Advair Interactions: Alcohol, Medications, and Others

Advair (fluticasone propionate/salmeterol) is a prescription drug that’s used to treat asthma and chronic obstructive pulmonary disease (COPD). This drug can interact with other medications and some foods. For example, Advair can interact with certain HIV medications and certain antifungals.

Advair comes in two forms: Advair Diskus and Advair HFA. These forms have different uses.

Advair Diskus is used to:

treat asthma in adults and in children ages 4 years and older

treat COPD in adults

The two forms of Advair have the same interactions. An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.

Keep reading to learn about Advair’s possible interactions. And for more information about Advair, including details about its uses, see this in-depth article.

Certain health conditions or other factors could raise your risk of harm if you use Advair. In such cases, your doctor may not prescribe Advair for you. These are known as contraindications. The list below includes Advair contraindications.

If you have an asthma attack. You should not take Advair to treat an asthma attack. It won’t work quickly enough to help your breathing.

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Instead, an asthma attack should be treated with a fast-acting rescue medication such as albuterol (Proair HFA, Ventolin HFA, others). Your doctor will likely prescribe a rescue medication to keep with you at all times. Advair is not a rescue medication. Instead, it’s an inhaler that you take on a regular basis to help manage your asthma or COPD.

If you’ve had an allergic reaction. If you’ve had an allergic reaction to Advair or any of its ingredients, your doctor likely won’t prescribe Advair. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

If you’ve had an allergic reaction to milk proteins. If you’ve had a severe allergic reaction to milk proteins, your doctor likely won’t prescribe Advair Diskus. This form of Advair contains lactose, which may contain milk proteins. It could cause an allergic reaction if you’ve had a severe allergic reaction to milk proteins. Advair HFA doesn’t contain lactose.

Before using Advair, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Advair is safe for you to use.

Advair isn’t known to interact with alcohol. But both Advair and alcohol can cause headache, nausea, and dizziness. You may be more likely to have these side effects or have worsened side effects if you drink alcohol with Advair.

Note that long-term heavy alcohol use can raise the risk of developing lung infections such as pneumonia. Lung infections can worsen symptoms of asthma and COPD. Advair may also raise the risk of pneumonia in people with COPD.

If you drink alcohol, talk with your doctor about how this may affect your lung condition. Also, ask how much (if any) alcohol is safe to drink during your Advair treatment.

Before you start using Advair, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Advair interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Advair?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Advair. Keep in mind that this table does not include all drugs that may interact with Advair. For more information about some of these interactions, see the “Drug interactions explained” section below.

Drug group or drug name	Drug examples	What can happen
long-acting beta agonists (LABAs)	• arformoterol (Brovana) • formoterol (Perforomist) • salmeterol (Serevent)	can increase the risk of side effects from Advair and LABAs
certain HIV drugs	• atazanavir (Reyataz) • cobicistat (Tybost) • nelfinavir (Viracept) • ritonavir (Norvir)	can raise the risk of side effects from Advair
clarithromycin	—	can increase the risk of side effects of Advair
certain antifungals	• itraconazole (Sporanox, Tolsura) • ketoconazole • posaconazole (Noxafil)	can raise the risk of side effects from Advair
beta-blockers	• propranolol (Inderal LA, Innopran XL) • nadolol (Corgard) • sotalol (Betapace, Sorine, others)	can make Advair less effective
monoamine oxidase inhibitor (MAOI) antidepressants	• isocarboxazid (Marplan) • phenelzine (Nardil) • tranylcypromine (Parnate)	can raise the risk of certain side effects from Advair
tricyclic antidepressants	• amitriptyline • clomipramine (Anafranil) • nortriptyline (Pamelor)	can increase the risk of certain side effects of Advair
certain diuretics (water pills)	• hydrochlorothiazide (Microzide) • furosemide (Lasix) • torsemide (Soaanz)	can raise the risk of certain side effects from Advair and the diuretic
nefazodone	–	can increase the risk of side effects from Advair

Learn more about certain drug interactions that can occur with Advair.

Long-acting beta agonists (LABAs)

LABAs are used to treat asthma or chronic obstructive pulmonary disease (COPD). These drugs help keep your airways open to make breathing easier. One of the active drugs in Advair is a LABA called salmeterol.

Examples of other LABAs include:

arformoterol (Brovana)
formoterol (Perforomist)
formoterol/budesonide (Symbicort)
formoterol/glycopyrrolate (Bevespi Aerosphere)
salmeterol (Serevent)

What could happen

Taking Advair with other LABA medications can raise your risk of serious side effects.

All LABA medications can cause high blood pressure, fast heart rate, and irregular heart rhythm. Taking more than one LABA at a time can raise your risk of these side effects or could make the side effects worse if you experience them. This could cause serious heart problems, which could even be life threatening in some cases.

