Alvesco alternatives: What can I take instead of Alvesco?

Compare Alvesco alternatives | Inhaled Corticosteroid Inhalers | Combination Product Inhalers | Oral Corticosteroids | Leukotriene Receptor Antagonists | Long-acting Muscarinic Antagonists | Natural alternatives | How to switch meds

The Centers for Disease Control estimates 1 in 13 people have asthma. It can occur at any age, but typically starts in childhood. We don’t usually know why someone develops asthma, though we do have a pretty good idea of the triggers. Exercise, pollen, infections, and cold air are a few of the things that can trigger asthmatic symptoms. When the symptoms get really bad, and you are having a difficult time breathing, this is called an asthma attack or asthma exacerbation, and that can be very scary.

But wait… What is asthma? Asthma is a lung disease. While you may treat it and control it, it never really goes away. Asthma is characterized by the airways in your lungs becoming inflamed and/or lined with mucus, and because of this, it is hard to move air through your lungs. This results in it feeling like it is hard to breathe. You will feel short of breath, chest tightness, coughing, and wheezing. This can become worse when you try to do activities like running or exercise.

When you are asthmatic or have asthma, the best thing you can do is have a treatment plan. There are two important components of this plan: your maintenance plan to minimize symptoms and your action plan for when you have an exacerbation. These won’t just involve asthma medications, they will include monitoring your breathing and knowing your triggers so you can avoid them to the best of your ability. What if exercise is one of your triggers? Are you never supposed to exercise again? No, that is not true. We want to make sure your maintenance plan and pre-medications allow you to exercise safely without an exacerbation.

It is important to know that maintenance asthma medications are different from rescue asthma medications. Rescue medications are fast-acting bronchodilators like the prescription drug albuterol. Those who are at an increased risk for a severe asthma exacerbation based on their medication history should always have access to a metered dose inhaler (MDI) of albuterol or other FDA-approved rescue medication to make sure lung function can be maintained until appropriate medical attention can be sought.

Alvesco (ciclesonide) is an inhaled corticosteroid prescription medication that was approved for the U.S. market in 2008 by the Food and Drug Administration (FDA) for asthma maintenance treatment in patients at least 12 years of age or older. As an inhaled corticosteroid, Alvesco limits the inflammatory processes in the airways which cause the restrictive inflammation that makes you feel short of breath. It is not fast-acting, so it will not save you if you are having an asthma attack or asthma exacerbation.

While steroids are very effective maintenance treatments for asthma, long-term use of corticosteroids have drawbacks to your health as well. They can weaken your systemic immune system making you more prone to serious viral infections or bacterial infections, including tuberculosis. Inhaled steroids, like Alvesco, leave you vulnerable to “thrush”, an oral Candida albicans infection which can be difficult to cure.

Fortunately, if you are concerned Alvesco is not right for you for any reason, whether because of your age, side effects, or any other reason, there are other maintenance choices out there to help you keep your asthma maintained as controlled so that you can live an active lifestyle. 

This is not intended to be medical advice, and you should always speak to your doctor before making changes to your medications.

What can I take in place of Alvesco?

You may have a few different options when looking for an alternative to Alvesco. Your age may determine what options are appropriate for you. There are other corticosteroid inhalers available, some of which are available generically. Alvesco does not currently have a generic on the market. Some inhalers have different delivery mechanisms, oral mists versus oral powder inhalers. There are combination inhalers that add long-acting beta-agonists to the corticosteroids for additional activity to control the asthma symptoms. If you are struggling with the technique of using an oral inhaler or just prefer an oral solid dosage form, those are available as well. Below are some options you could speak to your doctor about when planning out your asthma maintenance plan. Do not stop your current treatment plan before speaking to your healthcare professional.

Other alternatives to Alvesco

• ArmonAir Digihaler (fluticasone)
• ArmonAir Respiclick (fluticasone)
• Flovent Rotadisk (fluticasone)
• Pulmicort Nebuamp (budesonide)
• Aerobid-M (flunisolide)
• Asmanex Twisthaler (mometasone)
• Pulmicort Turbuhaler (budesonide)
• Aerospan HFA (flunisolide)
• Aerobid (flunisolide)
• Beclovent (beclomethasone)
• Advair Diskus (fluticasone/ salmeterol)
• Breo Ellipta (fluticasone/ vilanterol)
• Dulera (formoterol/ mometasone)

Top 5 Alvesco alternatives

The following are some of the most common alternatives to Alvesco.

