Flovent Hfa alternatives: What can I take instead of Flovent Hfa?

Compare Flovent Hfa alternatives | Flovent Diskus | Pulmicort Respules | Symbicort | Trelegy Ellipta | Singulair | Natural alternatives | How to switch meds

Finding yourself limited by asthma can be frustrating, particularly if you are unable to exercise comfortably or if flare-ups put you out of work or school for days. Preventing these problems with an asthma controller medication like Flovent HFA can be extremely empowering. The potential improvement with an inhaled corticosteroid such as Flovent HFA is not always realized however, so you may find yourself looking for an alternative drug for your treatment of asthma. A different or a generic version of your asthma maintenance drug may work better for you. Likewise, if you have a side effect from Flovent HFA, changing to an alternative might be best. A list of your options will be presented here, and some top choices will be pointed out.

What can I take in place of Flovent HFA?

The wheezing, coughing, and shortness of breath that arise from asthma have their origins in the bronchial tubes leading to our lungs. The muscles that line these tubes spasm, which is termed bronchospasm. As a result, the airways are more narrow, making breathing difficult and producing wheezing. In addition to bronchospasm, in the setting of asthma, the lining of bronchial tubes is inflamed and swollen, which narrows the airways even more, worsening asthma symptoms. It makes sense that effective control of asthma requires measures to reduce inflammation in the bronchial tubes and alleviate bronchospasm.

In some cases, asthma may only provoke infrequent symptoms, and the condition is called intermittent asthma if so. A rescue inhaler such as Proair HFA with the short-acting bronchodilator (SABA) albuterol or Xopenex HFA with the SABA levalbuterol may be all that is needed, and just on an as-needed basis. In comparison, persistent asthma creates more frequent symptoms or exacerbations. Daily asthma maintenance medications are needed in these situations.

Flovent HFA is the brand name for inhaled fluticasone propionate, an inhaled corticosteroid (ICS), and by taking puffs from this metered dose inhaler, a user can reduce airway inflammation and swelling. The anticipated result over time is a reduction in asthma attacks. While inhaled steroids do not open up airways in bronchospasm and are not rescue medications, their use is intended to reduce the need for rescue use of SABAs. If Flovent HFA is not helping you meet your asthma control goals, other inhaled steroids or a different delivery mechanism may be worth considering. 

For some, no inhaled steroid is effective or tolerable. In these instances, an inhaled long-acting beta agonist (LABA) or long-acting muscarinic antagonist (LAMA) may be in order, but these are typically done in combination with inhaled steroids. Leukotriene receptor antagonists (LRAs) are oral alternatives to inhaled options for asthma control, and for mild persistent asthma, they may be able to stand alone. LRAs can also be used in combination with inhaled medications for heightened effectiveness.

Other alternatives to Flovent HFA

• ArmonAir Digihaler (fluticasone)
• Wixela Inhub (fluticasone-salmeterol)
• Airduo Respiclick (fluticasone-salmeterol)
• Airduo Digihaler (fluticasone-salmeterol)
• Serevent Diskus (salmeterol)
• Zyflo (zileuton)

Top 5 Flovent HFA alternatives

The following are some of the most common alternatives to Flovent HFA.

1. Flovent Diskus

If you are disappointed with the ineffectiveness of Flovent HFA, the problem may be with the delivery mechanism. Flovent HFA is a traditional inhaler, and proper use requires one to coordinate actuation of the device and a deep inhalation. A spacer device, which is a plastic chamber with a mouthpiece, can be attached to traditional inhalers like Flovent HFA in order to avoid the need for these coordinated actions. Alternatively, you could switch to Flovent Diskus, a dry powder inhaler with the same active ingredients, fluticasone. Dry powder inhalers require only a quick inhalation instead of a coordinated actuation and inhalation. The downsides are that the quick inhalation has to be sufficiently powerful to get the medication to the bronchial tubes and the dry powder formulation can contain milk proteins, creating a contraindication to use for those with severe milk protein allergy.

