Singulair vs. Flovent

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

Key Takeaways

  • Singulair is a once-daily pill that blocks leukotrienes, while Flovent is a twice-daily inhaled steroid that reduces inflammation directly in the lungs.

  • Singulair also treats seasonal and perennial allergic rhinitis, while Flovent is approved only for asthma maintenance.

  • Singulair carries a boxed warning for neuropsychiatric side effects; Flovent's main long-term risks involve local and systemic steroid effects like thrush and reduced bone density.

Singulair vs. Flovent Drug Summary

Singulair

Singulair (montelukast) is a leukotriene receptor antagonist that blocks inflammatory chemicals involved in asthma and allergies. It comes as a tablet, chewable tablet, or oral granules taken once daily by mouth. It is also approved for exercise-induced bronchoconstriction and allergic rhinitis, not just asthma.

Flovent

Flovent (fluticasone propionate) is an inhaled corticosteroid used for ongoing maintenance treatment of asthma. It is delivered through a metered-dose inhaler or Diskus twice daily and works by reducing inflammation directly in the airways. Brand-name Flovent was discontinued in 2024 and replaced by authorized generic fluticasone propionate inhalers.

Singulair vs. Flovent Side Effects

Singulair

Most common
Headache (up to 5%)
Cough (up to 5%)
Upper respiratory infection (up to 5%)
Fever (up to 5%)

Flovent

Most common
Headache (up to 3%)
Cough (up to 3%)
Upper respiratory infection (up to 3%)
Throat irritation (up to 3%)

Singulair vs. Flovent Dosage

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

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

Singulair vs. Flovent Indications

Singulair

Singulair is FDA-approved for long-term asthma control, prevention of exercise-triggered breathing problems, and relief of seasonal and perennial allergy symptoms. It is not meant to treat a sudden asthma attack. Its broad approval across both asthma and allergic rhinitis makes it useful for patients managing both conditions with one medication.

  • Long-term asthma prophylaxis and control

  • Prevention of exercise-induced bronchoconstriction

  • Seasonal allergic rhinitis symptom relief

Flovent

Flovent is FDA-approved for the maintenance treatment of asthma in patients four years and older, including those who need oral corticosteroids. It is not a rescue medication and will not stop an asthma attack already underway. Because it works directly in the lungs, it is often used as a first-line controller therapy for persistent asthma.

  • Maintenance asthma treatment ages 4+

  • Asthma in patients needing oral steroids

  • Add-on option for persistent asthma symptoms

Singulair vs. Flovent Pros and Cons

Singulair

Singulair offers a needle-free, once-daily pill that also addresses allergic rhinitis symptoms, making it convenient for patients with overlapping conditions. It carries a boxed warning for serious mood and behavior changes, which some patients and caregivers weigh carefully against its convenience. Insurance coverage and cost vary widely since it is not preferred by all plans.

Pros

  • Oral tablet, no inhaler technique needed

  • Also treats seasonal and perennial allergies

  • Chewable and granule forms for children

  • No local steroid side effects like thrush

Cons

  • Boxed warning for neuropsychiatric side effects

  • Less effective than inhaled steroids for severe asthma

  • Roughly $289 to $375 per month without insurance, before savings programs

  • Not for acute asthma attack relief

Flovent

Flovent works directly in the airways to reduce the underlying inflammation that drives asthma, an approach many guidelines consider central to long-term control. It requires correct inhaler technique twice daily and carries the local and systemic risks common to inhaled steroids. Brand-name Flovent is no longer sold, so patients now use authorized generic versions.

Pros

  • Direct anti-inflammatory action in the lungs

  • Multiple dose strengths for precise titration

  • Roughly $50 to $150 per month without insurance, before savings programs

  • Decades of established use in asthma control

Cons

  • Requires correct inhaler technique twice daily

  • Risk of oral thrush and throat irritation

  • Long-term risk of reduced bone density and growth suppression

  • Brand-name version discontinued, generic only

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