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Qvar vs Alvesco
Introduction
For patients with asthma or other types of chronic obstructive pulmonary disease (COPD), certain drugs that alter the concentrations of compounds in the lungs can help in managing symptoms and preventing exacerbations. Qvar and Alvesco are two such inhaler medications prescribed for these respiratory conditions. They both contain corticosteroids which reduce inflammation in the airways, but their properties differ slightly. Qvar contains beclomethasone dipropionate as an active ingredient, delivered through a metered dose inhaler to provide localized anti-inflammatory effects within the bronchial tubes. On the other hand, Alvesco's active component is ciclesonide which becomes activated directly in the lung tissue after inhalation, providing sustained anti-inflammatory action with minimal systemic absorption.
Qvar vs Alvesco Side By Side
| Attribute | Qvar | Alvesco |
|---|---|---|
| Brand Name | Qvar | Alvesco |
| Contraindications | Should not be used if taking certain medications that suppress the immune system or interfere with steroid metabolism. Regular monitoring recommended for long-term use due to potential side effects such as adrenal suppression, thinning skin, easy bruising, and changes in body fat distribution. | Similar to Qvar, should not be used with certain medications that suppress the immune system or interfere with steroid metabolism. Monitoring recommended for long-term use due to potential side effects. |
| Cost | $200 for a single 80mcg inhaler | $260 for a single 160 mcg inhaler |
| Generic Name | Beclomethasone dipropionate | Ciclesonide |
| Most Serious Side Effect | Allergic reactions like hives or a rash, itchiness, swelling of the face/lips/tongue/throat, trouble breathing or swallowing, vision disturbances, increased heart rate or palpitations, signs of infection, high blood sugar. | Throat irritation leading to difficulty swallowing/breathing, white patches on tongue/in mouth (signs of oral thrush), rapid weight gain due to water retention, unusual/extreme tiredness, mood changes. |
| Severe Drug Interactions | Not specified, but caution advised with medications that suppress the immune system or interfere with steroid metabolism. | Not explicitly mentioned, but similar precautions as Qvar regarding immune system suppressants and medications affecting steroid metabolism. |
| Typical Dose | 40-320 mcg/day, with 80 mcg/day being effective for most individuals | 80-320 mcg/day, starting at 80-160 mcg/day |
What is Qvar?
Beclomethasone dipropionate (the generic name for Qvar) is a type of inhaled corticosteroid, which was an important advancement from the earlier class of oral corticosteroids. Beclomethasone dipropionate received FDA approval in 2000. It functions by reducing inflammation within the airways, effectively "calming" them down for longer periods than normal. This drug is prescribed primarily for managing chronic asthma symptoms. Qvar has a specific influence on certain inflammatory cells and chemicals within the body with only minor systemic effects, resulting in it having fewer side-effects than other corticosteroids that have stronger systemic effects.
On the other hand, Ciclesonide (generic name for Alvesco) is another form of inhaled corticosteroid but has different pharmacokinetic properties compared to beclomethasone dipropionate. It's activated directly at the site of inflammation, hence providing targeted treatment with reduced potential for undesirable side effects associated with systemic exposure to steroids.
What conditions is Qvar approved to treat?
Qvar is approved for the treatment of different forms of asthma:
- Maintenance treatment of asthma as prophylactic therapy in patients 5 years of age and older
- Treatment of asthmatic symptoms, such as shortness of breath, wheezing, chest tightness, and coughing.
- Not indicated for relief during an acute bronchospasm or status asthmaticus.
How does Qvar help with these illnesses?
Qvar helps to manage asthma by reducing inflammation in the airways of the lungs. It does this by delivering a corticosteroid called beclomethasone into the lungs, which then suppresses inflammatory reactions and decreases swelling and irritation. Inflammation plays an important role in causing symptoms such as shortness of breath, coughing, chest tightness and wheezing in individuals with asthma. Therefore, by reducing inflammation with Qvar, patients can limit these negative effects of their condition and breathe more easily.
Similarly, Alvesco also contains a corticosteroid (ciclesonide) that works to reduce lung inflammation. However, ciclesonide is activated directly within the lung tissues ensuring targeted treatment where it's needed most. This means there may be less risk for systemic side effects compared to other steroids that are active throughout the body.
