Advair and Symbicort: “Benefits Outweigh Risk” says an FDA Advisory Committee

By James Thompson, MD, Health Pro Monday, December 15, 2008

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Last week, the Food and Drug Administration (FDA) listened to presentations and comments from several members of an expert FDA advisory committee regarding the benefit-to-risk ratio of Long Acting Beta-agonist drugs (LABAs) -- namely Serevent (salmeterol), Foradil (formoterol), Advair (a combination ...

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Asthma: Advances in Medications this Decade

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Karen

7/ 7/10 12:02am

Can you use an inhaler if pregnant?

James Thompson, MD, Health Pro

12/31/10 12:33pm

Hi Karen,

I'll try not to make a habit of responding to comments several months after they have been posted. I just missed it, I'm sorry.

Advair is category C regarding pregnancy rating. This means studies in humans have not been done, and in this case animal studies did show some birth defects.

Animals may deal with drugs differently compared to humans. Your doctor must weigh the risks of Advair to the unborn child, against the risk of more severe asthma with use of other alternative medication.

Here is a link which covers the topic well: http://asthma.emedtv.com/advair/advair-and-pregnancy.html

So sorry about the delay,

J. Thompson, MD

Rob

12/24/10 1:27pm

hello. i have been using advair for about 6 weeks and it has really helped with my copd,however it does effect my voice. im always trying to clear my throat.i rinse and garggle each time but still have the problem. i don,t like answering the telephone as i never know what my voice will be like. is there anything that will help me with this problem? ty Ron

James Thompson, MD, Health Pro

12/31/10 12:48pm

Hi Rob,

If you are already rinsing, gargling and spitting after inhaled doses, there is not much more you can do. In similar settings with patients, I have tried stepping the doses down as low as possible (often not effective though) and using an aerosol form of Advair (Advair HFA) with a spacer device (which further reduces the deposition of the drug on the throat). Dysphonia (hoarseness) is not rare in patients on inhaled steroids.

Discuss your concerns and experience with your doctor. Do not make any changes in how you take your medications without authorization from your doctor. There is an inhaled steroid, Alvesco, which activates once it gets to the lung. This means there is less of a chance of having local (throat) side effects. One drawback is it does not have a combined form which includes a long-acting opening agent (as in the case of Advair, which has two medications in one).

Good Luck!

J. Thompson, MD

Concerned parent

12/25/10 3:32pm

If a 3-year old is currently receiving Symbicort for possible asthma, should the doctor change to a medication with less side-effects?

James Thompson, MD, Health Pro

12/31/10 12:53pm

Dear Concerned Parent,

Symbicort is FDA approved for treatment of asthma in those who are age 12 and older. Sometimes doctors decide that risks are outweighed by potential benefits in such situations. This must be discussed with your prescribing doctor.

Best Wishes,

J. Thompson, MD

Advair and Symbicort: “Benefits Outweigh Risk” says an FDA Advisory Committee

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