Can you stop Advair cold turkey? (+3 tips)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will explore whether you can stop Advair cold turkey or not, what happens if you stop taking Advair cold turkey, how to safely discontinue Advair and how to manage the withdrawal effects of Advair.
Can you stop Advair cold turkey?
No, stopping Advair (Fluticasone propionate+salmeterol) cold turkey is not recommended due to serious health consequences. Abrupt withdrawal of Advair can significantly worsen the condition of asthma due to the rebound effect.
Advair contains fluticasone propionate, a corticosteroid and salmeterol, a beta-2 adrenergic agonist. It is usually prescribed for the treatment of asthma or related symptoms as it can help in opening the airways and making it easier to breathe (1).
Advair should not be discontinued abruptly but a proper tapering strategy should be applied under the careful supervision of an experienced healthcare provider. If you have any concerns regarding the use of Advair or want to stop taking it due to any reason then you should consult your healthcare provider for a safe and effective treatment strategy.
What happens if you stop Advair cold turkey?
Sudden discontinuation of Advair can result in severe consequences. The major of all is the rebound effect.
Advair contains fluticasone propionate which is a corticosteroid and has anti-inflammatory action on the airways (2). This anti-inflammatory property helps it to open up the airways for better breathing. If you stop taking Advair, then due to the rebound effect of Advair the airways may get severe inflammation worsening the symptoms of asthma (3).
This can lead to significant difficulty in breathing, wheezing, coughing, tightness in the chest and other asthma symptoms. In severe cases, it can lead towards an asthma attack which may require immediate emergency medical attention.
What are the potential effects of the abrupt withdrawal of Advair?
Stopping Advair abruptly can lead to potential side effects, primarily due to the presence of corticosteroid (fluticasone propionate). These effects can vary in severity. They may include (4):
- Increased airway inflammation
- Worsening shortness of breath
- Wheezing
- Cough
- Increased mucus production
- Fatigue and low energy levels
- Irritability and anxiety
- Asthma attacks
- Muscle pain
- Nausea
- Lethargy
- Headache
- Low blood pressure
- Pneumonia
In some cases, individuals with diabetes might experience a temporary rise in blood sugar levels called rebound hyperglycemia due to the abrupt discontinuation of Advair (5).
The severity of the effects of Advair withdrawal depends upon the condition of the patient and the severity of the symptoms of asthma or related disorders.
How to safely discontinue Advair?
In order to discontinue Advair or any other medication, it is essential to consult your healthcare provider. It should be done under careful guidance to ensure a safe transition. Your doctor will help you tailor the treatment plan according to your needs.
Gradual tapering
Dose tapering is the cornerstone of safe Advair withdrawal. Your doctor will design a gradual tapering schedule, gradually reducing your dosage over weeks or months to minimize the risk of rebound inflammation or worsening of the symptoms. This gradual reduction in the dose helps your body to gradually adjust to the reduced amount of Advair in it (6).
Throughout this tapering process, you need to closely monitor any symptoms that may appear. Keep track of any changes and report if you experience any worsening of symptoms.
Your doctor might prescribe a rescue medication or an inhaler such as albuterol or a combination of pulmicort and albuterol to manage any worsening of symptoms during this tapering period.
How to manage the withdrawal effects of Advair?
Here is how to manage withdrawal effects of Advair if stopped abruptly.
- If you experience any of the withdrawal effects of Advair then seek medical assistance immediately.
- Your healthcare provider might prescribe you a rescue medication such as a short-acting bronchodilator (albuterol) to manage the sudden worsening of symptoms.
- In some cases, if the withdrawal effects are severe, your healthcare provider might reintroduce Advair in lower doses to manage the conditions.
- During an exacerbation or withdrawal effects, it is essential to stay calm and relaxed. Avoid activities that might strain your respiratory system.
In my opinion, the sudden withdrawal of Advair can lead to exacerbation of symptoms which may be life-threatening or dangerous. Therefore, it is crucial to never stop taking Adavir without consulting your healthcare provider. Stopping Advair cold turkey is never recommended.
If you are taking Advair for asthma or related disorders, then open communication with your doctor is essential. They can guide you about the proper use and any side effects that you might experience.
Was this helpful?
References
1.-
Nelson HS. Advair: combination treatment with fluticasone propionate/salmeterol in the treatment of asthma. J Allergy Clin Immunol. 2001 Feb;107(2):398-416. doi: 10.1067/mai.2001.112939. PMID: 11174215.
2.-
Remien, K. (2022, November 14). Fluticasone. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK542161/#:~:text=Fluticasone%20is%20a%20corticosteroid%20given,(COPD)%20and%20eosinophilic%20esophagitis.
3.-
Imai R, Ro S, Tomishima Y, Nishimura N. Steroid resistance and rebound phenomena in patients with COVID-19. Respir Invetsig. 2021;59:608–13. [PMC free article] [PubMed] [Google Scholar] [Ref list]
4.-
The Steroid Withdrawal Syndrome: A Review of the Implications, Etiology, and Treatments. (2007, February). Retrieved December 24, 2023, from https://doi.org/10.1016/j.jpainsymman.2006.08.013
5.-
Aberer, F., Hochfellner, D. A., Sourij, H., & Mader, J. K. (2021). A Practical Guide for the Management of Steroid Induced Hyperglycaemia in the Hospital. Journal of clinical medicine, 10(10), 2154. https://doi.org/10.3390/jcm10102154
6.-
Crossingham, I., Evans, D. J., Halcovitch, N. R., & Marsden, P. A. (2017). Stepping down the dose of inhaled corticosteroids for adults with asthma. The Cochrane database of systematic reviews, 2(2), CD011802. https://doi.org/10.1002/14651858.CD011802.pub2
