Breo vs. Singulair
See how Breo and Singulair compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Breo is an inhaled corticosteroid/LABA combination taken once daily for asthma and COPD, while Singulair is an oral pill used for asthma, exercise-induced bronchoconstriction, and allergic rhinitis.
Both drugs carry boxed warnings: Breo's LABA component carries a risk of asthma-related death, and Singulair carries a risk of serious neuropsychiatric events including suicidal thoughts.
Neither Breo nor Singulair is a rescue medication for sudden asthma or COPD symptoms; both are meant for daily, ongoing control.
Breo vs. Singulair Drug Summary
Breo
Breo is an inhaled corticosteroid and long-acting beta agonist (ICS/LABA) combination delivered once daily through the Ellipta inhaler. It is FDA-approved for maintenance treatment of asthma in patients 5 and older and for COPD, but it is not a rescue inhaler for sudden symptoms.
Singulair
Singulair is a leukotriene receptor antagonist taken as a once-daily oral tablet, chewable tablet, or granules. It is FDA-approved for long-term asthma control, prevention of exercise-induced bronchoconstriction, and relief of seasonal and perennial allergic rhinitis symptoms.
Breo vs. Singulair Side Effects
Breo
Singulair
Breo vs. Singulair Dosage
Breo
Singulair
| 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 |
| 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 |
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 |
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 |
Breo vs. Singulair Indications
Breo
Breo delivers an inhaled steroid and a long-acting bronchodilator together to reduce airway inflammation and keep airways open. It is approved for daily asthma control in people 5 and older and for maintenance treatment of COPD. It does not treat sudden flare-ups.
Maintenance treatment of asthma (ages 5+)
Maintenance treatment of COPD
Reduces airway inflammation daily
Not for acute asthma or COPD attacks
Singulair
Singulair blocks leukotrienes, chemicals that trigger airway swelling and allergy symptoms, when taken once daily by mouth. It is approved for long-term asthma control, preventing exercise-triggered breathing problems, and easing seasonal or year-round allergy symptoms. It does not treat a sudden asthma attack.
Long-term asthma control
Prevention of exercise-induced bronchoconstriction
Relief of seasonal allergic rhinitis
Relief of perennial allergic rhinitis
Breo vs. Singulair Pros and Cons
Breo
Breo combines an inhaled steroid with a bronchodilator in one daily inhaler, giving direct anti-inflammatory action in the lungs. It carries a boxed warning about LABA-related asthma death risk and is not appropriate for treating sudden symptoms. Insurance coverage and inhaler technique can both affect how well it works day to day.
Pros
Combines steroid and bronchodilator in one device
Once-daily dosing across three strengths for age and severity
Eligible patients may pay as little as $0 to $35 per month with GSK's savings program
Approved for both asthma and COPD
Cons
Boxed warning for LABA-related asthma death risk
Requires proper inhaler technique to work well
Contraindicated in severe milk protein allergy
Increased pneumonia risk in COPD patients
Singulair
Singulair works as a once-daily pill rather than an inhaler, which can suit patients who struggle with inhaler technique or want oral dosing. It carries a boxed warning about neuropsychiatric side effects, including suicidal thoughts, that patients and caregivers should watch for. It also treats allergic rhinitis, a use Breo does not cover.
Pros
Oral tablet, chewable, or granules — no inhaler needed
Also treats seasonal and perennial allergic rhinitis
Prevents exercise-induced bronchoconstriction
Available as chewable tablets for younger children
Cons
Boxed warning for neuropsychiatric events including suicidal thoughts
Chewable forms contain phenylalanine, a caution for PKU
Rare risk of Churg-Strauss syndrome
Not approved for COPD treatment
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