Flovent vs. Pulmicort

See how Flovent and Pulmicort compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Flovent and Pulmicort are both inhaled corticosteroids taken twice daily for long-term asthma control, not for sudden asthma attacks.

  • Flovent is approved starting at age 4, while Pulmicort's Flexhaler is approved starting at age 6, though Pulmicort also comes as a nebulized suspension for younger children.

  • Flovent typically costs less per month than Pulmicort at list price, before insurance or savings programs.

Flovent vs. Pulmicort Drug Summary

Flovent

Flovent (fluticasone propionate) is an inhaled corticosteroid used for daily, long-term control of asthma. It comes as either an HFA aerosol inhaler or a Diskus powder inhaler, taken twice a day, and is approved for patients 4 years and older.

Pulmicort

Pulmicort (budesonide) is an inhaled corticosteroid used for daily, long-term control of asthma. It is delivered through the Flexhaler dry powder device twice a day and is approved for patients 6 years and older.

Flovent vs. Pulmicort Side Effects

Flovent

Most common
candidiasis (>3%)
throat irritation (>3%)
sinusitis (>3%)
dysphonia (>3%)

Pulmicort

Most common
nasopharyngitis (up to 9.3%)
nasal congestion (up to 2.7%)
pharyngitis (up to 2.7%)
nausea (up to 1.8%)

Flovent vs. Pulmicort Dosage

Flovent

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 88 mcg twice daily At the start
Maximum dose 880 mcg twice daily If needed
Dose changes 3 increases As tolerated

Pulmicort

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 180 mcg twice daily At the start
Maximum dose 720 mcg twice daily If needed
Dose changes 2 increases As tolerated

Flovent vs. Pulmicort Indications

Flovent

Flovent is approved for the ongoing prevention of asthma symptoms in patients 4 years and older. It is also used in patients who need oral corticosteroids for asthma control, as it can help reduce or eliminate the need for oral steroids over time.

  • Long-term maintenance therapy for asthma, ages 4 and up

  • Add-on therapy for patients requiring oral corticosteroids

  • Not for relief of sudden asthma attacks

  • Not for status asthmaticus or acute breathing emergencies

Pulmicort

Pulmicort is approved for the ongoing prevention of asthma symptoms in patients 6 years and older. It is sometimes used off-label to help manage eosinophilic esophagitis, a chronic inflammatory condition of the esophagus.

  • Long-term maintenance therapy for asthma, ages 6 and up

  • Off-label use in eosinophilic esophagitis management

  • Not for relief of sudden asthma attacks

  • Not for status asthmaticus or acute breathing emergencies

Flovent vs. Pulmicort Pros and Cons

Flovent

Flovent has a long track record as one of the most widely used inhaled corticosteroids and now offers a generic option since the brand was discontinued. It comes in two device formats, giving patients and families some flexibility in choosing an inhaler style.

Pros

  • Approved down to age 4, one year younger than Pulmicort's Flexhaler

  • Available in two device types: HFA aerosol and Diskus powder inhaler

  • Generic fluticasone is available at a lower typical monthly cost, roughly $50 to $150 versus $200 to $350 for Pulmicort

Cons

  • Original brand-name Flovent HFA and Diskus were discontinued in 2024, requiring a switch to generic

  • No nebulized liquid option for very young children or those who cannot use a handheld inhaler

  • Candidiasis and dysphonia are listed among its common side effects

Pulmicort

Pulmicort has been on the market since 2006 and is unique among inhaled corticosteroids in offering a nebulized suspension for young children. That flexibility comes with a higher typical price and a milk protein consideration some patients need to know about.

Pros

  • Available as a nebulized suspension (Respules) for children too young for a handheld inhaler

  • Long, well-established safety record since its 2006 approval

  • Widely used off-label for eosinophilic esophagitis with good published experience

Cons

  • Higher typical monthly cost, roughly $200 to $350 versus $50 to $150 for Flovent

  • Contains trace milk proteins, which can pose a risk for patients with severe milk allergy

  • Flexhaler device not approved for children under 6

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