ADVAIR® HFA

USA Advair HFA:
– Comes in strengths of 45/21 mcg, 115/21 mcg, or 230/21 mcg.
– The first number represents the micrograms of the active ingredient fluticasone propionate (an inhaled corticosteroid) per actuation.
– The second number represents the micrograms of the active ingredient salmeterol (a long-acting beta2-agonist) per actuation.

Canada Advair HFA:
– Comes in strengths of 125 mcg/25 mcg or 250 mcg/25 mcg.
– The first number represents the micrograms of fluticasone propionate per actuation.
– The second number represents the micrograms of salmeterol per actuation.

So in summary:
– The salmeterol component is labeled as 21 mcg in the USA and 25 mcg in Canada.
– The fluticasone propionate component is labeled in different strengths between the two countries.
– The ratio of the two drugs is the same, but the labeled mcg amounts differ.

The rationale is that the FDA approved a different labeling convention for Advair HFA in the USA compared to Health Canada’s approved labeling for the Canadian market, even though it is the same product.