I've been on the 500 Diskus for about 8 years and never went back. Ask your doc, I tried to go back once and I couldn't breathe as well.

While we often talk about medications helping us to breathe better the important goal for all COPD patients is to avoid exacerbations. COPD is chronic and progressive; breathing better makes our current life easier, but avoiding exacerbations slows the progression. If you were experiencing problems with 250 and now you are not with 500 why in the world would you ever consider going back?

Is there more to the story?

I don't know if it's the case with the OP, but I know sometimes I used to have worries about taking "the hard stuff" after I've pulled through an exacerbation in fear that I'd sort of acclimate to that and it would no longer be effective when I got bad and really needed it.

I have since come to realize that won't make a whole lot of difference. As you noted, this is progressive anyway so I might as well take it. I accept that now, with the hope that by the time whatever I'm on seems to be losing its effectiveness, they'll have come up with something newer and better, or finally be able to 3D print me a new set of lungs.

I have a suggestion, if you still have the lower dose Advair available.

Since the doc put you on 500 that's where you should be for now. But remember you take Advair 2x per day and knowing that Advair (no matter what doseage) is expensive, why not alternate in some manner between 250 & 500 (A.M. dose / P.M. dose,whatever). The old meds are still valuable, why not make use of them before they expire.

This is only a suggestion....

All of the advise given above is good. Including j.h's mention of using up your old inhalers due to cost factors.

If you are concerned of the increased dosage due to advair's warnings of "could cause asthma related death" (LABA) it is something to speak with your dr about & see if he wants you to go back to the lower dose now that you are feeling better.

Do you still take spiriva also?

Gnott: I know what you're saying. I'm not sure the Advair is what improved my breathing, or just the change of seasons. I thought (mistakenly, I'm sure) that the less medicine you could feel good on, the better. I also have glaucoma, and was afraid that maybe the increased strength would have more of an adverse effect on that. And finally, I read that Advair could increase the chances of pneumonia and maybe at the lesser dose this would decrease that risk.
SimplyDani: You hit that nail on the head.
Whatsauname: Yep, that's another factor, since I do have some still available at the lower dose.
Jarca: I am concerned about that warning. Yes, I take Spiriva also.
Thanks, everyone. Love and hugs.