More Options for Inhalers – Fluticasone/Salmeterol

More Options for Inhalers – Fluticasone/Salmeterol

July 18th, 2019 | Clinical Connections

You may recall the AHP Inhaler Initiative from 2018 that focused on prescribing fluticasone/salmeterol RespiClick when possible and Symbicort when the former was not covered/unavailable. Since the beginning of this initiative, two other generic maintenance inhalers have been approved, both versions of fluticasone/salmeterol.

• Fluticasone/salmeterol Diskus contains the same medications in the same doses as Advair Diskus in the same device
• Wixela Inhub contains fluticasone/salmeterol in the same doses as Advair Diskus, but in a different device
• Fluticasone/salmeterol RespiClick remains available and contains the same medications as Advair, but in different doses and a different device

Prescriptions sent to the pharmacy as “fluticasone/salmeterol” 100/50, 250/50, or 500/50 DAW0 can be filled for Advair Diskus, Wixela Inhub, or fluticasone/salmeterol Diskus based on whichever is covered/cheapest for the patient. It may also be helpful to write “please dispense least expensive formulation” in the notes to the pharmacist if your EMR allows.

There are also generic albuterol rescue inhalers now available. Similar to above, writing prescriptions as generically as possible will increase the chance that the patient obtains the least expensive product. Prescriptions sent as “albuterol HFA” can be filled for whichever albuterol rescue inhaler is covered/cheapest for the patient. Again, it is helpful to write “please dispense least expensive formulation” in the note to the pharmacist.

Please see our most recent Pharmacy Pearls for more information on the available ICS/LABA inhalers.
As always, we welcome your feedback and are available to answer any questions you may have.

Erica Dobson, Pharm.D., BCPS
Jenny Radcliffe, Pharm.D., BCACP