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
Singulair
Advair vs. Singulair Dosage
Advair
Singulair
| 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 | 4 mg once daily | At the start |
| Maximum dose | 10 mg 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 |
Singulair
| 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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