Thursday, June 26, 2008 Dee asks

Q: CAN I TAKE ADVAIR WITH SINGULAR & SPIRIVA

i HAVE ASTHMA AND HAVE BEEN ON ADVIR & SINGULAIR FOR SOME TIME AND WAS GIVEN SAMPLE OF THE SPIRIVA AND IT SEEMED TO HELP A LOT TO LOOSEN UP MY LUNG AND NEED TO KNOW WILL THEY ALL WORK TOGETHER.

Answers (2)

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James Thompson, MD

7/11/08 10:04pm

Hi Dee,

This is a topic that should be discussed with your doctor. Spiriva is a brand of Tiotropium that is prescribed to prevent bronchospasm. I am not aware of studies that address the safety of Advair, Singulair and Spiriva taken together. I have managed patients with asthma and COPD (Chronic Obstructive Pulmonary Disease) that are on all three medications (all prescribed by a referring lung specialist). I don't recall any specific complaints from these patients.

That said, Spiriva is indicated for treatment of COPD. The most common complaint in clinical trials conducted before its FDA approval was dry mouth. Caution should be taken in people with glaucoma or bladder emptying problems (especially males with prostate problems) or heart disease.

Guidelines for treating asthma, published by the National Institute of health and revised last year, did not include Spiriva as a drug recommended to treat asthma.

It is assumed that asthma patients with a history of tobacco smoking may benefit from Spiriva (because they may have a component of bronchitis or COPD).

Some doctors opt to add Spiriva to the inhalant list for asthma treatment when the other asthma medications have failed.

In many cases the determination of whether the three inhalers can work together is based on feedback from the patient (until clinical studies are available). It seems, based on your comments, you have improved. The need for more than two controller agents (Advair counts for two controllers in one) for asthma warrants consultation by an allergist or lung specialist. If you have not seen a specialist I advise you take steps to get a consultation from one.

To Continued Good Health,

J. Thompson, MD

Ben

1/23/10 11:10am

Thanks Dr Thompson

I battle bladder cancer and COPD. 2+ years. My treatments for both takes place at Duke Medical Center in Durham, NC. They have been outstanding with all treatments.

This week my doctor in Pulmonary care added Advair to my Spiriva.

This is the 2nd day and my lungs appear to have a difficult time expanding after taking both in the AM.

Your imput on this matter.

Ben

James Thompson, MD

1/23/10 2:33pm

Hi Ben,

Thank you for your comments. The best advice I can give you is to talk to your pulmonary consultant as soon as you can. You should not feel worse after taking any of your inhalers. Perhaps your inhaler technique should be reviewed by a physician or nurse. Even the dry-powdered Diskus inhalers are sometimes not used properly. It is also possible that you are intolerant to an ingredient in the Advair inhalant. Continued use in this case could be risky.

You have reason to be concerned. Either some adjustment in the use of your new inhaler needs to be made, or possibly a change to a different formulation or another medication. Your prescribing doctor needs to address your concern and decide on the appropriate action.

Thanks for sharing and good luck!

J. Thompson, MD

Pamela

10/27/11 3:21am

I have COPD and have used all three medications. The singulair I no longer use since it did not seem to help me one way or the other. I also use an albuterol inhaler for emergency symptoms. As for the Advair 250 and Spiriva, I don't think I would be able to function as well as I do if not for those two medications. They are both very expensive medications and I belong to two wonderful patience assistance programs through the manufacturers in order to receive both of them at little or no cost. The problem is that I have to make sure I don't ever run out. I ran out of the Spiriva for 19 days while I had to wait to receive a new prescription in the mail. By the third day of not using Spiriva, I was having a more difficult time breathing and by day ten, I was unable to walk around my home without the assistance of oxygen. By day 19, I was using oxygen 24/7 and could not take it off even for short periods of time. After receiving the Spiriva and taking it immediately, I knew I was going to be better soon. It has been four days since I received it, and I only use my oxygen for a few hours a day. By the time I have been back on it for a week to ten days I won't have to use the oxygen at all (unless I catch a cold, which I pray I don't).

The Advair kept me functional and I am sure it is a wonderful drug alone for some people, but without the Spiriva my life would be horrible. I have three grandchildren, two of which are ten month old babies and a six year old boy. When I am on my medication, I am able to babysit for any or all of them, play with the six year including playing baseball outside and take the babies for walks in their strollers. I also have dogs that love daily walks. When I have my meds, my life is full. But this month when I mistakenly ran out of the Spiriva, I was acutely aware of how much I needed this medication. I will always make sure to keep an eye on the expiration dates of my membership (this is what happened to me) and how much I have left in my prescription. Anyhow, I know this is not the question you asked but I had to share my experience with these medications. I take the Advair twice a day and the Spiriva once a day. I NEVER FORGET TO TAKE THEM ON A TIMELY BASIS AND I TAKE THEM AT THE SAME TIME. I AM FAIRLY CERTAIN THAT THEY ARE SAFE TAKEN TOGETHER SINCE I HAVE NEVER HAD A PROBLEM DOING SO AND HAVE NOT BEEN TOLD OTHERWISE. Good luck with your health issues.

Q: CAN I TAKE ADVAIR WITH SINGULAR & SPIRIVA

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