From the Guidelines
Inhaled ipratropium is a recommended alternative to Advair for post-viral cough, as it may attenuate the cough, according to the American College of Chest Physicians evidence-based clinical practice guidelines 1.
Alternatives to Advair
Other alternatives include:
- Budesonide/formoterol (Symbicort)
- Mometasone/formoterol (Dulera)
- Fluticasone/salmeterol (Wixela, AirDuo) These medications work similarly by reducing airway inflammation and relaxing airway muscles.
Key Considerations
Typical dosing is twice daily, with improvement often seen within 1-2 weeks. For immediate relief during coughing episodes, a rescue inhaler like albuterol may be used alongside these maintenance inhalers. These medications help by reducing inflammation in the airways that persists after viral infections, which can trigger coughing. If cost is a concern, using only an inhaled corticosteroid like fluticasone (Flovent) or budesonide (Pulmicort) might be sufficient for some patients. Always consult with a healthcare provider before switching medications to ensure appropriate dosing and to rule out other causes of persistent cough.
Rationale
The guidelines suggest that therapy with antibiotics has no role in the treatment of postinfectious cough, as the cause is not bacterial infection 1. Inhaled ipratropium may be helpful in attenuating the cough, and inhaled corticosteroids may be considered when the cough adversely affects the patient's quality of life and persists despite use of inhaled ipratropium 1. Central acting antitussive agents such as codeine and dextromethorphan should be considered when other measures fail 1.
From the Research
Acceptable Alternatives to Advair Inhaler for Post-Viral Cough
- There are no direct studies comparing alternatives to Advair inhaler for post-viral cough, but some studies suggest the following options:
- Oral corticosteroids, as studied in 2, may be beneficial for post-infectious cough, which could be considered as an alternative to Advair inhaler.
- Inhaled salmeterol/fluticasone propionate, as reviewed in 3 and 4, is effective in improving lung function and symptoms in patients with asthma, but its effectiveness in post-viral cough is not directly studied.
- Other inhaled corticosteroids, such as budesonide, or combination therapies, like formoterol/budesonide, may be considered as alternatives, as mentioned in 3 and 4.
- Non-pharmacological remedies, like honey, glycerol, and certain herbal agents, as discussed in 5, may provide some relief for post-viral acute cough, but further studies are needed to confirm their efficacy and safety.
Key Considerations
- The effectiveness of these alternatives may vary depending on the individual patient and the specific condition being treated.
- It is essential to consult with a healthcare professional to determine the best course of treatment for post-viral cough.
- More research is needed to establish the efficacy and safety of these alternatives in treating post-viral cough, as noted in 2 and 5.