contain a LABA (like Symbicort, Breo Ellipta, or Stiolto Respimat).
These don't block fluticasone metabolism as strongly as the major inhibitors listed above, but can still increase fluticasone levels with prolonged use:
Short courses (a few days) are generally acceptable, but long-term use alongside Advair should be monitored.
Don't forget that OTC products and supplements can also interact with Advair:
Advair has minimal food interactions compared to many medications:
Before starting Advair — and at every follow-up visit — make sure your doctor and pharmacist have a complete picture:
Advair is generally well-tolerated, but its two active ingredients — fluticasone and salmeterol — each have their own interaction profiles. The most important interactions to be aware of are strong CYP3A4 inhibitors (especially ritonavir), non-selective beta-blockers, and MAO inhibitors/tricyclic antidepressants.
Your pharmacist is one of your best resources for catching drug interactions. Every time you fill a prescription, your pharmacy's system checks for interactions automatically — but it only works if they know about everything you're taking.
Need to fill your Advair prescription? Medfinder can help you find a pharmacy with Advair in stock near you.
Related Advair guides:
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