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Medically Approved

Is Advair safe for long-term use?

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Long-term side effectsOther side effectsBenefitsManaging side effectsAlternativesSummary
Advair is generally safe for long-term use, but like all medications, it has potential risks. It can have some side effects in the long term, but there are ways to manage them.
Medically reviewed by Alyssa Peckham, PharmD, BCPP
Written by Charlotte Parker
Updated on November 21, 2023

Doctors usually prescribe Advair as a long-term treatment. It contains the active drugs fluticasone propionate and salmeterol, and people use it to treat asthma and chronic obstructive pulmonary disease (COPD). The medication helps by reducing inflammation in the lungs and relaxing your airways, making it easier to breathe.

There are two main types of Advair: Advair Diskus, which is a dry powder inhaler, and Advair HFA, which is an aerosol metered-dose inhaler. These medications are designed to be taken at the same time each day and should not be used for quick relief during sudden breathing problems.

It is important to know about its side effects and to talk with a doctor if you have concerns.

Long-term side effects

A person sitting on a couch using an Advair inhaler, which is safe for long-term use.
Photography by Ljubaphoto/Getty Images

Although Advair helps millions of people with respiratory conditions like asthma or COPD, it does have potential side effects when used over an extended period. According to the Food and Drug Administration (FDA), at least 3% of people experience adverse side effects with Advair medications.

Its safety profile can vary based on age groups:

Children and adolescents

In kids and teens, there is a slight concern about the potential impact of corticosteroids like Advair on their growth. Some studies have suggested that inhaled corticosteroids, like the fluticasone found in Advair, may slightly reduce children’s growth rate.

It is essential to monitor growth in children and adolescents who use Advair.


In general, Advair is well-tolerated in the adult population. Common side effects might include headaches, throat irritation, and respiratory infections.

However, the long-term use of Advair in adults might increase the risk of pneumonia in those with COPD, especially as they get older.

Older adults

According to the FDA, negative side effects with Advair Diskus are more common in people with COPD over age 65, and these side effects are generally worse in this older population.

There isn’t enough research to determine the effects of age in people with asthma who are taking Advair.

It’s important to understand that while these side effects are possible, they don’t occur in everyone. Monitoring for any unusual symptoms and maintaining regular check-ups with a healthcare professional is essential. If you notice any new or worsening symptoms, it’s vital to consult a doctor immediately.

Other side effects to look out for

If you notice any of these side effects, discuss them with a healthcare professional:

Common side effects

  • Respiratory: throat irritation, hoarseness, voice changes, cough, or bronchitis
  • Infections: upper respiratory tract infection, sinusitis, or fungal infections in the mouth (oral candidiasis or thrush) — rinsing the mouth with water after using the inhaler can help reduce the risk of developing thrush
  • Neurological: headache and dizziness
  • Musculoskeletal: muscle pain, bone pain, or muscle cramps

Less common but more serious side effects

  • Cardiovascular: increased blood pressure, fast or irregular heartbeat, or chest pain
  • Endocrine: reduced kidney function, which can lead to fatigue, weakness, nausea, vomiting, and low blood pressure
  • Ophthalmologic: glaucoma or cataracts
  • Bone: osteoporosis (weak or brittle bones), especially with long-term use
  • Neurological: tremors or nervousness
  • Allergic reactions: rash, hives, swelling of the face, mouth, and tongue, or breathing difficulties — these can be signs of a serious allergic reaction and require immediate medical attention
  • Respiratory: paradoxical bronchospasm, which is when the airways suddenly constrict after using the inhaler, leading to increased shortness of breath — if this occurs, it’s essential to stop using Advair and seek medical attention
  • Immunological: increased susceptibility to infections due to the immunosuppressive effects of corticosteroids

Rare but serious side effects

  • Endocrine: a condition called Cushing syndrome, which involves weight gain in the upper back and abdomen, a rounded face, and thinning of the skin
  • Psychiatric: mood changes, depression, anxiety, agitation, and hallucinations
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Benefits of Advair

Although Advair’s popularity has been declining over the past decade, it remains a popular medication for many people with respiratory conditions, and for good reason. Medications like Advair, which combine a long-acting beta2-agonist (LABA) with an inhaled corticosteroid, can improve lung function.

Here are some of the key benefits:

  • Dual action: Advair combines two active ingredients, fluticasone propionate and salmeterol. While fluticasone reduces inflammation in the airways, salmeterol helps relax and open them. This dual action provides both immediate relief and long-term control.
  • Improved breathing: Many users report noticeable improvements in their breathing soon after starting the medication. This can lead to increased physical activity and better overall quality of life.
  • Reduced flare-ups: Regular use of Advair can help reduce the frequency and severity of asthma or COPD flare-ups, leading to fewer hospital visits and a more stable respiratory condition.
  • Convenient dosage forms: With both dry powder and aerosol forms available, people can choose the type of inhaler that suits them best, ensuring effective delivery of the medication.

Managing side effects

While Advair offers numerous benefits, it’s essential to be proactive in managing potential side effects. Here are some general guidelines and tips:

  • Stay informed: Familiarize yourself with the potential side effects of Advair. Being aware can help you identify any unusual symptoms early on.
  • Regular check-ups: Schedule regular visits with a healthcare professional to monitor your respiratory condition and discuss any concerns or side effects you might be experiencing.
  • Use as directed: Always use Advair as prescribed. Avoid using more than the recommended dose, as this can increase the risk of side effects.
  • Rinse after use: After using the inhaler, rinse your mouth with water to reduce the risk of oral thrush, a common side effect.
  • Monitor bone density: If you’re on long-term Advair therapy, consider periodic bone density tests, especially if you’re at risk of osteoporosis.
  • Stay active: Regular exercise can help improve lung function and overall health, potentially reducing the severity of some side effects.
  • Seek immediate help: If you experience severe side effects like chest pain, blurred vision, or allergic reaction, seek medical attention immediately.

Advair alternatives

For those considering alternatives to Advair, several other medications are available to help manage asthma and COPD. Here’s a brief overview of some commonly prescribed options:

Generic nameBrand nameDrug classUses
Budesonide/formoterolSymbicortcombination inhaled corticosteroid
and long-acting bronchodilator
asthma, COPD
Mometasone/formoterolDuleracombination inhaled corticosteroid
and long-acting bronchodilator
asthma (in patients 12 years and older)
Fluticasone/vilanterolBreo Elliptacombination inhaled corticosteroid
and long-acting bronchodilator
asthma, COPD
TiotropiumSpirivalong-acting muscarinic antagonist (LAMA)COPD

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Advair’s dual-action mechanism offers both immediate relief and long-term management of respiratory symptoms. However, at least 3% of users have reported adverse effects.

While there are alternatives available, your choice of medication should always be based on your personal needs and medical history and made with the guidance of a doctor.

It is essential to use Advair as prescribed, be proactive in managing potential side effects, and seek medical advice when needed to ensure its safe and effective use.

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