Tuesday, October 21, 2014

Tuesday, July 01, 2008 Dori, Community Member, asks

Q: supposed to rinse & spit. Why not swallow?

I,m new to Advair. Instructions r to small to read. Not supposed to rinse & swallow? I do after puffer. Is it harmfull to swallow? If so why?


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Answers (1)
James Thompson, MD, Health Pro
7/12/08 12:24am


Hi Dori,


I also have trouble with small print. I usually go on the Internet to look up patient information on the pharmaceutical website that makes the medication. I magnify the words on the screen (usually the bottom right corner) so the text can be easily read.


Advair has Fluticasone and Salmeterol in it. The Fluticasone is the inhaled steroid component which is considered essential for control of persistent asthma. Inhaled steroids (as well as other asthma inhalants) should be inhaled deeply into the lung (which means you should completely empty your lungs first, before inhaling). You should then count slowly to ten while holding your breath, as if you are under water.


The final step after exhaling is to rinse your mouth and spit. I have many of my patients rinse, gargle and spit in order to clear the throat and mouth of any residual inhalant.


All inhaled steroids should be rinsed out of the mouth after inhaled. Spitting after rinsing reduces the amount of steroid inhalant that is swallowed. Only about 1% of Fluticasone that is swallowed gets through the digestive system to the rest of the body. Higher percentages of the swallowed portion of other inhaled steroids get to the body. The goal is to minimize any systemic steroid exposure since these inhalants are usually taken for long periods of time.


To Your Health,


J. Thompson, MD

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By Dori, Community Member— Last Modified: 06/03/12, First Published: 07/01/08