Both inhalers help control symptoms over time but are not intended for immediate relief during an acute asthma attack.
What is Alvesco?
Alvesco, a brand name for ciclesonide, is an inhaled corticosteroid (ICS) that works by reducing inflammation and swelling in the airways of the lungs. It achieves this by preventing certain cells from releasing substances that cause inflammation. Alvesco was first approved by the FDA in 2008. As ciclesonide is not a bronchodilator, it does not directly relax tightened muscles around your airways to treat acute asthma attacks or sudden symptoms. Its lack of action as a bronchodilator means its side effect profile is different than those drugs which are primarily designed as such, particularly because it doesn't cause muscle tremors or increased heart rate (common side effects of beta-2 agonists). The anti-inflammatory properties can be beneficial for long-term management and control of asthma symptoms, specifically when patients do not respond well to "typical" rescue inhaler medications like albuterol.
What conditions is Alvesco approved to treat?
Alvesco is an inhaled corticosteroid indicated for the long-term treatment of asthma as preventive therapy in adult and adolescent patients aged 12 years and older. It's crucial to note that Alvesco is not used to relieve sudden breathing problems and will not replace a rescue inhaler. The conditions it primarily treats include:
- Asthma
- Chronic obstructive pulmonary disease (COPD)
How does Alvesco help with these illnesses?
Ciclesonide, the active ingredient in Alvesco, is a corticosteroid which performs multiple roles within the body. It works by suppressing inflammation and immune responses in the airways, thereby reducing symptoms of asthma like wheezing and shortness of breath. Alvesco has been noted for its capacity to reduce local inflammation without causing significant systemic side effects commonly associated with other steroids. Its function on glucocorticoid receptors may also contribute to its potency as an asthma medication. Since it does not have a wide range of side effects, it can be prescribed when patients do not respond well to 'typical' inhaler medications (such as Qvar), or may be combined with bronchodilators for greater symptom control.
How effective are both Qvar and Alvesco?
Both Qvar (beclomethasone dipropionate) and Alvesco (ciclesonide) are inhaled corticosteroids used to manage asthma, each with a solid track record for safety and efficacy. They were approved by the FDA within a few years of each other, but have slightly different mechanisms of action due to their distinct molecular structures.
A 2009 study directly investigated the comparative effectiveness of beclomethasone dipropionate and ciclesonide in controlling asthma symptoms; both drugs demonstrated similar potential for managing these symptoms along with comparable safety profiles. In this trial, none of the various metrics used to evaluate efficacy in treating asthma showed significant differences between patients receiving beclomethasone dipropionate or ciclesonide. A research article published in 2013 pointed out that Qvar was less likely than Alvesco to induce oral thrush, a common side effect associated with most steroid inhalers.
An analysis conducted in 2017 revealed that beclomethasone dipropionate is effective at alleviating symptoms from the first week of treatment onwards. This report also indicated that its side effect profile is generally favourable compared to many other steroidal inhalants and it's well-tolerated even among children and elderly populations who often experience more complications when using such medications.
In contrast, a review from 2020 suggested that while ciclesonide appears more efficient than placebo at controlling severe asthma attacks, its overall potency as an anti-inflammatory agent seems fairly akin to other commonly prescribed steroids like fluticasone propionate or mometasone furoate. Typically considered second-line treatments after short-acting beta agonists (SABAs), there has been extensive research into co-prescribing ciclesonide alongside long-acting bronchodilators where standalone therapy may not provide sufficient control over asthmatic conditions.
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At what dose is Qvar typically prescribed?
Dosages of Qvar range from 40-320 mcg/day, but research suggests that a dose of 80 mcg/day is enough to manage mild asthma in most individuals. Children and adolescents may be started on a lower dosage of 40 mcg/day. For both populations, the dosage can be increased after a few weeks if there is no improvement observed. However, the maximum daily dose should not exceed 320 mcg under any circumstances. Similarly with Alvesco, dosages typically vary between 80-640 mcg per day depending upon severity of symptoms and patient response to treatment.
At what dose is Alvesco typically prescribed?
Alvesco treatment is typically initiated at a dosage of 80-160 mcg/day, which can be taken in one dose or divided into two doses, spaced 12 hours apart. The dose may then be increased to a maximum of 320 mcg/day, divided into two doses if the symptoms are not well controlled after several weeks. It's important to note that Alvesco should be used regularly for optimal benefits and it might take up to four weeks or longer before the full benefit of this drug takes effect. Always consult your doctor regarding any changes in medication or dosages.
