Is Advair Inhaler a Steroid?

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Question

Asked by Joanne

I was wondering if advair is a steroid?

Answer

Hi Joanne,

Advair is what's called a combination inhaler. That means it contains a combination of two different types of medicines in one canister. The two types are an inhaled corticosteroid or ICS (fluticasone propionate, found in Flovent) and a long-acting beta agonist (LABA), or bronchodilator (salmeterol, found in Serevent). Symbicort, another combination inhaler, contains budesonide, and formoterol. Dulera contains mometasone and formoterol, and Breo contains fluticasone and vilanterol.

Advair is generally prescribed when an inhaled steroid alone (the first treatment of choice for asthma) does not provide adequate control of asthma symptoms. It has been proved that many moderate to severe asthmatics who have trouble getting control with the inhaled steroid alone have success when an LABA is added to the mix.

What's important to understand are possible side effects. Inhaled steroids are considered generally safe for both adults and kids, although all medicines can have side effects. The side effects with inhaled corticosteroids, though, are usually mild and short-term. And the kind of steroid used in an inhaled steroid is very similar to natural substances found in the human body and NOTHING like the catabolic steroids sometimes used by athletes to enhance performance.

Side effects from the salmeterol, though, could be more problematic, which is why the FDA issued a black box warning for Advair in 2003. A black box warning means that potential side effects are so serious (though they may not be at all common) that the patient and doctor need to weigh risks vs. benefits before taking. This was because findings from the SMART study showed increased deaths among individuals with asthma using salmeterol. Experts do know that when an LABA is used with another medication, those risks are limited. Still it took years for the warning to be re-evaluated and removed. In 2018, the FDA removed the warning not only from Advair, but also from Breo, Symbicort, Dulera, and AirDuo.

Answered by Kathi MacNaughton