Prescription required Inhaled corticosteroid + LABA (ICS/LABA) controller

Buy Advair (Fluticasone / Salmeterol) — Online Prescription

Name: Advair (Fluticasone / Salmeterol)
Published: 2026-09-29

Advair, called Seretide outside the US, is the purple twice-daily controller inhaler for asthma and COPD. It combines a steroid (fluticasone) with a long-acting bronchodilator (salmeterol). This guide covers how it works, which strength is which, generic Wixela, what the safety data really shows, how it compares with Symbicort and Breo, and how to pay less.

Medically reviewed Medically reviewed by Angelo DeFazio, R.Ph. — NPI 1629115530 · Last updated 2026-09-29

Medical disclaimer This page is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your physician or pharmacist before starting, stopping, or changing any medication. Never disregard professional medical advice or delay seeking it because of something you have read on this site.

Active ingredient	Fluticasone propionate (inhaled corticosteroid) + salmeterol (long-acting beta2-agonist)
Dosage form	Diskus dry-powder inhaler (100/50, 250/50, 500/50 mcg, 60 doses); HFA inhaler (45/21, 115/21, 230/21 mcg)
Administration route	Oral inhalation

FDA Drug Facts — ADVAIR DISKUS

Indications: 1 INDICATIONS AND USAGE ADVAIR DISKUS is a combination product containing a corticosteroid and a long-acting beta 2 -adrenergic agonist (LABA) indicated for: • Twice-daily treatment of asthma in patients aged 4 years and older. ( 1.1 ) • Maintenance treatment of airflow obstruction and reducing exacerbations in patients with chronic obstructive pulmonary disease (COPD). ( 1.2 ) Important limitation of use: Not indicated for relief of acute bronchospasm. ( 1.1 , 1.2 ) 1.1 Treatment of Asthma ADVA…

Contraindications: 4 CONTRAINDICATIONS The use of ADVAIR DISKUS is contraindicated in the following conditions: • Primary treatment of status asthmaticus or other acute episodes of asthma or COPD where intensive measures are required [see Warnings and Precautions ( 5.2 )] . • Severe hypersensitivity to milk proteins or demonstrated hypersensitivity to fluticasone propionate, salmeterol, or any of the excipients [see Warnings and Precautions ( 5.11 ), Adverse Reactions ( 6.3 ), Description ( 11 )] . • Primary treat…

Excerpted from the FDA-approved prescribing information. Read the full label on Drugs@FDA →

openFDA label data — Updated 2026-09-29

Quick answer

Advair (called Seretide outside the US) is a prescription controller inhaler for asthma and COPD. It combines fluticasone, an inhaled steroid that calms inflammation, with salmeterol, a bronchodilator that lasts 12 hours. You take it every day, twice a day, not for sudden attacks. Keep albuterol for those. The purple Diskus comes in 100/50, 250/50 and 500/50. Its generic, Wixela Inhub, is the same medicine and costs pharmacies about 60% less. Insured patients can often get brand Advair for $35. Rinse your mouth after each dose to prevent thrush.

12 hoursHow long each dose keeps airways open (FDA trials)

30–60 minTime to start working. Too slow for a rescue inhaler.

$1.245What pharmacies pay per dose of generic 250/50 (CMS NADAC)

How Advair works: controller, not rescue

Advair treats both halves of the asthma and COPD problem at once: inflammation that makes airways swollen and twitchy, and tight airway muscles that narrow them.

Inflamed airwaysSwelling and mucus make the airways narrow and quick to react to triggers.

Fluticasone (steroid)Calms the inflammation over days to weeks, so there are fewer flare-ups.

Salmeterol (LABA)Relaxes airway muscle for about 12 hours, but takes 30–60 minutes to kick in.

Controlled asthma or COPDFewer symptoms, less rescue-inhaler use and fewer exacerbations, as long as it's taken every day.

Controller · every day

Advair

When: Morning and evening, about 12 hours apart, even when you feel fine
Starts working: 30–60 minutes. Full control builds over 1+ weeks.
Job: Prevent symptoms and flare-ups

Rescue · as needed

Albuterol (Ventolin)

When: Only when symptoms hit, or before exercise
Starts working: About 5 minutes
Job: Relieve an attack now. See our albuterol guide.

Advair dosage: 100/50 vs 250/50 vs 500/50

The first number is the fluticasone (steroid) dose in micrograms. The second is salmeterol, which is the same in every Diskus strength. You always take 1 inhalation twice daily, and a stronger strength means more steroid, not more puffs.

