Talk:Fluticasone/salmeterol

metaanalysis study

How in the world can you say that the following is spamming?

Three common asthma inhalers containing the drugs salmeterol or formoterol may be causing four out of five U.S. asthma-related deaths per year and should be taken off the market, researchers from Cornell and Stanford universities have concluded after a search of medical literature.[1]

The link is the reference to a valid study by respected scientists and physicians.

Doing a search on google for salmeterol or formoterol may be causing four out of five U.S. asthma-related deaths I found that there are 11,400 references to the article. I don't think this is a spamming effort..

The effect being suggested is from the salmeterol rather than the fluticasone (which on its own has, like all steroids, been previously shown to reduce death rates). Would info not be better placed on salmeterol, with this and the other combination-product articles then linking there?

Also are you aware if the current comment in salmeterol article re the FDA’s November 2005 warning to much the same effect, was due to forewarning by these researchers (date of meta-analysis can be well before final publication dates) or from a separate source ?

Finally even if the risk is confirmed by other researchers and accepted by the consensus of medical opinion, does this necessarily mean that they will be banned ? I suspect not for this ignores the huge symptom relieve given to very large numbers of patients (so small mortality against very large morbidity effects) - I'm not saying one is right or wrong, but I have seen lives previously ruined by poorly controlled asthma (frequent GP visits or time off work affecting job security, earning potential etc) transformed as LABA were introduced. One might compare to the well recognised situation of strong analgesics being associated with increased falls in the elderly (with risks hip fractures, morbidity & mortality), yet there would be outrage if such analgesics were withdrawn from the thousands of patients incapacitated by unbearable arthritic pain (with I am sure some renewed calls for legalising euthanasia). Stronger warnings and a change in use might minimise the problem (so LABA fine for routine control of symptoms, but if any exacerbation then immediate discontinuation and use of just normal short-acting bronchodilator with high-dose steroid inhaler ? I've no idea if that would have the desired effect, but it is the type of shift in management/usage that I can more realistically see occurring. David Ruben ^Talk 23:48, 19 July 2006 (UTC)

meta analysis

I don't know why I am getting such resistance to posting the article (11,400 references to it on google). I had posted it on salmeterol and other places as well only to be removed. I do have a concern about the safety and efficacy of salmeterol based on the article written (as well as other references). These were written by other physicians/researchers not connected financially to the manufacturer. One can not keep this information back in the bottle despite the forces that wish to ("the fourth bestselling drug in the world with $5.6 billion in annual sales"). The general public has a right to know if 4 out of 5 people are dying from this drug -- salmeterol or maybe any long-acting beta-agonists ... ("These agents can improve symptoms through bronchodilation at the same time as increasing underlying inflammation and bronchial hyper-responsiveness, thus worsening asthma control without any warning of increased symptoms," said Shelley Salpeter.").

I'm sure further research will probably confirm this if given a chance and an open airing of the information at hand.

Looking at the Salmeterol article, I appreciate you adding in the references to the study David.

--Ian.desouza 02:35, 24 July 2006 (UTC)

Information, if needed

I've got the box and information leaflet from an Advair 100 diskus, if anyone who watches this page thinks that the information may be useful. I could scan/photograph either if it doesn't infringe on any copyrights, but only if it is requested. BigNate37_T·C 06:56, 29 July 2006 (UTC)

Where can this be purchased?

Could someone please add a list of countries where the drug is marketed and/or readily available, and perhaps which countries use which trade names?—Preceding unsigned comment added by 131.107.0.73 (talk • contribs) 21:21, 25 May 2007

I'll start with UK.David Ruben ^Talk 22:22, 17 June 2007 (UTC)

Expiration of patent

Can we put when GSK's patent will expire? Opticalnoise 22:10, 17 June 2007 (UTC)

Can't have a patent surely on a drug combination, but only on the consituent drugs ? David Ruben ^Talk 22:23, 17 June 2007 (UTC)

Drug box

Maybe my ignorance will defeat me here but on the drug box there is a section which asks for CAS number, ATC code, and PubChem. Clearly finding them for each of the individual drugs is not difficult but because this is a combination product therin lies the difficulty. Maybe one could do away with these althogether because they would fit better on each of the individual drugs own pages. Otherwise maybe it would benefit from some sort of redesign. - Medos (talk • contribs) 12:47, 17 February 2008 (UTC)

Questionable statistic

In a clinical trial, thirteen people died out of a group of 13,176 people taking salmeterol.

