ProAir vs. Pulmicort

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

Key Takeaways

  • ProAir is a quick-relief inhaler used as needed for sudden asthma symptoms, while Pulmicort is a twice-daily steroid inhaler that controls inflammation over time.

  • ProAir starts working within minutes but does not treat the underlying inflammation that causes asthma flare-ups.

  • Pulmicort takes days to weeks to build its full effect and is not meant for immediate symptom relief during an asthma attack.

ProAir vs. Pulmicort Drug Summary

ProAir

ProAir is a short-acting beta2-agonist (SABA) delivered through a metered-dose inhaler that quickly relaxes airway muscles. It is used to treat or prevent sudden bronchospasm in asthma and other reversible airway diseases, and to prevent exercise-induced bronchospasm, in patients 4 years and older.

Pulmicort

Pulmicort is an inhaled corticosteroid delivered through a twice-daily dry powder inhaler that reduces airway inflammation over time. It is approved as a maintenance treatment for asthma in patients 6 years and older, taken on a regular schedule rather than for immediate relief.

ProAir vs. Pulmicort Side Effects

ProAir

Most common
Headache (3%)
Tachycardia (3%)
Pain (3%)
Dizziness (3%)

Pulmicort

Most common
Nasopharyngitis (up to 9.3%)
Nasal congestion (up to 2.7%)
Pharyngitis (up to 2.7%)
Rhinitis allergic (up to 2.2%)

ProAir vs. Pulmicort Dosage

ProAir

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 2 inhalations pre-exercise At the start
Maximum dose 2 inhalations pre-exercise Same as starting
Dose changes None Fixed dose

Pulmicort

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 180 mcg twice daily At the start
Maximum dose 180 mcg twice daily Same as starting
Dose changes None Fixed dose

ProAir vs. Pulmicort Indications

ProAir

ProAir treats sudden asthma symptoms by relaxing tightened airway muscles within minutes. It is also used just before exercise to prevent breathing difficulty triggered by physical activity. Doctors prescribe it for patients as young as 4 years old.

  • Treats or prevents bronchospasm in reversible airway disease

  • Prevents exercise-induced bronchospasm

  • Approved for patients 4 years and older

  • Used as a rescue inhaler on an as-needed basis

Pulmicort

Pulmicort is taken every day to control asthma inflammation and reduce flare-ups over time. It is not meant to treat an asthma attack already underway. It is approved for ages 6 and up, and sometimes used off-label for eosinophilic esophagitis.

  • Maintenance treatment for asthma prophylaxis

  • Approved for patients 6 years and older

  • Used on a fixed twice-daily schedule

  • Off-label use for eosinophilic esophagitis (not FDA-approved)

ProAir vs. Pulmicort Pros and Cons

ProAir

ProAir works within minutes, making it the go-to choice for sudden asthma symptoms or before exercise. It does not address the underlying airway inflammation that drives asthma over time. Needing it more often than usual can be a sign that asthma is not well controlled.

Pros

  • Starts working within minutes for fast symptom relief

  • Simple as-needed dosing, no daily schedule required

  • Built-in dose counter tracks doses remaining

  • Roughly $85 to $95 per month before insurance, lower than Pulmicort

Cons

  • Does not treat the underlying airway inflammation

  • Not intended for daily asthma control

  • Frequent use may signal worsening asthma needing other treatment

  • Can raise heart rate and affect blood pressure

Pulmicort

Pulmicort steadily lowers airway inflammation, which can mean fewer and milder asthma flare-ups over months of consistent use. It provides no relief during an active asthma attack, so it must be paired with a rescue inhaler. The dry powder form also carries some steroid-specific risks.

Pros

  • Reduces airway inflammation for long-term control

  • Available as Respules for children too young for Flexhaler

  • May lower the frequency of asthma flare-ups over time

  • Simple, predictable twice-daily dosing schedule

Cons

  • Does not relieve acute bronchospasm or asthma attacks

  • Contains trace milk proteins, risky for milk protein allergy

  • Can cause oral thrush; rinsing mouth after use is advised

  • Roughly $200 to $350 per month before insurance, higher than ProAir

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