Diskus strength	Who it's for (FDA label)	Dose
100/50	Asthma, ages 4–11 (the only children's strength). Milder asthma in ages 12+	1 inhalation twice daily
250/50	Asthma, ages 12+. The only FDA-approved strength for COPD.	1 inhalation twice daily
500/50	More severe asthma, ages 12+. This is the maximum dose.	1 inhalation twice daily
HFA 45/21, 115/21, 230/21	Asthma, ages 12+. A spray inhaler, for people who can't use a dry-powder device well.	2 puffs twice daily

Why the HFA numbers look different

Advair HFA labels the dose that leaves the mouthpiece per puff (for example 115 mcg fluticasone and 21 mcg salmeterol), and you take 2 puffs. The Diskus labels the dose per blister. The strengths are designed to be comparable, but don't swap one for the other without a new prescription. Note: GSK will stop distributing the smaller 60-dose Advair HFA canisters around December 31, 2026. The 120-dose canisters remain.

30–60 min

First bronchodilator effect after the first dose, in the FDA trials

~3 hours

Peak effect on breathing capacity. It lasts about 12 hours.

1 week+

Asthma control builds. Morning lung function kept improving over the 12-week trials.

2 weeks

Reassessment point. If you're not controlled on your starting strength, the label suggests a higher strength may help.

Generic Advair: Wixela and fluticasone/salmeterol

"Advair generic" and "Wixela" are among the most-searched questions about this drug. Wixela Inhub (Viatris, launched in 2019 as the first generic Advair Diskus) and unbranded fluticasone propionate/salmeterol inhalers contain the same medicines in the same 100/50, 250/50 and 500/50 strengths. What pharmacies pay per 60-dose inhaler:

Pharmacy cost per 60-dose inhaler, 250/50 strengthCMS NADAC per dose × 60 doses

BrandGeneric

Advair Diskus 250/50

$187.37

Generic fluticasone/salmeterol 250/50

$74.71

Wixela Inhub 250/50

$74.71

Source: CMS NADAC, data.medicaid.gov, September 2026 survey. NADAC is the pharmacy's cost, not your price.

Different device, same routine. Wixela's Inhub looks and opens differently from the purple Diskus. You still take 1 inhalation twice daily. Ask us for a quick demo the first time you switch.
Brand can still be cheaper for you. With commercial insurance, GSK's $35 monthly cap on Advair can beat a generic copay. We check both.
Other ICS/LABA generics include budesonide/formoterol (generic Symbicort, also sold as Breyna) and fluticasone/salmeterol versions of AirDuo RespiClick. They're different products, so a new prescription is needed to switch.

How to use the Advair Diskus

A dry-powder inhaler works differently from a spray: you have to power the dose with a fast, deep breath.

OpenHold the Diskus flat. Push the thumb grip away from you until the mouthpiece appears and it clicks.
LoadSlide the lever away from you until it clicks. That loads one dose. Don't tilt or shake it afterward, and don't slide the lever again, or you'll waste a dose.
Breathe out away from itBreathe out fully, but never into the mouthpiece. Moisture ruins the powder.
Breathe in fast and deepSeal your lips on the mouthpiece and take one quick, steady, deep breath. Hold for about 10 seconds, or as long as is comfortable.
Close, rinse, spitSlide the thumb grip back to close it. Rinse your mouth with water and spit it out, don't swallow. This is your best defense against thrush and hoarseness.

Doses60 per DiskusOne month at 1 inhalation twice daily

CounterRed at 5The numbers turn red when 5 doses are left. Get your refill then.

NeverWash itKeep the Diskus dry. No spacer is needed or possible.

Missed doseSkip itTake the next dose at the usual time. Don't double up.

Advair side effects

Advair 250/50 side effects vs. placebo in asthmaPercent of patients 12 and older, two 12-week U.S. placebo-controlled trials

Advair Diskus 250/50Placebo

Upper respiratory infection

21%14%

Headache

13%7%

Sore throat (pharyngitis)

10%6%

Bronchitis

8%2%

Cough

6%2%

Nausea / vomiting

6%1%

Oral thrush

4%0%

Source: ADVAIR DISKUS FDA prescribing information, Table 2. Bars are scaled to 25%. In COPD trials of 250/50, mouth or throat thrush reached 10% (vs. 1% on placebo), and hoarseness 5%.