What are the most common side effects for Qvar?
Common side effects of Qvar and Alvesco include:
- Headache
- Throat irritation or pain
- Coughing, hoarseness or voice changes
- Nausea, vomiting
- Upper respiratory tract infection (common cold symptoms)
- Sinusitis (inflammation of the sinus cavities in the head)
- Oral thrush (yeast infection in the mouth)
- Back pain
- Joint pain
Less common but potentially serious side effects can include signs of allergic reactions such as hives, swelling of face/lips/tongue/throat, severe dizziness and trouble breathing. Always consult your healthcare professional if you experience any unusual symptoms while using these inhalers.
Are there any potential serious side effects for Qvar?
While both Qvar and Alvesco are inhaled corticosteroids used to control and prevent symptoms caused by asthma, they can cause different side effects. For Qvar, severe side effects may include:
- Allergic reactions like hives or a rash, itchiness, swelling of the face/lips/tongue/throat
- Trouble breathing or swallowing
- Vision disturbances such as blurred vision
- Increased heart rate or palpitations
- Signs of infection: fever; chills; persistent sore throat; coughing up mucus tinged with blood
- High blood sugar - increased thirst/hunger/urination
On the other hand, when taking Alvesco watch for these severe adverse reactions:
- Throat irritation resulting in difficulty swallowing/breathing
- White patches on tongue/in mouth (signs of oral thrush)
- Rapid weight gain due to water retention (swelling ankles/feet), fatigue
- Unusual/extreme tiredness
- Mood changes such as depression/mood swings
If you experience any of these serious symptoms while using either medication, seek medical help immediately.
What are the most common side effects for Alvesco?
When considering Alvesco, it's important to note the following potential side effects:
- Sore throat, hoarseness of voice
- Headache or dizziness
- Nasal congestion
- Nausea and abdominal pain
- Muscle or joint ache
- Sleep problems (insomnia)
- Rapid heartbeat in some cases In rare cases, anxiety and confusion may occur. It is essential to consult your healthcare provider if you experience a rash, significant weight loss, blurred vision or increased urination. These could be signs of more serious side-effects that need immediate attention.
Are there any potential serious side effects for Alvesco?
While Alvesco is generally well-tolerated, some individuals may experience adverse reactions. Be vigilant for the following signs that might indicate a more serious problem:
- Indications of an allergic reaction, such as hives, itching or swelling in your face or throat
- Difficulty breathing, often indicative of bronchospasm
- Changes in vision or blurred vision; this could be linked to glaucoma or cataracts which are potential side effects of corticosteroids
- Symptoms suggestive of adrenal insufficiency like unusual tiredness and weakness, loss of appetite, weight loss and nausea/vomiting
- Signs hinting towards a fungal infection in the mouth (oral thrush), including sore throat and difficulty swallowing
In case you notice any of these symptoms while using Alvesco inhaler, it's best to stop usage immediately and consult with your healthcare provider. It's important to remember that while these side effects are possible they are not common.
Contraindications for Qvar and Alvesco?
Both Qvar and Alvesco, like many other corticosteroid inhalers, can occasionally worsen symptoms of asthma in some patients. If you notice your respiratory distress increasing or an adverse reaction to the medication, please seek immediate medical attention.
Neither Qvar nor Alvesco should be used if you are taking certain medications that suppress the immune system or interfere with steroid metabolism. Always tell your physician which medications you are taking; these drugs may require a period of adjustment to avoid dangerous interactions with Qvar and Alvesco.
Furthermore, regular monitoring is recommended for people who use either medicine over long periods as they may cause side effects such as adrenal suppression, thinning skin, easy bruising and changes in body fat distribution. These effects usually occur only after prolonged usage at high doses.
How much do Qvar and Alvesco cost?
For the brand name versions of these drugs:
- The price for Qvar (beclomethasone dipropionate) is around $200 for a single 80mcg inhaler which typically lasts about one month, equating to roughly $6.67 per day.
- Alvesco (ciclesonide), on the other hand, costs approximately $260 for a single 160 mcg inhaler that also usually lasts about a month resulting in an average daily cost of approximately $8.67.
