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

Most common
headache (3% or more)
nasopharyngitis (3% or more)
upper respiratory tract infection (3% or more)
oral candidiasis (3% or more)

Singulair

Most common
headache (5% or more)
upper respiratory infection (5% or more)
fever (5% or more)
pharyngitis (5% or more)

Breo vs. Singulair Dosage

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

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

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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