Important warnings from the FDA label

Pneumonia in COPD: the risk is higher, so report fever, chills, increased mucus or a change in its color. Not for acute attacks, and don't add another LABA. Steroid effects with long-term or high-dose use: lower bone density, cataracts and glaucoma, slower growth in children, and adrenal suppression, especially when switching from steroid pills. Infections: use caution with TB, fungal or herpes eye infections, and avoid chickenpox or measles exposure if you're not immune. Paradoxical bronchospasm: if breathing worsens right after a dose, stop and get help.

The LABA warning: what the safety trials showed

Salmeterol used alone for asthma was linked to more asthma-related deaths in a large trial (SMART) in the early 2000s. That's why Advair once carried a boxed warning, and why a LABA should never be used without an inhaled steroid for asthma. The FDA then required four large trials of steroid + LABA combinations:

Patients studied35,089 adults and teensICS/LABA vs. ICS alone, 26 weeks each, plus 6,208 children

Serious asthma events116 vs. 105ICS/LABA vs. ICS alone. Hazard ratio 1.10, not statistically significant.

ResultBoxed warning removedFDA, December 2017, for ICS/LABA combination inhalers

Bottom line: in a combination inhaler like Advair, salmeterol does not significantly raise the risk of serious asthma events compared with a steroid alone, and it improves control. The rule that remains: never use salmeterol or any LABA by itself for asthma.

Advair vs. Symbicort, Breo and other inhalers

Fluticasone + salmeterol

Advair

Device: Diskus dry powder (1 inhalation) or HFA spray (2 puffs)
Dosing: Twice daily
Onset: 30–60 minutes
As a reliever?: No. Keep albuterol for attacks.
Ages (asthma): 4+ (Diskus), 12+ (HFA)

Budesonide + formoterol

Symbicort (generic: Breyna, budesonide/formoterol)

Device: HFA spray (2 puffs). Works with a spacer.
Dosing: Twice daily
Onset: Within about 15 minutes
As a reliever?: Yes, in guideline "SMART/MART" regimens your prescriber sets up
Ages (asthma): 6+

The real difference is formoterol's speed (see our full Symbicort guide). Because it works within minutes, US (NAEPP 2020) and international (GINA) guidelines recommend budesonide/formoterol as both the daily controller and the as-needed reliever for many people with moderate-to-severe asthma. That single-inhaler approach reduces severe flare-ups, and it isn't possible with Advair. For COPD, both are established options. The choice often comes down to insurance formulary, cost and which device you use best.

Inhaler	Ingredients	How often	Notes
Advair / Wixela	Fluticasone propionate + salmeterol	Twice daily	Cheap Diskus generics. Not a reliever.
Symbicort / Breyna	Budesonide + formoterol	Twice daily	Fast onset. Can be used as the reliever too (SMART).
Breo Ellipta	Fluticasone furoate + vilanterol	Once daily	One inhalation a day. Asthma and COPD.
Dulera	Mometasone + formoterol	Twice daily	Asthma, ages 5+
Trelegy Ellipta	Fluticasone furoate + umeclidinium + vilanterol	Once daily	Triple therapy for COPD and asthma not controlled on two drugs
Flovent / fluticasone alone	Fluticasone propionate only	Twice daily	Steroid only, the step before an ICS/LABA. See our Flovent guide.

Drug interactions and who should be careful

Drug or condition	What can happen
Strong CYP3A4 inhibitors: ritonavir and cobicistat-boosted HIV drugs, ketoconazole, itraconazole, clarithromycin	Much higher fluticasone levels, which can cause Cushing's syndrome and adrenal suppression. Not recommended together.
Beta-blockers	Can block salmeterol and trigger bronchospasm
Non-potassium-sparing diuretics	Can add to low potassium and ECG changes
MAO inhibitors, tricyclic antidepressants	Stronger effects on the heart and blood vessels. Use caution, including 2 weeks after stopping them.
Other LABA products (formoterol, arformoterol, salmeterol alone)	Don't combine. Overdose risk.
Severe milk-protein allergy	Advair Diskus and Wixela contain lactose and are contraindicated. The HFA spray has no lactose.

Buy Advair: price, $35 cap and coupons

Commercial insurance: ask about the $35 cap. GSK caps eligible patients' out-of-pocket cost for Advair Diskus and Advair HFA at $35 a month. It doesn't apply to Medicare, Medicaid or other government insurance.
Cash or high deductible: go generic. Wixela Inhub or fluticasone/salmeterol Diskus-type generics are the cheapest route, at about 60% below brand at wholesale. See the price table below and ask for a current cash quote.
Medicare Part D: plans usually prefer a generic Diskus. Your 2026 out-of-pocket drug costs are capped at $2,100 a year.
Prescription required. Primary care, pulmonology, allergy and telehealth prescribers can send it to us electronically, or you can transfer an existing prescription. A site selling Advair "without a prescription" isn't a licensed US pharmacy.
Refill on time. Advair works only if you take it every day. When the counter turns red, call us. Ask about next-day delivery in the Hartford area.

