How long to wait between doses of Spiriva Handihaler & Advair Diskus & which goes first?

Spiriva and Advair Diskus are both preventative medicines used to treat asthma or COPD (chronic obstructive respiratory disease). Advair is a first line medicine and is often all that is required to keep symptoms under control but if it isn't getting the job done then a second line medicine like Spiriva may be added.

Advair has both a corticosteroid (fluticasone) to treat the underlying inflammation component of asthma, and long-acting bronchodilator (salmeterol) to prevent the bronchospasm (airway narrowing) component of asthma. Salmeterol is a beta-adrenergic medicine that causes bronchodilation (relaxes smooth muscles). It attaches to beta receptors in the lungs, and when this happens the lung muscles relax.

Spiriva is a long acting bronchodilator that works by blocking cholinergic receptors in the lungs that cause bronchoconstriction (airway narrowing) when stimulated. Thus, Spiriva is an anticholinergic medicine. It is not quite as effective a bronchodilator as salmeterol, and therefore is a second-line therapy for asthma. Studies show that Spiriva improves lung function in COPD patients and some difficult to control asthma cases.

It is recommended you use your quickest acting bronchodilator first and your steroid last.
So in your case use Spiriva first then wait 5 minutes, and use the Advair. Always rinse your mouth after using the Advair so as not to get thrush.