Medication Class Comparison: Breztri vs. Advair vs. Breyna
Direct Answer
No, Breztri is not the same class as Advair and Breyna—Breztri is a triple therapy (ICS/LAMA/LABA) while Advair and Breyna are dual therapies (ICS/LABA). 1, 2, 3
Detailed Class Breakdown
Breztri (Budesonide/Glycopyrrolate/Formoterol)
- Triple fixed-dose combination containing three medication classes 1:
- Inhaled corticosteroid (ICS): budesonide
- Long-acting muscarinic antagonist (LAMA): glycopyrrolate
- Long-acting β2-agonist (LABA): formoterol fumarate
- Approved for COPD maintenance treatment only 1, 4
- Delivered via pressurized metered-dose inhaler using co-suspension delivery technology 1, 5
Advair (Fluticasone/Salmeterol)
- Dual fixed-dose combination containing two medication classes 2:
- Inhaled corticosteroid (ICS): fluticasone propionate
- Long-acting β2-agonist (LABA): salmeterol
- Approved for both asthma and COPD 6, 2
- Available as Diskus (dry powder inhaler) in three ICS strengths (100,250,500 mcg) with fixed 50 mcg salmeterol 6, 2
Breyna (Budesonide/Formoterol)
- Dual fixed-dose combination containing two medication classes 3:
- Inhaled corticosteroid (ICS): budesonide
- Long-acting β2-agonist (LABA): formoterol
- Approved for asthma management 6, 3
- Can be used in SMART protocol (Single Maintenance and Reliever Therapy) for patients ≥12 years at steps 3-4 7, 3
Key Clinical Distinctions
Shared Components
- All three contain an ICS component (budesonide or fluticasone) for anti-inflammatory effects 6
- All three contain a LABA component (formoterol or salmeterol) for bronchodilation 6
- Breztri uniquely adds glycopyrrolate (LAMA) for additional anticholinergic bronchodilation 1
Therapeutic Positioning
- Advair and Breyna represent step-up therapy from ICS monotherapy when asthma or COPD remains inadequately controlled 6, 7
- Breztri represents further escalation for COPD patients inadequately controlled on dual ICS/LABA or LAMA/LABA therapy 1, 4
- Triple therapy (like Breztri) is recommended for COPD patients with FEV1 <50% predicted and ≥1 exacerbation treated with systemic steroids/antibiotics in the past year 7
Common Pitfall to Avoid
Never use Breztri for asthma management—it is FDA-approved only for COPD maintenance treatment 1, 4. For asthma requiring triple therapy, prescribe ICS/LABA combinations (Advair or Breyna) with a separate LAMA inhaler if needed, following asthma-specific guidelines 6, 7.