Not directly referenced, and possibly misleading - i.e. is that statistically significant vs. the control group? I suggest that unless this is revised it be removed. --WhirlwindChemist (talk) 15:52, 28 December 2008 (UTC)

General combined steroid / beta agonist inhalers

It would be useful to have some general info on the combined info on generic beta-ag/steroid inhaler combos. Linking to other formulations and also, ideally, a page on combinations would I think be useful general info (I was unable to see such a page). -Xris0 (not signed in) — Preceding unsigned comment added by 170.53.84.206 (talk) 18:54, 19 November 2012 (UTC)

Statement doesn't correlate to reference (8)

The statement in the article : In order to reduce the side effects of the salmeterol/fluticasone combination, Mometasone furoate nasal sprays are now prescribed.[8] Does not relate to the reference article (8). The reference article is actually a comparison of a similar product NOT a nasal spray used to reduce side effects. — Preceding unsigned comment added by 99.140.164.97 (talk) 12:10, 4 January 2014 (UTC)

Study removed

It seems reasonable to remove this old study:

No increase in bone loss or osteoporosis was noted in one study of 658 patients on high dose Advair (500 μg fluticasone/50 μg salmeterol twice daily), although the 57% dropout rate over three years may have biased the reported outcome.[6][7] Gandydancer (talk) 03:59, 11 February 2016 (UTC)

Formulations etc

The following is all unsourced:

from the lead

It is marketed by GlaxoSmithKline under various trade names including Advair (in the US and Canada), Seretide (Brazil, India, Australia, Colombia, EU, Russia, México, New Zealand, South Africa, South Korea, Turkey, UK, Estonia), Viani (Germany), Adoair (Japan) and Foxair (South Africa). In India it is marketed by Cipla under the trade name Seroflo. Annual worldwide sales were approximately US$7 billion in 2009. (details may differ depending on what spammer has been by the article recently, eg. this kind of garbage)

Formulations

The Diskus device

Inner Workings of Diskus

The Evohaler device, which uses compressed gas to deliver the medicine

Advair is available in several dosage strengths, depending on the patient's country, as a DPI (dry-powder inhaler). The smallest dosage is 100 μg fluticasone/50 μg salmeterol, the intermediate dosage is 250/50 μg and the highest dosage is 500/50 μg.

Advair HFA aerosol as a MDI (metered-dose inhaler) is available in Canada and the U.S. and now in Australia and New Zealand as Advair HFA 45/21 μg, Advair HFA 115/21 μg, and Advair HFA 230/21 μg. These contain 60 inhalations and are generally prescribed as a 30-day supply (1 inhalation twice a day).

Internationally the fluticasone/salmeterol combination is delivered by a number of devices, including standard aerosol metered dose inhalers (named Evohaler in Mexico and UK) or dry-powder devices (termed Accuhaler in Australia and the UK, Diskus in France and the U.S. and Multidisk in Russia). These purple disk-shaped containers are about 3.5 inches (8.9 cm) across and about 1 inch thick (2.5 cm). The disc container uses a machined 2 piece long foil ribbon with each unit dose held in small caplet-shaped depressions along the entire dose-count-length. Once the lever is actuated the dose is advanced by peeling away the flat outermost layer exposing the medication that is ready to be inhaled.

Generic equivalents

Seroflo, manufactured by Cipla, is a generic form of Advair available outside of the US.

-- Jytdog (talk) 07:11, 30 November 2016 (UTC)

pricing

This too was unsourced

The price of an Advair Discus in the USA has risen from $200 in 2010 to $419 in January 2015 to $915.19 in May 2016.(Anthem BlueCross via ExpressScripts mailorder pharmacy)

-- Jytdog (talk) 07:30, 30 November 2016 (UTC)