Wixela Inhub is a combination inhaler used to treat two chronic lung conditions: asthma and chronic obstructive pulmonary disease (COPD). It contains two active ingredients, fluticasone propionate (a corticosteroid that reduces inflammation) and salmeterol (a long-acting bronchodilator that relaxes airway muscles), and is taken twice daily as a maintenance treatment. It is the FDA-approved generic equivalent of Advair Diskus.
Conditions Wixela Treats
Wixela is approved for the twice-daily treatment of asthma in patients aged 4 and older. It’s specifically intended for people whose asthma isn’t well controlled on an inhaled corticosteroid alone, or whose symptoms are severe enough to justify starting on two medications at once. For COPD, it’s used in adults with chronic bronchitis who need both an anti-inflammatory and a bronchodilator to manage their breathing.
One important distinction: Wixela is not a rescue inhaler. It won’t relieve sudden breathing difficulty or an asthma attack in progress. You still need a separate fast-acting inhaler for those situations. Wixela works over time to keep your airways open and reduce the chronic inflammation that makes them narrow in the first place.
How It Works
The two ingredients in Wixela tackle airway problems from different angles. The corticosteroid component reduces swelling and inflammation inside the airways, which is the underlying driver of both asthma and COPD symptoms. With less inflammation, the airways are less reactive and less likely to tighten in response to triggers.
The bronchodilator component works by relaxing the smooth muscle wrapped around your airways, physically widening them so air flows more freely. Salmeterol has an unusually long-lasting effect because of its molecular structure. Part of the molecule anchors itself near the receptor on airway cells, allowing the active portion to keep engaging with the receptor repeatedly over about 12 hours. This is why Wixela is dosed twice daily rather than more frequently. Salmeterol also suppresses the release of histamine and other inflammatory chemicals from immune cells in the lungs, adding a secondary anti-inflammatory benefit.
Wixela vs. Advair Diskus
Wixela Inhub is a generic version of Advair Diskus and contains the same active ingredients at the same strengths. A clinical trial of over 1,100 adults with asthma confirmed that the two inhalers are bioequivalent, meaning they deliver the same therapeutic effect in the lungs. Patients using Wixela showed the same improvements in lung function on both the first day and after 28 days of twice-daily use. The main practical difference is the inhaler device itself. Wixela uses the “Inhub” device rather than the Diskus, so the steps for loading and inhaling a dose are slightly different. Both are dry powder inhalers that don’t require coordination with a spray.
How to Use the Inhub Device
Using the Inhub correctly matters for getting the full dose into your lungs. Start by checking the dose counter on the side. If it reads zero, the inhaler is empty and needs to be replaced.
To prepare a dose, hold the inhaler in one hand and pull the mouthpiece cover open from top to bottom with the other. Keep the inhaler upright (don’t tip it sideways) and push the lever down until you hear a click. Sit or stand up straight, then breathe out fully, away from the device. Never exhale into the mouthpiece.
Tilt your head back slightly, place the mouthpiece between your teeth, and close your lips tightly around it. Breathe in quickly and deeply through your mouth. Remove the device, hold your breath for up to 10 seconds, then exhale slowly away from the inhaler. Close the cover by pushing the mouthpiece cover back up. After each use, rinse your mouth with water and spit it out. This rinsing step helps prevent one of the most common side effects: oral thrush.
Common Side Effects
The side effect profiles differ somewhat depending on whether you’re using Wixela for asthma or COPD.
In asthma patients, the most frequently reported issues in clinical trials were upper respiratory tract infections (21% to 27% of users), headaches (12% to 13%), sore throat (10% to 13%), and nausea or vomiting (4% to 6%). Hoarseness affected about 2% to 5% of users, and oral thrush (a yeast infection in the mouth) occurred in 1% to 4%, with higher rates at the stronger dose.
In COPD patients, headaches were the most common complaint at 16%, followed by oral thrush (10%), musculoskeletal pain (9%), and throat irritation (8%). Pneumonia is a notable risk for COPD patients using inhaled corticosteroids and appeared at rates above 3% in trials. Muscle cramps, dizziness, fatigue, and fever each affected 3% to 4% of COPD users.
Who Should Not Use Wixela
Because Wixela is a dry powder inhaler, it uses lactose as a carrier to help deliver the medication. Lactose derived from milk can contain trace amounts of milk proteins. If you have a severe milk protein allergy, Wixela is contraindicated. Reports of anaphylactic reactions have occurred in patients with milk protein allergies who used lactose-containing dry powder inhalers. This is different from lactose intolerance, which is a digestive issue and not a concern with inhaled medications.
Wixela should also not be used as a first-line treatment for asthma before trying an inhaled corticosteroid on its own. It’s designed as a step-up therapy for people who need more control than a single medication provides. Children under age 4 are not approved to use it.