What you can do

Before starting Advair treatment, tell your doctor about all the medications you take for asthma or COPD. Your doctor likely won’t prescribe Advair with other medications that contain a LABA. Your doctor can discuss other treatment options that may be safer for you.

Certain antifungals

Antifungals are medications used to treat fungal infections. Your doctor may prescribe an antifungal if you develop a fungal infection while using Advair. For example, Advair can sometimes cause oral thrush, which is a fungal infection in your mouth or throat.

What could happen

Certain antifungals can make it harder for your body to clear Advair. Taking one of these antifungals with Advair can cause Advair to build up in your body. This could raise your risk of Advair side effects from the drug. Examples of these side effects include tremor, fast heart rate, irregular heart rhythm, and problems with your adrenal glands.

Examples of antifungal medications include:

itraconazole (Sporanox, Tolsura)
ketoconazole
posaconazole (Noxafil)
voriconazole (Vfend)

What you can do

If you get a fungal infection while using Advair, talk with your doctor or pharmacist about how to treat it. Be sure to tell them that you’re using Advair. Your doctor likely won’t prescribe certain antifungals with Advair. Instead, they can recommend an antifungal that doesn’t interact with Advair.

Certain diuretics

Diuretics (water pills) help remove fluid from your body. Some are used to treat swelling caused by fluid retention. Others may be used to treat high blood pressure or heart failure.

Examples of diuretics include:

hydrochlorothiazide (Microzide)
furosemide (Lasix)
torsemide (Soaanz)

What could happen

Taking certain diuretics with Advair may raise your risk of hypokalemia (low potassium levels. This is because both Advair and certain diuretics can cause hypokalemia.

Having hypokalemia can raise your risk for irregular heart rhythm.

What you can do

Before starting Advair treatment, tell your doctor about any other medications you take. If your doctor prescribes Advair with a diuretic medication, your doctor may want to check your potassium levels regularly during your treatment.

If you have symptoms of hypokalemia while taking Advair with a diuretic, talk with your doctor. Examples of these symptoms include:

fatigue (low energy)
muscle weakness or muscle cramps
constipation
irregular heart rhythm

If you have hypokalemia, your doctor may adjust your dosage of the diuretic. They may also prescribe a potassium supplement to raise your potassium level.

Advair may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Advair.

Does Advair interact with supplements?

There are currently no reports of Advair Diskus or Advair HFA interacting with supplements. But this doesn’t mean that interactions with supplements won’t be recognized in the future.

Before you start using Advair, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Advair and herbs

There are currently no reports of Advair Diskus or Advair HFA interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using Advair.

Advair and vitamins

There are currently no reports of Advair Diskus or Advair HFA interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using Advair.

Does Advair interact with food?

Advair may interact with certain foods. For example, it may interact with:

caffeine
grapefruit and grapefruit juice

Caffeine and Advair can both increase your heart rate and cause heart palpitations. Combining Advair and caffeine can make these side effects worse. Ask your doctor if you should avoid or limit your caffeine intake while using Advair. Caffeine is found in food and drinks such as coffee, tea, cola, energy drinks, and chocolate.

Grapefruit can make it harder for your body to clear Advair. So consuming grapefruit or grapefruit juice could make Advair build up in your body, which could raise your risk of side effects. Your doctor will likely recommend that you don’t eat grapefruit or drink grapefruit juice while using Advair.

Does Advair interact with vaccines?

Advair isn’t known to interact with vaccines. But this doesn’t mean that vaccine interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before getting any vaccines while using Advair.

Does Advair interact with lab tests?

Advair isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests won’t be recognized in the future.

For this reason, if you need any lab tests it’s still important to tell the healthcare professional ordering the test that you’re using Advair.

Does Advair interact with cannabis or CBD?

There are currently no reports of Advair Diskus or Advair HFA interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Advair.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions or other health factors may raise the risk of interactions with Advair. Before using Advair, talk with your doctor about your health history. They’ll determine whether Advair is right for you.

Health conditions or other factors that might interact with Advair include:

Asthma attack or sudden trouble breathing. Advair is not a rescue medication.You shouldn’t use it to treat an asthma attack or sudden breathing difficulties. To learn more, see “When should I avoid Advair?” above.

Rapidly worsening asthma or COPD. Your doctor likely won’t have you continue Advair treatment if you have rapidly worsening asthma or chronic obstructive pulmonary disease (COPD). If your condition gets worse while you’re using Advair, talk with your doctor. They may need to adjust your asthma or COPD treatment.

Allergic reaction. If you’ve had an allergic reaction to Advair or any of its ingredients, your doctor will likely not prescribe Advair. To learn more, see “When should I avoid Advair?” above.

Allergy to milk proteins. If you’ve had a severe allergic reaction to milk proteins, your doctor will likely not prescribe Advair Diskus. To learn more, see “When should I avoid Advair?” above.

