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Flovent vs Pulmicort
Introduction
For patients with asthma or chronic obstructive pulmonary disease (COPD), certain drugs that help manage inflammation within the airways, called corticosteroids, can assist in reducing symptoms and preventing exacerbations. Flovent and Pulmicort are two such drugs that are often prescribed to control these conditions. Both medications work by decreasing inflammation within the lungs but they do so in slightly different ways. Flovent, also known as Fluticasone Propionate, is a synthetic glucocorticoid which works by mimicking the effects of natural steroids found in your body to reduce swelling of the airways and prevent allergic reactions leading to breathing difficulties. On the other hand, Pulmicort (Budesonide) is another type of steroid medication which also decreases inflammation but does so more directly at the site of inflammation within your respiratory tract.
Flovent vs Pulmicort Side By Side
| Attribute | Flovent | Pulmicort |
|---|---|---|
| Brand Name | Flovent | Pulmicort |
| Contraindications | Worsening of existing lung infections, conditions for fungal infections, use with certain antifungal medications like ketoconazole or itraconazole, liver diseases | Worsening of existing lung infections, conditions for fungal infections, use with certain antifungal medications like ketoconazole or itraconazole, liver diseases |
| Cost | Around $260 for Flovent HFA (110 mcg inhaler) | Approximately $250 for Pulmicort Flexhaler (180 mcg inhaler) |
| Generic Name | Fluticasone Propionate | Budesonide |
| Most Serious Side Effect | Severe allergic reactions, bone thinning or weakness, blurred vision, fast heartbeat irregularities, signs of low potassium, adrenal gland problems | Allergic responses, behavioral changes, vision problems, white patches in the mouth or on the tongue, changes to heartbeat rhythms, indications of an adrenal gland problem |
| Severe Drug Interactions | Certain antifungal medications like ketoconazole or itraconazole | Certain antifungal medications like ketoconazole or itraconazole |
| Typical Dose | 88 mcg twice a day for adults and adolescents aged 12 years and older, up to a maximum of 880 mcg per day. For children aged 4 to 11 years, 88 mcg twice a day, not exceeding 264 mcg per day. | 180–360 mcg/day for adults, administered in one or two divided doses. For children aged six years and older, around 90-180 mcg per day divided into one or two doses. |
What is Flovent?
Fluticasone propionate (known by the brand name Flovent) is a corticosteroid used to prevent asthma attacks. It belongs to the class of drugs known as glucocorticoids and was first approved by the FDA in 1990. Flovent works by reducing inflammation and swelling in the airways, making it easier for people with asthma to breathe more normally. This medication does not work immediately and should be taken regularly for maximum benefit.
Budesonide (marketed under the brand name Pulmicort among others) is another type of corticosteroid that also serves as an asthma preventive medication. Like Fluticasone, Budesonide works by decreasing inflammation in the lungs, which can lead to breathing problems if left untreated.
While both medications belong to the same class of drugs and have similar effects on patients' bodies, there are differences between them that might affect their appropriateness or effectiveness for individual patients. For instance, while both medications are used primarily for long-term control rather than immediate relief of symptoms, they come in different forms: Fluticasone comes as an inhaler whereas Budesonide is available both as an inhaler and a nebulizer solution.
What conditions is Flovent approved to treat?
Flovent is approved for the treatment and management of several respiratory conditions:
- Chronic asthma in patients aged 4 years and older as a maintenance treatment
- Chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema
- Seasonal or perennial allergic rhinitis in adults and pediatric patients aged 12 months to 16 years.
How does Flovent help with these illnesses?
Flovent (fluticasone) helps manage asthma by reducing inflammation in the airways of the lungs. It does this by mimicking cortisol, a hormone naturally produced by our adrenal glands that has strong anti-inflammatory effects. Fluticasone binds to glucocorticoid receptors inside cells in the lung tissue, which leads to multiple anti-inflammatory actions such as decreasing proinflammatory cytokines and chemokines production. Inflammation is a key factor in asthma attacks because it can cause swelling and narrowing of airways, making breathing difficult. Therefore, by reducing inflammation with fluticasone, Flovent can limit the negative effects of an asthma attack and help patients better manage their condition.
Pulmicort (budesonide), on the other hand, also manages asthma symptoms but via slightly different mechanisms albeit still acting as corticosteroids like Flovent does. Both medications act at similar locations but have different binding affinities for glucocorticoid receptors which means they may be more or less effective depending on individual patient's response.
