Last year Advair's 21 million prescriptions dwarfed the 1.7 million for Serevent, according to IMS Health.
She believes Advair and Serevent cause four of every five asthma-related deaths each year.
Advair's one-two punch seemed ideal: Serevent to expand constricted airways, Flovent to ease inflammation.
The six-month study, when extrapolated, suggested one extra death for every 700 patients on Serevent for one year.
But Serevent had been under suspicion from the start, and earlier beta agonists had stirred doubts for decades.
Those who are still suffering may need to add an LABA, such as Serevent or Foradil, which are longer-lasting bronchodilators.
Marcus Faulk of Louisville, Ala. also had a bad reaction to Advair or to Serevent, one of the two drugs it comprises.
Serevent was introduced in 1994, touted as longer lasting than older beta agonists like albuterol (12 hours versus 4 to 6 hours).
It debuted in 2001 and soon after had largely replaced Serevent-only prescriptions.
The rampant prescribing of Advair grew a bit more alarming in 2003 when results were released from Glaxo's big safety trial of Serevent.
The FDA has strengthened label warnings for Serevent and Advair three times amid wrangling with the company over how to interpret trial data.
He started out on Serevent and "said that every time he took the medicine it made him feel worse, " says his aunt, Annette Glanton.
But in response to the worries, Glaxo set up an even bigger study in 1996, ultimately aiming to track a massive 60, 000 patients on Serevent.
Just 20 years old, he was dead by the time the ambulance pulled up to the hospital, his Serevent inhaler still clutched in one hand.
It may be that the presence of the second drug in Advair, the steroid Flovent, quells any threat posed by Serevent (the beta agonist) in many patients.
Now growing evidence suggests that a small percentage of patients--perhaps 4, 000 people a year, by one doctor's estimate--may be dying because of Advair or its Serevent component.
People died clutching their inhalers long before Serevent came along.
In that trial Glaxo found a total of 13 people on Serevent had died of asthma, while only 3 people had died in the placebo inhaler group (everyone was allowed albuterol).
Last July an FDA advisory panel, which included Martinez of Arizona, voted unanimously in favor of keeping both Advair and Serevent on the market, although the FDA now says Serevent should never be used on its own.
In 1993, a year before Serevent made its debut, a Glaxo study found 12 asthma deaths among almost 17, 000 patients on Serevent for four months, three times the death rate in an equivalent control group of asthma patients.
She pored over the results of 19 previous trials of Serevent-style drugs and found that patients have twice the rate of asthma hospitalizations, twice the rate of life-threatening asthma and four times as many deaths as patients who aren't on those drugs.
Glaxo added warnings on proper use (it doesn't work instantly, so don't take it to quell a new attack) but denied any problem: "No patient is known to have died as a direct result of taking Serevent, " it said at the time.
The purple puck delivers a blast of two Glaxo medicines that won approval years before: Serevent, a "beta agonist" that was cleared in England in 1990 and in the U.S. in 1994, and Flovent, an inhaled steroid that won U.S. approval in 1996.
Pfizer 's (nyse: PFE - news - people ) arthritis pill Bextra, Abbott Laboratories ' (nyse: ABT - news - people ) weight loss pill, Meridia, GlaxoSmithKline 's (nyse: GSK - news - people ) asthma drug, Serevent and Roche 's acne pill, Accutane all made the list.
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