Last night I posted a post that spoke to the concern of Dry Powered Inhalers like Advair. The reaction from the parent community was as I expected, thanking me for bringing this up and many sharing their own personal stories of issues. Yet  some doubted what I said in my post. So I am going to post here some of my sources and reports to back up my concern.

This post is out of Canada, but I use it a lot because for the most part the drugs are the same. Note this allergist explores the issue in lactose in pills vs dry powered inhalers. His recommendation is not to use.


My next piece of evidence is two medical journal reports

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187530/ This was in 2014

This one was in 2004 http://www.jacionline.org/article/S0091-6749(03)02677-0/abstract

Allergic living was asked this question as well http://allergicliving.com/2013/11/07/do-asthma-inhalers-contain-milk-protein/

If this isn’t enough to question it, the drug company’s themselves have put a SERVERE cow milk allergy warning out.  From Advair’s own page

  • Do not use ADVAIR DISKUS if you have a severe allergy to milk proteins. Do not use ADVAIR DISKUS or ADVAIR HFA if you are allergic to any of the ingredients in the products. Ask your healthcare provider if you are not sure.



http://www.asmanex.com/asmanex/index.xhtml Do not take ASMANEX TWISTHALER if you have an allergy to milk proteins.

These are just two of the popular dry powered inhalers, others like Spiriva have the same warning.

While reactions maybe rare,enough have been reported to obviously make a cow milk allergy a contraindication. I am not saying people shouldn’t take them, but I do think asthmatics with a severe cow milk allergy should know that this is a real issue and that is well documented. At same time Doctors should know the risk is real. These drugs are available in versions which are safe . I think this issue needs more discussion and awareness. Patients and providers need to discuss the risk and benefits, but don’t ignore the issue .


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