Advair vs. Singulair

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

Key Takeaways

  • Advair is a twice-daily inhaled steroid/bronchodilator combination approved for both asthma and COPD, while Singulair is a once-daily oral tablet approved for asthma and allergies but not COPD.

  • Advair works directly in the lungs to reduce inflammation and open airways, while Singulair blocks leukotrienes throughout the body, which is why it also treats allergic rhinitis.

  • Singulair carries a boxed warning for serious mood and behavior changes, while Advair carries warnings tied to its long-acting bronchodilator component.

Advair vs. Singulair Drug Summary

Advair

Advair combines an inhaled corticosteroid (fluticasone) with a long-acting bronchodilator (salmeterol) in one inhaler. It's used for daily maintenance treatment of asthma in people 4 and older and for COPD, taken as two inhalations twice a day. It is not a rescue medication for sudden breathing problems.

Singulair

Singulair is an oral leukotriene receptor antagonist taken once daily as a tablet, chewable tablet, or granules. It's used for ongoing asthma control, preventing exercise-triggered breathing problems, and relieving seasonal or year-round allergy symptoms. It is not used to stop an asthma attack already in progress.

Advair vs. Singulair Side Effects

Advair

Most common
Upper respiratory tract infection/inflammation (≥3%)
Headache (≥3%)
Bronchitis/cough (≥3%)
Oral candidiasis (thrush) (≥3%)

Singulair

Most common
Upper respiratory infection (≥5%)
Headache (≥5%)
Cough (≥5%)
Abdominal pain (≥5%)

Advair vs. Singulair 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

Singulair

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 4 mg once daily At the start
Maximum dose 10 mg once daily If needed
Dose changes 2 increases As tolerated

Advair vs. Singulair Indications

Advair

Advair is approved for daily maintenance treatment of asthma in patients 4 years and older and for maintenance treatment of COPD-related airflow obstruction. It's also used to reduce the number of COPD flare-ups in people who have had them before. It does not treat sudden asthma attacks or acute breathing emergencies.

  • Maintenance treatment of asthma (age 4+)

  • Maintenance treatment of COPD airflow obstruction

  • Reduction of COPD exacerbations

  • Not for acute bronchospasm or status asthmaticus

Singulair

Singulair is approved for ongoing asthma control and for preventing bronchoconstriction triggered by exercise. It's also approved to relieve symptoms of both seasonal and perennial allergic rhinitis. It is not intended to treat an asthma attack that has already started.

  • Prophylaxis and chronic asthma treatment

  • Prevention of exercise-induced bronchoconstriction

  • Seasonal allergic rhinitis relief

  • Perennial allergic rhinitis relief

Advair vs. Singulair Pros and Cons

Advair

Advair combines a steroid and bronchodilator in one device, which makes it useful for both asthma and COPD, including cutting down COPD flare-ups. Its LABA component carries a long-studied safety history, and a generic version is available for patients seeking a lower-cost option.

Pros

  • Approved for COPD as well as asthma

  • Reduces COPD exacerbations

  • Generic version available (Wixela Inhub)

  • Three dose strengths allow step-up therapy

Cons

  • Twice-daily inhaler dosing

  • Requires mouth rinsing to prevent thrush

  • LABA component linked to asthma-related death risk

  • Contraindicated with severe milk protein allergy

Singulair

Singulair offers a simple once-daily pill instead of an inhaler, and it doubles as an allergy treatment, which Advair does not. That convenience comes with a boxed warning for serious mood and behavior changes that patients need to watch for.

Pros

  • Oral tablet, no inhaler technique needed

  • Also treats seasonal and perennial allergies

  • Chewable and granule forms for children

  • Prevents exercise-induced bronchoconstriction

Cons

  • Boxed warning for suicidal thoughts and behavior

  • Not approved for COPD

  • Rare risk of Churg-Strauss syndrome

  • Chewable tablets contain phenylalanine

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