Heart problems or high blood pressure. If you have a heart problem or high blood pressure, using Advair could worsen your condition. Talk with your doctor about whether Advair is safe for you.

High thyroid hormone levels. If you have high thyroid hormone levels, Advair could worsen your symptoms. Talk with your doctor about whether Advair is right for you.

Adrenal gland problems. If you have an adrenal gland problem, Advair could worsen your symptoms. Ask your doctor whether Advair is right for you.

Diabetes. Advair can sometimes increase blood sugar levels. If you have diabetes, Advair could make your blood sugar harder to manage. Your doctor may want to check your blood sugar levels more often while you’re using Advair.

Infections. Using Advair could make it harder for your immune system to fight infections. Before starting Advair treatment, tell your doctor about any infections you have. Your doctor may want to treat the infection before you start using Advair. Also, talk with your doctor about whether you need any vaccines before starting Advair treatment to help prevent infections.

Liver problems. Your liver helps remove Advair from your body. If you have liver problems, Advair could build up in your body. This could raise your risk of Advair side effects. If you have a liver problem, talk with your doctor about whether Advair is right for you.

Seizures. If you have a condition that causes seizures, such as epilepsy, Advair may raise your risk of having a seizure. Talk with your doctor about whether Advair is safe for you.

Osteoporosis. Long-term use of Advair could weaken your bones. If you have osteoporosis or risk factors for osteoporosis, your doctor may monitor your bone health while you’re using Advair. If needed, they may prescribe medication or supplements to help protect your bones.

Glaucoma or cataracts. Advair could worsen glaucoma and cataracts. If you have one of these eye conditions, talk with your doctor about whether Advair is right for you. Your doctor may recommend getting regular eye exams while using Advair.

Low potassium levels. If you have low potassium levels, using Advair could worsen your condition. Your doctor may monitor your potassium levels while you’re using Advair. If needed, they may prescribe potassium supplements to raise your potassium levels.

Pregnancy. It’s not known whether Advair is for use during pregnancy. But if asthma or COPD isn’t well managed during pregnancy, it can have serious risks for the pregnant person and the fetus. If you’re pregnant or planning to become pregnant, talk with your doctor about whether Advair is right for you.

Breastfeeding. It’s not known if Advair is safe to use while breastfeeding. If you’re breastfeeding or planning to breastfeed, talk with your doctor about whether Advair is right for you.

Find answers to some frequently asked questions about Advair and possible interactions.

How long after Advair can I take albuterol?

Albuterol (Proair HFA, Ventolin HFA, others) is a rescue medication used to treat and help prevent asthma attacks. It acts quickly to open your airways and make breathing easier. Levalbuterol (Xopenex, Xopenex HFA) is another rescue medication prescribed for this use.

You can use rescue medications such as albuterol at any time during your Advair treatment. If needed, you can use your rescue medication right after taking a dose of Advair.

If you need to use your rescue medication more often than usual or if it seems less effective than usual, talk with your doctor. These could be signs that your asthma or COPD is getting worse. In some cases, your doctor may need to adjust your asthma or COPD treatment.

How do the interactions of Advair compare with those of Symbicort?

Advair and Symbicort are both used to treat asthma and chronic obstructive pulmonary disease (COPD) These drugs have many of the same interactions. For example, both Advair and Symbicort can interact with:

beta-blockers, such as propranolol (Inderal LA, Innopran XL)
monoamine oxidase inhibitor (MAOI) antidepressants, such as phenelzine (Nardil)
tricyclic antidepressants, such as nortriptyline (Pamelor)
certain diuretics (water pills), such as hydrochlorothiazide (Microzide)
nefazodone

Both drugs can also interact with caffeine and grapefruit or grapefruit juice. But Advair and Symbicort have some different interactions as well.

To learn more about how Advair and Symbicort compare, see this article. You can also talk with your doctor about whether one of these drugs is right for you.

Taking certain steps can help you avoid interactions with Advair. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

Whether you drink alcohol or use cannabis.
Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list .
What to do if you start taking a new drug during your Advair treatment.

It’s also important to understand Advair’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Advair, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Using Advair exactly as prescribed can also help prevent interactions.

If you still have questions about Advair and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

If I take Advair and have certain health conditions, will I be monitored more closely during treatment?
Does my risk of interactions depend on my dosage of Advair?
Can I take allergy medications such as steroid nasal sprays with Advair?

To learn more about Advair, see these articles:

Advair (fluticasone propionate/salmeterol)
Advair and Cost: What You Need to Know
All About Advair’s Dosage
Side Effects of Advair: What You Need to Know

To get information on different conditions and tips for improving your health, subscribe to any of Austra Health’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Austra Health has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Last medically reviewed on March 16, 2023