I just started using advair and am very concerned at how safe it is 500/50. Is there an alternate that will work the same. And be a little safer for long term use.
I can understand your concerns. Advair has been getting a lot of bad press over the past year, because of a black box warning that had to be applied to it as required by the FDA. This warning was really about one of Advair's ingredients, a drug called Serevent. Studies have shown that people taking Serevent had more asthma emergencies than people who don't take it. However, subsequent studies have pointed out that what the original researchers failed to take into account is that Serevent alone is not an adequate treatment for someone with asthma. So, people who took that and nothing else were bound to have more problems, because their asthma was not under control.
Advair is a combination drug that includes an inhaled steroid (Flovent) with the Serevent (salmeterol). Combination drugs are the treatment of choice for people with severe persistent asthma that has not been well controlled by an inhaled steroid alone. And Advair itself has rarely been associated with the serious side effects linked to Serevent alone.
In the end, experts feel that you must weigh a drug's benefits against its possible side effects. In the case of Advair, it has considerable benefits if it keeps your asthma under control, both short-term and long-term. Asthma that is not under control has much more serious side effects than Advair does, in most cases. But, it's a good idea to discuss your concerns with your own doctor, just to be sure.
And yes, there are alternatives. Symbicort is another combination drug. It contains budesonide (the steroid) and a different bronchodilator, formeterol. But Symbicort carries the same black box warning that Advair does, because its bronchodilator is in the same class as Serevent. So you may not feel any better about it.
Another option you might discuss with your doctor is Xolair, an injectable asthma medication that acts directly on the immune system. But it also carries the black box warning. The thing to keep in mind is that the FDA has not banned these drugs, and the reason is because most people are taking them without any problems at all. And enjoying tremendous improvements in their asthma.
So, talk to your doctor...