What is Pulmicort?
Pulmicort, a brand name for budesonide, is an inhaled corticosteroid used to manage and prevent asthma symptoms. It works by decreasing inflammation in the lungs which leads to better breathing. Pulmicort was first approved by the FDA in 1991. Unlike Flovent, another inhaled corticosteroid medication that contains fluticasone propionate, Pulmicort does not have significant mineralocorticoid activity — this means it has less of an effect on water and electrolyte balance in your body. The side-effect profile of Pulmicort also differs from Flovent's; while both can cause throat irritation or coughing, Pulmicort is less likely to lead to hoarseness or voice changes (a common side effect with Flovent). Moreover, due to its effects on lung inflammation rather than bronchial constriction alone, Pulmicort may be more effective at reducing asthma exacerbations compared to traditional bronchodilators such as albuterol.
What conditions is Pulmicort approved to treat?
Pulmicort, also known as budesonide, is a corticosteroid that is approved for the long-term management of:
- Asthma
- Chronic obstructive pulmonary disease (COPD) It's important to note that Pulmicort isn't used to relieve sudden breathing problems and won't replace a rescue inhaler. It helps decrease inflammation in the lungs which can lead to easier breathing.
How does Pulmicort help with these illnesses?
Budesonide, the active ingredient in Pulmicort, is a corticosteroid that serves to reduce inflammation and irritation within the airways. This action can lead to improved breathing and reduced occurrence of asthma attacks. Like Flovent's fluticasone, it works by decreasing swelling and inflammation in the airways, making breathing easier. However, Pulmicort has an added advantage as it can be used with other medications such as long-acting bronchodilators when treating severe cases of asthma or COPD (chronic obstructive pulmonary disease). Its versatility makes Pulmicort an effective choice for many patients suffering from these chronic conditions.
How effective are both Flovent and Pulmicort?
Both fluticasone propionate (Flovent) and budesonide (Pulmicort) have well-established records in managing asthma symptoms, having been FDA approved within a few years of each other. These medications are both corticosteroids that reduce inflammation in the airways, but they may be used under different circumstances depending on patient profiles. The effectiveness of Flovent and Pulmicort was compared directly in multiple double-blind clinical trials; these studies showed comparable efficacy between the two drugs for managing asthma symptoms with similar safety profiles.
A 2001 meta-analysis demonstrated that fluticasone propionate is effective at reducing asthma exacerbations starting from the first week of treatment, exhibits a favourable side effect profile over many other corticosteroids, and is generally well-tolerated even among elderly populations. This review also reported that Flovent has become one of the most commonly prescribed inhaler medications globally due to its high potency per dose, allowing for less frequent administration which enhances adherence.
On the other hand, a 2016 systematic review indicated budesonide to be comparably effective as placebo in controlling mild-to-moderate persistent asthma when administered via nebulizer or metered-dose inhaler. Although often considered as an alternative rather than first-line therapy due to its lower relative potency per dose compared to some competitors like fluticasone propionate—necessitating more frequent dosing—budesonide offers unique benefits such as better taste tolerance which can greatly improve inhalation techniques especially among children. Furthermore, its broad-spectrum anti-inflammatory action makes it ideal for patients who exhibit sensitivities or allergies to specific components present in alternative treatments.
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At what dose is Flovent typically prescribed?
Inhaler dosages of Flovent (fluticasone propionate) for adults and adolescents aged 12 years and older typically start from 88 mcg twice a day, with a maximum dosage of 880 mcg per day. For children aged between 4 to 11 years, the usual starting dose is 88 mcg twice a day, not exceeding more than 264 mcg per day. In contrast, Pulmicort (budesonide) inhalation doses for adults usually begin at ranges from 180-2400 micrograms daily divided into two doses. For children up to age eight, it would be ideal to start with lower doses often ranging from 90-400 micrograms daily in one or two separate administrations. As always, any increase in dosage should only be considered after consultation with your healthcare provider.
At what dose is Pulmicort typically prescribed?
Pulmicort treatment typically begins with a dosage of 180–360 mcg/day for adults, administered in one or two divided doses. The dose can then be increased to a maximum of 720 mcg/day, split into two administrations with an interval of approximately 12 hours between each use. For children aged six years and older, the starting dose is often lower, around 90-180 mcg per day divided into one or two doses. If there's no adequate response to the initial dosage after several weeks, physicians may consider increasing it up to a maximum daily dosage of 360 mcg for this age group. Always remember that these dosages are subject to individual medical advice and should never exceed your doctor's prescribed amount.
