a man having an asthma attack using an inhaler, hoarseness from Advair

Have you become so hoarse you could barely talk? Most people have experienced laryngitis as part of a respiratory tract infection like a cold or bronchitis. But some people report that certain inhaled medications affect their voice. In particular, we have heard from a number of readers who experience hoarseness from Advair.

Can You Avoid Hoarseness from Advair?

Q. I read that some people become hoarse when taking Advair. I had this problem too. My doctor switched me over to Singulair, an oral medication, to control my asthma. My hoarseness went away, and my asthma is now under control. Perhaps this will help someone else.

Singulair as an Alternative:

A. Montelukast (Singulair) is used to treat asthma and allergies. It works differently from corticosteroids such as fluticasone (found in Advair and Flonase).
Singulair blocks inflammatory compounds called leukotrienes. Because it is not inhaled, it is much less likely to cause hoarseness. While Singulair may not be appropriate for every person with asthma, we encourage readers faced with hoarseness from Advair to discuss this possible treatment with their physicians.

Do You Have Infection-Induced Asthma?

You may want to consider another possibility. Most people don’t realize that sometimes an infection lies at the root of hard-to-treat asthma symptoms. To treat such infection-mediated asthma, doctors prescribe an antimicrobial compound that will eliminate the infection (Webley & Hahn, Respiratory Research, May 19, 2017).

Unfortunately, this is more easily said than done. The Chlamydia pneumoniae bacteria that can trigger asthma symptoms often hide deep inside lung cells. To eradicate them, people must take antibiotics such as azithromycin (Zithromax) for an extended period of time. You can learn more about the protocol for treating such infection-induced asthma from the book, A Cure for Asthma? by Dr. David Hahn.  (He co-wrote the review article cited above.) People’s Pharmacy Press published this book to make the information broadly available.

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  1. Gerrie
    Allentown, PA

    Consider asking your doctor for a “spacer” to use with inhalers that contain steroids. Some states require a Rx to purchase them. They can be found on line as well as your pharmacy. The use of a spacer may avoid the voice changes and the tendency to get ‘candida’/thrush.

  2. Eleanor
    San Juan Island Washington

    I gargle thoroughly after my puff of Advair and it prevents hoarseness most of the time.

  3. Kathy
    San Diego

    I’ve taken inhaled drugs for asthma. I was always cautioned to rinse my mouth after inhaler use. When hoarseness occurred, the doctor recommended gargling after mouth rinsing. Another suggestion that he gave me was to eat something prior to using the inhaler. I’ve had no hoarseness, since using these two tips. (I take a quarter to half teaspoon of Manuka honey, before using my inhaler.)

  4. Jane

    Not very helpful for those with COPD. Both Advair and Trelegy have steriods in them, hence the hoarseness. All I’ve read is to rinse your mouth/throat well after use but that doesn’t work very well. I’m about to give up. Being hoarse all the time is for the birds. My conclusion is that there is no help for hoarseness with inhaled steroid use.

  5. Jill
    Pacific Grove

    Advair comes in three strengths of steroid, and occasionally a patient may be on a higher dose of steroid that is required to minimize their symptoms of asthma. Secondly, although this is not always a cure for hoarseness, mouth rinse and gargle after using any steroid inhaler is important.

    Singulair is a different drug than Advair with a different route of action. In fact, it is often pescribed along with a long acting bronchodilator.

    Asthmatics should be sure they take adequate omega 3 fatty acids (fish oil) and magnesium supplement (magnesium rich foods also). Exercise daily and drink water (water thins airway mucus).

    • Susan
      St. Paul, MN

      Gargling and rinsing your mouth with warm water 3 – 4 times immediately after each use of the inhaler should help a lot more than just doing it once with cold water. I’ve been told there’s an oil in it that breaks down better with warm water. I have used a steroid inhaler twice a day on a continuous basis for years, so I’ve had a lot of experience with this.

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