Fill, transfer or switch to generic

Call (860) 522-9289. A pharmacist will compare Advair's $35 cap with the generic cash price, show you how the Diskus or Wixela device works, and check your rescue inhaler is up to date.

FDA drug shortage status

No active shortage reported — Shortage records exist for this drug historically, but none are currently marked active.

FDA openFDA — Updated 2026-09-29

Fair price reference

National Average Drug Acquisition Cost (NADAC): $1.245 per dose (FLUTICASONE-SALMETEROL 250-50). This is the average price pharmacies pay wholesalers — not your out-of-pocket cost — published by CMS for pricing transparency.

CMS NADAC — Updated 2026-09-29

Advair (Fluticasone / Salmeterol) Prices in the USA

These are estimated average US retail cash prices — not insurance copays, not coupon prices, and not a quote from Arrow Pharmacy. Actual cost varies significantly by pharmacy, region, quantity, and insurance. Commercially insured? GSK caps out-of-pocket cost for Advair Diskus and Advair HFA at $35 a month for eligible patients (not Medicare, Medicaid or other government insurance), so brand can cost less than generic at the counter. The generic HFA inhaler has not been much cheaper than brand. The big savings are on the Diskus generics. Call us at (860) 522-9289 for a current price.

Dosage	Brand-name avg. price	Generic avg. price
Diskus 100/50 mcg, 60 doses (30 days)	$330–450 (Advair Diskus)	$50–110 (Wixela Inhub or fluticasone/salmeterol)
Diskus 250/50 mcg, 60 doses (30 days)	$400–520 (Advair Diskus)	$55–130 (Wixela Inhub or fluticasone/salmeterol)
Diskus 500/50 mcg, 60 doses (30 days)	$530–700 (Advair Diskus)	$70–160 (Wixela Inhub or fluticasone/salmeterol)
HFA 115/21 mcg, 120 puffs (30 days)	$400–560 (Advair HFA)	Priced close to brand. Ask us.

Average market pricing — Updated 2026-09-29

Frequently asked questions

What is Advair used for?

Advair is a twice-daily controller inhaler for asthma (ages 4 and older) and COPD (chronic bronchitis and emphysema). It combines fluticasone, an inhaled steroid that calms airway inflammation, with salmeterol, a long-acting bronchodilator that keeps airways open for about 12 hours. It prevents symptoms and flare-ups when used every day; it is not a rescue inhaler for sudden attacks.

What is the generic for Advair?

Generic Advair Diskus is fluticasone propionate/salmeterol inhalation powder, sold as Wixela Inhub (Viatris, the first generic, launched 2019) and as unbranded fluticasone/salmeterol from other makers. Same medicines and strengths (100/50, 250/50, 500/50), a different-looking device. At wholesale, generic Diskus-type inhalers cost pharmacies about 60% less than brand. A generic of Advair HFA exists too, but it has been priced close to the brand.

Is Wixela the same as Advair?

Same active ingredients and strengths — fluticasone propionate 100, 250 or 500 mcg with salmeterol 50 mcg per dose — and FDA-approved as a generic equivalent of Advair Diskus. The device (Inhub) looks and opens differently from the Diskus, so ask your pharmacist to show you the new one the first time. You still take 1 inhalation twice daily.

Is Advair a steroid?

It contains one. Fluticasone propionate is an inhaled corticosteroid, which works locally in the airways at doses far lower than steroid pills. Salmeterol, the other ingredient, is not a steroid — it's a long-acting bronchodilator. Rinsing your mouth after each dose reduces the steroid's most common local side effects, thrush and hoarseness.

What do Advair 100/50, 250/50 and 500/50 mean?

The first number is the micrograms of fluticasone (the steroid) per dose; the second is salmeterol, which is always 50 mcg. 100/50 is the lower steroid dose (and the only strength for children 4–11), 250/50 is the middle dose and the only FDA-approved strength for COPD, and 500/50 is the highest asthma dose. The HFA inhaler uses different numbers (45/21, 115/21, 230/21) because it measures what leaves the mouthpiece and is taken as 2 puffs.

Can I use Advair as a rescue inhaler?

No. Salmeterol takes 30 to 60 minutes to start opening the airways, and the label limits Advair to 1 inhalation twice daily — extra doses add salmeterol side effects without faster relief. Keep a fast-acting rescue inhaler such as albuterol with you. This is one of the main practical differences from Symbicort, whose formoterol works within minutes.