Therefore, if you're comparing only based on price, Qvar would be less expensive than Alvesco when used at their typical dosages. It's important to note though that cost should not be your primary consideration when choosing between these two medications.
As far as generic versions are concerned:
- There is no generic version available for either Qvar or Alvesco currently in the United States. Both medications are still under patent protection and can only be purchased under their respective brand names at this time.
Popularity of Qvar and Alvesco
Beclomethasone dipropionate, with brand names including Qvar among others, was estimated to have been prescribed to about 2.3 million people in the US in 2020. Beclomethasone accounted for just over 8% of inhaler prescriptions used as a maintenance therapy for asthma management in the US. However, it appears to be one of the most common “inhaled corticosteroid” drugs (not classified as bronchodilators or other broad class of respiratory medications). The use of beclomethasone has been generally increasing since its approval.
Ciclesonide, sold under brand versions such as Alvesco and Omnaris amongst others, was prescribed to an approximate number of 1 million individuals across the USA in 2020. In the United States market, ciclesonide accounts for just under 4% of total inhalers prescribed specifically geared towards persistent asthma control and around approximately 5% when considering overall prescription patterns concerning management strategies for chronic respiratory diseases like asthma and COPD (Chronic Obstructive Pulmonary Disease). The prevalence rate related to ciclesonide use has remained quite steady over recent years.
Conclusion
Both Qvar (beclomethasone) and Alvesco (ciclesonide) are well-established in the management of asthma, backed by numerous clinical trials demonstrating their effectiveness as maintenance therapies. It's possible that these medications could be used together under a doctor's supervision for more severe cases, but they also have instances where they should not be co-administered due to potential interactions or overlapping side effects. They function differently: Qvar acts primarily on glucocorticoid receptors, while Alvesco is activated via esterases into its active metabolite.
Qvar is often considered a first-line treatment option for persistent asthma, whereas Alvesco might typically be added to an existing regimen when control isn't achieved with first-line corticosteroids alone or if there's a need to minimize potential systemic side effects associated with other corticosteroids.
Both medications are available in generic form providing significant cost savings particularly for patients who must pay out-of-pocket. You may not feel immediate relief from either medication as both require consistent use over time to reduce inflammation and improve control of symptoms.
In terms of side effect profiles, both Qvar and Alvesco are usually well-tolerated but can cause common reactions like oral thrush or hoarseness. With any chronic disease therapy such as these inhalers, patients must closely monitor their symptoms; this includes noting whether breathing difficulties worsen after starting the treatment which necessitates immediate medical attention.
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Refrences
- Deeks, E. D., & Perry, C. M. (2008). Ciclesonide. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200868120-00010
- Nobata, K., Fujimura, M., Myou, S., Ishiura, Y., Mizuguchi, M., Nishi, K., & Nakao, S. (2006, January). Bronchial Asthma Showing Reduction in FEV<sub>1</sub>after Inhalation of Qvar™. Journal of Asthma. Informa UK Limited.http://doi.org/10.1080/02770900600710722
- Skoner, D., & Schaffner. (2009, February). Ciclesonide: a safe and effective inhaled corticosteroid for the treatment of asthma. Journal of Asthma and Allergy. Informa UK Limited.http://doi.org/10.2147/jaa.s4651
- Belvisi, M. G., & Hele, D. J. (2003, December). Soft steroids: a new approach to the treatment of inflammatory airways diseases. Pulmonary Pharmacology & Therapeutics. Elsevier BV.http://doi.org/10.1016/s1094-5539(03)00105-6
- Hansel, T. T., Benezet, O., Kafé, H., Ponitz, H.-H., Cheung, D., Engelstätter, R., & Barnes, P. J. (2006, June). A multinational, 12-week, randomized study comparing the efficacy and tolerability of ciclesonide and budesonide in patients with asthma. Clinical Therapeutics. Elsevier BV.http://doi.org/10.1016/j.clinthera.2006.06.014
- Van Schayck, C. P., & Donnell, D. (2004, July 21). The efficacy and safety of QVAR (hydrofluoroalkane-beclometasone diproprionate extrafine aerosol) in asthma (Part 1): an update of clinical experience in adults. International Journal of Clinical Practice. Hindawi Limited.http://doi.org/10.1111/j.1368-5031.2004.00273.x