From the Guidelines
Alternatives to Advair Diskus include other combination inhalers containing inhaled corticosteroids and long-acting beta-agonists (ICS/LABA) such as Symbicort (budesonide/formoterol), Breo Ellipta (fluticasone furoate/vilanterol), Dulera (mometasone/formoterol), and Wixela Inhub (a generic version of Advair). These medications all serve the same purpose of controlling asthma or COPD by reducing inflammation in the airways (via the corticosteroid component) while simultaneously providing long-term bronchodilation (via the LABA component) 1. The specific alternative chosen would depend on factors like insurance coverage, patient preference for the delivery device, dosing schedule, and individual response. Some key considerations when selecting an alternative include:
- Insurance coverage and cost of the medication
- Patient preference for the delivery device, such as an inhaler or nebulizer
- Dosing schedule, including the frequency and timing of doses
- Individual response to the medication, including efficacy and side effects Some patients may find certain inhaler devices easier to use than others. For instance, Symbicort requires twice-daily dosing while Breo Ellipta is taken once daily 1. When switching between these medications, it's essential to work with a healthcare provider to ensure proper dosing equivalence and to monitor for any changes in symptom control or side effects. According to the most recent guidelines, inhaled corticosteroids are the preferred long-term control medication for initiating therapy, and the benefits of ICSs outweigh any concerns about potential risks of a small, nonprogressive reduction in growth velocity or other possible adverse effects 1. Additionally, LABAs should only be used in combination with ICS therapy, as monotherapy with LABAs has been associated with increased risk of asthma-related events 1. Overall, the choice of alternative to Advair Diskus should be based on individual patient needs and circumstances, and should be made in consultation with a healthcare provider.
From the FDA Drug Label
Fluticasone Furoate/Vilanterol ELLIPTA is a combination of fluticasone furoate, a corticosteroid, and vilanterol, a long‑acting beta2-adrenergic agonist (LABA), indicated for: • the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD). • the maintenance treatment of asthma in patients aged 5 years and older.
The alternatives to Advair Diskus (fluticasone-salmeterol) are Fluticasone Furoate/Vilanterol ELLIPTA for the maintenance treatment of COPD and asthma in patients aged 5 years and older 2.
- Key points:
- Fluticasone Furoate/Vilanterol ELLIPTA is a combination of a corticosteroid and a LABA.
- It is indicated for the maintenance treatment of COPD and asthma.
From the Research
Alternatives to Advair Diskus (fluticasone-salmeterol)
- Budesonide/formoterol (Symbicort) is an alternative to Advair Diskus, as shown in a study comparing the efficacy of budesonide/formoterol with salmeterol/fluticasone propionate in adults with asthma 3.
- Beclometasone/formoterol (Foster) is another alternative, although there is limited information available on its comparison with Advair Diskus 3.
- Fluticasone furoate/vilanterol combination is also an option, as it has been compared with budesonide/formoterol combination in the treatment of controlled stable asthma, showing similar clinical effects 4.
- Umeclidinium bromide and vilanterol as a combination therapy with fluticasone furoate is an alternative for patients with chronic obstructive pulmonary disease (COPD) 5.
Comparison of Alternatives
- A study compared budesonide/formoterol maintenance and reliever therapy with fluticasone/salmeterol fixed-dose treatment in patients with COPD, finding that budesonide/formoterol might be similarly effective at a lower daily ICS dosage 6.
- Another study compared combination therapy with single inhaler budesonide/formoterol with a high dose of fluticasone propionate alone in patients with moderate persistent asthma, showing that budesonide/formoterol was more effective in improving lung function and reducing use of reliever medication 7.