2. Pulmicort Respules

A change to Pulmicort Respules would swap out the ICS fluticasone with budesonide instead. A number of other ICS options exist too, including mometasone, beclomethasone, and ciclesonide. While potencies vary amongst the products, the dosages are set up to make up for this and to achieve similar results. The argument for Pulmicort Respules is that the medication is delivered in a nebulized form. A nebulizer machine provides pressurized air that aerosolizes the liquid medicine, and the user breathes in the medicinal aerosol. Individuals with the inability to coordinate a traditional inhaler or effectively use a dry powder inhaler often find nebulized options like Pulmicort Respules preferable despite the fact that a nebulizer treatment takes more time. For this reason, the product is approved by the Food and Drug Administration (FDA) for use in young children.

3. Symbicort

The ineffectiveness of Flovent HFA may not have to do with the delivery mechanism or the particular ICS. Sometimes, for adequate control of asthma management, an ICS needs to be paired with a LABA. In this way, airway inflammation and bronchospasm can both be treated. It is worth noting that LABAs are never used alone in asthma care. The FDA has placed a black box warning against such usage on products like Serevent Diskus, which only has the LABA salmeterol. An increase in asthma-related mortality was seen in studies when a LABA was used without an ICS. Naturally, it makes good sense then to just package LABAs with an ICS in one product. Advair, Symbicort, Breo Ellipta, and Dulera do so. 

Symbicort has made a special name for itself by combining the ICS budesonide with the unique LABA formoterol. Formoterol has both a quick onset and long duration of action, permitting its use for both quick relief and long lasting prevention of asthma symptoms. The ability to use Symbicort for asthma maintenance and acute relief of symptoms has led to the acronym SMART, single maintenance and reliever therapy. Using Symbicort for SMART is an off-label usage and does not have FDA approval, but you could still consider Symbicort as an alternative to Flovent HFA for asthma maintenance care.

4. Trelegy Ellipta

Going another step further in intensity of asthma treatment, a LAMA can be added to an ICS and LABA. Dual bronchodilators along with an airway anti-inflammatory can make for a powerful treatment trio. Trelegy Ellipta packages them all in a dry powder inhaler. As convenient as that sounds, you should keep in mind that more drugs mean more potential side effects. To name a few, ICSs can increase your risk of thrush and cataracts; LABAs can trigger palpitations; and LAMAs can lead to urinary difficulties.

5. Singulair

Adding a LRA onto your Flovent HFA therapy could make sense if you need additional help with control, or substituting a LRA in place of Flovent HFA could work out if you are looking to avoid a side effect or inhaled drug delivery. The LRA drug class offers a different mechanism than ICSs to reduce airway inflammation and does so in an oral tablet form. Members of the leukotriene receptor antagonist category include Singulair, Accolate, and Zyflo. The nice thing about Singulair is that it also has an FDA indication for treatment of allergies, a health condition that often coexists with asthma. 

Natural alternatives to Flovent HFA

Your desire to better control your asthma does not need to solely rely on prescription drugs . Yes, the aforementioned drug classes do a marvelous job of asthma control in most cases. They do not have to be the only intervention though. Studies have repeatedly shown that a healthy diet, regular exercise, and weight loss have proven valuable in achieving optimal asthma control. Smoking cessation should also be on the list of lifestyle modifications with great potential benefit for asthma. Antioxidants and omega-3 fatty acids are getting some attention as dietary supplements which could help airway inflammation, but the jury is still out on whether they are effective. Likewise, herbal remedies require further clinical trials.

How to switch to a Flovent HFA alternative

Being unhindered by your asthma should be a goal that you share with your healthcare provider. Together, you both can share thoughts on why Flovent HFA may or may not be the best choice for asthma maintenance. Alternatives can be vetted in the context of your list of your other health conditions, your lifestyle, your other prescriptions,over-the-counter medications and cost. Through this careful analysis and discussion, you can get the best medical advice on what to do moving forward with the care of your asthma.