Advair vs. Breo

See how Advair and Breo compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Advair is inhaled twice a day while Breo is inhaled once a day, but both are long-term controllers, not rescue inhalers for sudden symptoms.

  • Advair has a lower-cost generic (Wixela Inhub) and a longer track record, while Breo offers simpler once-daily dosing and a manufacturer savings program that can substantially lower out-of-pocket costs for eligible patients.

  • Breo carries an active FDA boxed warning for LABA-related asthma death risk, while Advair's original boxed warning was later removed after FDA review of ICS/LABA combinations.

Advair vs. Breo Drug Summary

Advair

Advair is an inhaled corticosteroid and long-acting beta agonist (ICS/LABA) combination used for long-term asthma and COPD control. It combines fluticasone propionate and salmeterol in a twice-daily Diskus inhaler. It is not intended for fast relief of a sudden asthma or COPD flare.

Breo

Breo is also an ICS/LABA combination inhaler, pairing fluticasone furoate with vilanterol for ongoing asthma and COPD management. It is inhaled once daily through the Ellipta device instead of twice daily. Like Advair, it is meant for maintenance therapy, not quick relief during a flare-up.

Advair vs. Breo Side Effects

Advair

Most common
Headache (up to 12%)
Respiratory infection (up to 10%)
Throat irritation (up to 9%)
Hoarseness (up to 5%)

Breo

Most common
Headache (up to 7%)
Respiratory infection (up to 5%)
Nasopharyngitis (up to 9%)
Pneumonia (up to 7%)

Advair vs. Breo Dosage

Advair

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 100 mcg/50 mcg twice daily At the start
Maximum dose 500 mcg/50 mcg twice daily If needed
Dose changes 2 increases As tolerated

Breo

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 50 mcg/25 mcg once daily At the start
Maximum dose 200 mcg/25 mcg once daily If needed
Dose changes 2 increases As tolerated

Advair vs. Breo Indications

Advair

Advair is approved as a long-term controller for asthma in patients age 4 and older, and for maintenance treatment of COPD, including reducing the frequency of exacerbations. It is taken every day, twice daily, regardless of symptoms, to keep airways open and inflammation down. It should never be used to treat a sudden attack of wheezing or shortness of breath.

  • Maintenance treatment of asthma in ages 4 and up

  • Maintenance treatment of COPD-related airflow obstruction

  • Reduces the frequency of COPD exacerbations

  • Not for sudden asthma or COPD attacks

Breo

Breo is approved as a once-daily maintenance treatment for COPD, including chronic bronchitis and emphysema, and for asthma in patients age 5 and older. It is taken every day, even when symptoms are absent, to control inflammation and keep airways open. Like Advair, it is not a rescue inhaler and cannot treat a sudden flare-up.

  • Maintenance treatment of COPD, including bronchitis/emphysema

  • Maintenance treatment of asthma in ages 5 and up

  • 200/25 mcg strength not approved for COPD

  • Not for sudden asthma or COPD attacks

Advair vs. Breo Pros and Cons

Advair

Advair has more than two decades of clinical use behind it and is approved for asthma in children as young as 4. Its twice-daily Diskus inhaler and multiple strengths let clinicians step dosing up or down based on disease severity. A generic version, Wixela Inhub, gives patients a lower-cost alternative to the brand name.

Pros

  • Backed by more than two decades of real-world safety data since 2000

  • Specifically approved to reduce COPD exacerbations, not just maintain airflow

  • Approved for asthma in children as young as 4, younger than Breo's cutoff of 5

  • Available as a generic (Wixela Inhub) at a lower price than brand-name Advair

Cons

  • Twice-daily dosing is less convenient than Breo's once-daily schedule

  • Diskus inhaler requires a specific inhalation technique that takes practice

  • Not approved for asthma treatment in children younger than 4

Breo

Breo's once-daily Ellipta inhaler and three available strengths make it a simpler routine for patients who prefer fewer daily doses. It carries an FDA boxed warning about LABA-related asthma death risk and a labeled pneumonia risk in COPD patients. No generic version exists yet, though GSK offers a copay cap for eligible patients.

Pros

  • Once-daily dosing simplifies the routine compared with Advair's twice-daily schedule

  • Comes in three strengths, allowing more precise dose adjustments by age and severity

  • Only fluticasone furoate/vilanterol combination approved once daily for asthma and COPD

  • Offers a manufacturer savings program that can substantially lower out-of-pocket costs for eligible patients

Cons

  • Carries an active FDA boxed warning for LABA-related asthma death risk

  • Labeled with an increased pneumonia risk in COPD patients

  • No generic version is currently available, unlike Advair's generic option

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