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
Breo
Advair vs. Breo Dosage
Advair
Breo
| 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 |
| 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
| 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
| 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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