1. Other Inhaled Corticosteroid Inhalers

Alvesco may not be the best choice for your asthma maintenance plan, but that doesn’t necessarily mean that other corticosteroid inhalers wouldn’t be. One consideration is age. Alvesco is only approved for those ages 12 and up. However, Flovent Diskus and Flovent HFA are approved in children as young as 4 years old. Alvesco is an aerosol inhaler, meaning it works by releasing the medication in a fine mist. This does require some mechanical technique to time the breath to the actuation of the inhaler. For those that can’t do this, a spacer device may be required, or they may find the use of a powder capsule inhaler easier to use, like that of Flovent Diskus. Regardless of the mechanism, all steroid inhalers carry similar warnings for oral fungal infections, so it is important to rinse your mouth after the use of oral steroid inhalers.

Examples: Flovent HFA (fluticasone), Flovent Diskus (fluticasone), Qvar Redihaler (beclomethasone), Pulmicort Flexhaler (budesonide), Asmanex HFA (mometasone)

2. Combination Product Inhalers

Combination inhalers most commonly bring together an inhaled corticosteroid (ICS) and a long-acting beta-2 agonist (LABA) to provide two mechanisms for symptom relief. This combination brings together the anti-inflammatory properties of the ICS and the dilation effects of the LABA to really keep the airways open and allow air to move through freely. These products are not only used in asthma maintenance treatment but in COPD treatment as well. This class of inhalers also has aerosol and powder formulation options available and options for younger children. Some options in this class are available generically, and these can typically be cost-effective maintenance therapy. These contain steroids, and therefore you should still rinse your mouth after use just like you would with Alvesco or the alternatives listed above.

Examples: Symbicort (budesonide/ formoterol), Advair Diskus (fluticasone/ salmeterol), Breo Ellipta (fluticasone/ vilanterol), Dulera (formoterol/ mometasone)

3. Oral Corticosteroids

If using an inhaler is not an option for you, taking corticosteroids orally as an oral tablet is. There are some things to consider with this option, however. The risk of serious infections, like tuberculosis or pneumonia, is much higher with oral therapy. Long-term oral therapy causes immunosuppression and leaves you vulnerable to many negative effects from that. Some of those can be visible like swelling, specifically in the face known as “moon face.” Systemic steroids can cause mood changes and sleep disruptions too. Long-term steroid use can cause cataracts and exacerbate glaucoma as well, so they should be used with caution in those with a family history. Inhaled steroids are not linked to these issues as strongly and are generally considered a safer option for most people.

Examples: Deltasone (prednisone), Decadron (dexamethasone)

4. Leukotriene Receptor Antagonist (LTRA)

Leukotriene receptors in the human airways are very reactive to allergens and play a key role in airway disease. Leukotrienes are released from mast cells and eosinophils in response to allergens. Once the leukotriene connects with its receptor, this stimulates inflammation, constriction, and fluid build-up in the airway. LTRAs block these receptors to minimize this response. For asthma that is strongly responsive to the presence of allergens, having an LTRA as a part of the maintenance treatment plan can be a viable option. LTRAs are available in chewable dosage forms for children and solid tablet forms for adults.

Example: Singulair (montelukast)

5. Long-acting Muscarinic Antagonists (LAMA)

Long-acting muscarinic antagonists block the action of acetylcholine by blocking muscarinic cholinergic receptors. Acetylcholine is responsible for airway contraction and music secretion, both of which agitate asthmatic symptoms. By blocking these receptors, LAMA drugs promote airway dilation and decrease mucus secretion, leaving the airways open and easier to breathe through. Technically, the only form of Spiriva approved by the FDA for asthma maintenance is Spiriva Respimat, the aerosol version of tiotropium. The powder version of tiotropium, Spiriva Handihaler, is only approved for the maintenance treatment of COPD.

Example: Spiriva Respimat (tiotropium)

Natural alternatives to Alvesco

The best non-medication way to manage your treatment of asthma is to avoid your triggers and live a healthy lifestyle. Keep your home clean and free of dust, mold, and fur. Keep your windows closed when allergens are high. Avoid tobacco and secondhand smoke. 

Even your diet plays a role in asthma. Obesity can make asthma harder to manage. Fruits and vegetables provide you with immune-boosting antioxidants and minerals. Manage your stress and get good sleep.

You will see over-the-counter inhalers and tablets for breathing. These are not safe for asthma maintenance or long-term use. You should always speak to your doctor before using them.

There have been attempts to use natural or complementary and alternative medicine treatments for asthma. From analysis of data available, it is not recommended to replace your current medication regimen with these types of natural therapies. While the natural alternatives may not be harmful in and of themselves, stopping your prescriptions treatments or replacing them can be very dangerous. Delaying treatment of a sudden asthma attack can be fatal.

How to switch to an Alvesco alternative

If you feel that Alvesco is not the right choice for your asthma maintenance therapy, start by speaking to your physician. Don’t stop taking your Alvesco or other medications until you speak to your physicians. Speak to your doctor about your concerns. Your insurance company or pharmacist can provide information on your insurance coverage. If you want to shop for the best price without insurance, visit www.SingleCare.com to save from driving to multiple pharmacies. It’s a convenient way to see the available prices all at once.