CAN I TAKE ADVAIR WITH SINGULAR & SPIRIVA

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