What are the most common side effects for Flovent?
Common side effects of Flovent and Pulmicort may include:
- Headache
- Sore throat, hoarseness or loss of voice
- Coughing
- Dry mouth, tongue irritation
- Nausea, vomiting
- Stomach discomfort or pain
- Diarrhea, constipation
- Respiratory tract infection (cold symptoms)
- Sinusitis (inflammation in the sinus cavities)
- Oral candidiasis (yeast infection in the mouth/throat) Remember that these medications can also cause more serious side effects such as adrenal insufficiency. Always communicate with your healthcare provider about any unusual or bothersome symptoms you experience while taking these medications.
Are there any potential serious side effects for Flovent?
While using Flovent, patients should be aware of potential serious side effects, including:
- Severe allergic reactions: symptoms can include hives, difficulty breathing or swallowing, swelling in your face or throat
- Bone thinning or weakness
- Blurred vision, tunnel vision, eye pain or swelling
- Fast heartbeat irregularities and chest discomfort
- Signs of low potassium - leg cramps, constipation, irregular heartbeats
- Adrenal gland problems - severe nausea or vomiting, feeling light-headed when standing up from a sitting position
For Pulmicort these may include:
- Allergic reaction signs such as itching/swelling (especially of the face/tongue/throat) -Severe dizziness and trouble breathing -Wheezing after treatment -Signs of infection (e.g., fever)
If you notice any unusual side effects while taking either Flovent or Pulmicort for asthma control therapy please seek medical attention immediately.
What are the most common side effects for Pulmicort?
Pulmicort, like other inhaled corticosteroids, may cause the following side effects:
- Dry mouth or throat irritation
- Hoarseness or voice changes
- Cough
- Mild rash or skin irritation
- Headache or dizziness
- Stomach discomfort and nausea
- Nosebleeds Note: Despite these potential adverse reactions, it's important to remember that Pulmicort is often effective at managing symptoms of asthma and chronic obstructive pulmonary disease (COPD). However, if any symptoms persist or become problematic, consult your healthcare professional right away.
Are there any potential serious side effects for Pulmicort?
While Pulmicort is often well-tolerated by many individuals, it can sometimes cause severe side effects that necessitate immediate medical attention. Some of these reactions include:
- Allergic responses such as hives or itching, a rash or redness on the skin, swelling in your face or throat, and difficulty breathing
- Behavioral changes like agitation, depression, restlessness which are unusual for you
- Vision problems including blurred vision and seeing halos around lights
- White patches in the mouth or on the tongue which could indicate oral thrush (a fungal infection)
- Changes to heartbeat rhythms - either extremely fast heartbeats or irregular pulses
- Indications of an adrenal gland problem: persistent fatigue, constant feeling of being unwell,
increased thirst/urination
If you experience any of these symptoms while using Pulmicort, discontinue its use and consult with your healthcare provider immediately.
Contraindications for Flovent and Pulmicort?
Both Flovent and Pulmicort, along with other corticosteroids, may worsen symptoms of existing lung infections or create conditions for fungal infections in some people. If you notice your breathing problems worsening, an increase in wheezing or a change in the color of sputum, please seek immediate medical attention.
Neither Flovent nor Pulmicort should be taken if you are using certain antifungal medications like ketoconazole or itraconazole. Always inform your physician about any medication you are taking; these antifungals can raise the levels of corticosteroids in your blood leading to more side effects. It is also crucial to mention if you have been diagnosed with liver diseases as this could affect how these drugs are metabolized.
How much do Flovent and Pulmicort cost?
For the brand name versions of these drugs:
- The price of Flovent HFA (110 mcg inhaler) averages around $260, which works out to about $8.67 per day based on a typical dose of two puffs daily.
- The cost for Pulmicort Flexhaler (180 mcg inhaler) is approximately $250, averaging to nearly $8.33 per day given a regular dosage of two puffs daily.
If you are taking larger doses or more frequent dosages, then Flovent could become more expensive than Pulmicort on a per-day basis. But remember that cost should not be your sole consideration in determining which medication best fits your needs.