Advair vs. Symbicort: which is better?

Both are ICS/LABA controllers and work well for asthma and COPD. Advair (fluticasone/salmeterol) is 1 inhalation twice daily from a dry-powder Diskus, or 2 puffs from an HFA inhaler. Symbicort (budesonide/formoterol) is 2 puffs twice daily from a spray inhaler, and its formoterol starts working within about 15 minutes. That speed is why guidelines allow budesonide/formoterol to be used as both controller and reliever ("SMART" or "MART"), which is not an option with Advair. Cost, insurance formulary and which device you use well usually decide.

Does Advair have a boxed warning?

Not anymore. Advair once carried a boxed warning about asthma-related deaths with long-acting beta-agonists. In 2017 the FDA removed it for ICS/LABA combination inhalers after four large safety trials found no significant increase in serious asthma events compared with an inhaled steroid alone. The warning still applies to salmeterol used alone (without a steroid) for asthma — that's why Advair combines them.

What are the side effects of Advair?

The most common in asthma trials were upper respiratory infections, sore throat, headache, bronchitis, cough, nausea, hoarseness and oral thrush. In COPD trials, thrush affected 10% of people on Advair 250/50 versus 1% on placebo, and the label warns of a higher risk of pneumonia in COPD. Rinsing and spitting after every dose cuts thrush and hoarseness. Long-term, high-dose inhaled steroids can affect bone density, eyes (cataracts, glaucoma) and children's growth, so use the lowest dose that controls symptoms.

How long does it take Advair to work?

In the FDA trials, a meaningful bronchodilator effect usually started within 30 to 60 minutes of the first dose, peaked within about 3 hours, and lasted 12 hours. Full control of asthma builds over the first week and keeps improving for several weeks, which is why prescribers usually wait at least 2 weeks before moving to a higher strength.

Is Advair being discontinued?

Advair Diskus is still marketed. For Advair HFA, GSK has told the FDA it will stop distributing the smaller 60-dose canisters around December 31, 2026; the 120-dose canisters remain available. Generic Diskus versions (Wixela Inhub and others) and a generic HFA are also on the market.

Can I take Advair if I have a milk allergy?

Advair Diskus contains lactose, which may contain milk proteins, and the label contraindicates it in people with a severe milk-protein allergy. Advair HFA does not contain lactose. Tell your prescriber and pharmacist about any milk allergy.

Is Seretide the same as Advair?

Yes. Seretide is the brand name used in the UK, Europe and many other countries (Seretide Accuhaler or Evohaler) for the same fluticasone propionate/salmeterol combination that is sold as Advair Diskus and Advair HFA in the US.

Sources

ADVAIR DISKUS (fluticasone propionate and salmeterol inhalation powder) — FDA-approved prescribing information — U.S. National Library of Medicine (DailyMed) / U.S. FDA
ADVAIR HFA (fluticasone propionate and salmeterol) inhalation aerosol — FDA-approved prescribing information — U.S. National Library of Medicine (DailyMed) / U.S. FDA
Wixela Inhub (fluticasone propionate and salmeterol inhalation powder, USP) — FDA-approved prescribing information — U.S. National Library of Medicine (DailyMed) / U.S. FDA
SYMBICORT (budesonide and formoterol fumarate dihydrate) inhalation aerosol — FDA-approved prescribing information — U.S. National Library of Medicine (DailyMed) / U.S. FDA
FDA Drug Safety Communication: FDA review finds no significant increase in risk of serious asthma outcomes with long-acting beta agonists (LABAs) used in combination with inhaled corticosteroids (ICS) — U.S. Food and Drug Administration (2017)
2020 Focused Updates to the Asthma Management Guidelines (NAEPP Expert Panel Report) — National Heart, Lung, and Blood Institute (NIH)
Global Strategy for Asthma Management and Prevention (GINA Report) — Global Initiative for Asthma
Mylan launches Wixela Inhub, the first generic of Advair Diskus — Mylan N.V. (2019)
GSK announces cap of $35 per month on U.S. patient out-of-pocket costs for its entire portfolio of asthma and COPD inhalers — GSK US
openFDA Drug Shortages — Advair HFA 60-dose presentations "To Be Discontinued" (posted 07/27/2026) — U.S. FDA
NADAC (National Average Drug Acquisition Cost) — ADVAIR DISKUS, WIXELA INHUB, FLUTICASONE-SALMETEROL — CMS