As for generic versions, neither Flovent nor Pulmicort currently have FDA-approved generics available in the U.S., so costs remain relatively high compared to some other medications:
- Fluticasone propionate (the active ingredient in Flovent) may be available as an off-label generic from compounding pharmacies; however prices and availability can vary widely.
- Budesonide (the active ingredient in Pulmicort), though it does have an approved generic version for certain forms such as nebulizer solution and oral tablets/capsules but not yet for the flexhaler formulation used in asthma treatment.
Popularity of Flovent and Pulmicort
Fluticasone, both in its generic form and under brand names such as Flovent, was estimated to have been prescribed to about 6.3 million people in the US in 2020. Fluticasone accounted for approximately 9% of the total prescriptions for inhaler medications used to manage asthma and chronic obstructive pulmonary disease (COPD). Being a type of corticosteroid medication, fluticasone helps reduce inflammation within the airways making it easier for patients to breathe.
Budesonide, including brand versions like Pulmicort, was prescribed to roughly 4.5 million individuals in America during the same year. Budesonide makes up just over 7% of all inhaler prescriptions intended for treating conditions such as asthma and COPD. The prevalence rate of budesonide has remained relatively stable over the past decade with minor fluctuations noted based on seasonal variations linked with higher incidences of respiratory illnesses.
Conclusion
Both Flovent (fluticasone) and Pulmicort (budesonide) are frequently used corticosteroid inhalers for managing asthma symptoms. They have been shown to be effective in reducing inflammation in the bronchial tubes, which subsequently aids in preventing asthma attacks. The choice between these medications often depends on individual patient factors and physician preference.
Flovent and Pulmicort operate by similar mechanisms of action but may be prescribed under different circumstances due to their varying strengths or delivery devices. For example, Flovent comes as an aerosol inhaler while Pulmicort is available as a dry powder inhaler or respules that can be used with a nebulizer.
Both medications are also available in generic form, offering significant cost savings especially for patients who must pay out of pocket. Both Flovent and Pulmicort require regular use to maintain control over asthma symptoms; immediate effects should not necessarily be expected after initial usage.
The side effect profiles of these two drugs tend to be relatively similar, with both generally being well tolerated by most patients; however, some common side effects such as oral thrush and hoarseness might occur more commonly with fluticasone than budesonide. For both products, it's important that patients rinse their mouths after each use to reduce the risk of developing oral fungal infections or experiencing voice changes.
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Refrences
- Staresinic, A. G., & Sorkness, C. A. (2000, September). Fluticasone propionate: a potent inhaled corticosteroid for the treatment of asthma. Expert Opinion on Pharmacotherapy. Informa UK Limited.http://doi.org/10.1517/14656566.1.6.1227
- Hoogsteden, H. C., Verhoeven, G. T., Lambrecht, B. N., & Prins, J. ‐B. (1999, June). Airway inflammation in asthma and chronic obstructive pulmonary disease with special emphasis on the antigen‐presenting dendritic cell: influence of treatment with fluticasone propionate. Clinical & Experimental Allergy. Wiley.http://doi.org/10.1046/j.1365-2222.1999.00020.x
- Crompton, G. K. (2000, November). Fluticasone propionate bioavailability in asthma. The Lancet. Elsevier BV.http://doi.org/10.1016/s0140-6736(05)70383-4
- Tinkelman, D. G., Bronsky, E. A., Gross, G., Schoenwetter, W. F., & Spector, S. L. (2003, January). Efficacy and Safety of Budesonide Inhalation Powder (Pulmicort Turbuhaler®) During 52 Weeks of Treatment in Adults and Children with Persistent Asthma. Journal of Asthma. Informa UK Limited.http://doi.org/10.1081/jas-120020186
- Ställberg, B., Pilman, E., Skoogh, B.-E., & Hermansson, B. A. (2007, March). Potency ratio fluticasone propionate (Flixotide Diskus)/budesonide (Pulmicort Turbuhaler). Respiratory Medicine. Elsevier BV.http://doi.org/10.1016/j.rmed.2006.06.008
- Chuchalin, A. G., Kremer, H.-J., Metzenauer, P., O`Keefe, E., & Hermann, R. (2002). Clinical Equivalence Trial on Budesonide Delivered either by the Novolizer<sup>®</sup> Multidose Dry Powder Inhaler or the Turbuhaler<sup>®</sup> in Asthmatic Patients. Respiration. S. Karger AG.http://doi.org/10.1159/000066461