Spiriva vs. Flovent

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

Key Takeaways

  • Spiriva is a once-daily LAMA bronchodilator for COPD and, in the Respimat form, asthma maintenance in patients 6 and older.

  • Flovent is a twice-daily inhaled corticosteroid used only for asthma maintenance in patients 4 and older, not for COPD.

  • Neither drug relieves sudden asthma or COPD symptoms; both require a separate rescue inhaler for flare-ups.

Spiriva vs. Flovent Drug Summary

Spiriva

Spiriva (tiotropium) is a long-acting muscarinic antagonist that relaxes airway muscles to ease breathing in COPD and, with the Respimat device, asthma. It is inhaled once a day, either as a capsule powder through the HandiHaler or a mist through the Respimat.

Flovent

Flovent (fluticasone propionate) is an inhaled corticosteroid that reduces airway inflammation for long-term asthma control. It is inhaled twice a day using either the HFA aerosol inhaler or the Diskus powder device.

Spiriva vs. Flovent Side Effects

Spiriva

Most common
pharyngitis (up to 12.5%)
sinusitis (up to 6.5%)
headache (up to 5.7%)
constipation (up to 5.1%)

Flovent

Most common
upper respiratory tract infection or inflammation (>3%)
throat irritation (>3%)
sinusitis (>3%)
dysphonia (>3%)

Spiriva vs. Flovent Dosage

Spiriva

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 2.5 mcg once daily At the start
Maximum dose 18 mcg 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

Spiriva vs. Flovent Indications

Spiriva

Spiriva is approved for long-term maintenance of COPD, including chronic bronchitis and emphysema, and for cutting down COPD flare-ups. The Respimat version is also approved for asthma maintenance in people 6 and older. It is not a rescue inhaler and will not stop a sudden attack.

  • COPD maintenance and bronchospasm control

  • Reduces COPD exacerbations

  • Asthma maintenance, ages 6+ (Respimat only)

  • Supports chronic bronchitis and emphysema care

Flovent

Flovent is approved for long-term asthma maintenance in patients 4 and older, including those who need oral corticosteroids alongside it. It comes as an HFA aerosol inhaler or a Diskus powder inhaler. It does not work fast enough to treat a sudden asthma attack.

  • Asthma maintenance, ages 4 and up

  • Add-on for asthma needing oral steroids

  • Available as HFA inhaler or Diskus powder

  • Not for acute asthma attacks

Spiriva vs. Flovent Pros and Cons

Spiriva

Spiriva offers once-daily dosing and covers both COPD and, through the Respimat device, asthma in one product line. It avoids the steroid-related risks that come with inhaled corticosteroids but carries anticholinergic side effects instead.

Pros

  • Only needs to be taken once a day

  • Covers both COPD and asthma (Respimat)

  • Over two decades of real-world use

  • No steroid-related bone or eye risks

Cons

  • HandiHaler form not approved for asthma

  • Can cause dry mouth and constipation

  • May worsen urinary retention in men with enlarged prostate

  • Costs roughly $600 to $630 a month without insurance

Flovent

Flovent directly targets airway inflammation, which is central to asthma control, but it must be inhaled twice daily and carries long-term steroid risks. Since the brand was discontinued in 2024, patients now use authorized or FDA-approved generic fluticasone.

Pros

  • Approved for asthma starting at age 4

  • Low-cost generic versions widely available

  • Multiple strengths allow fine-tuned dosing

  • Directly reduces airway inflammation

Cons

  • Requires inhaling twice every day

  • Can cause oral thrush; rinsing after use is needed

  • Long-term use may reduce bone density or slow growth in children

  • Costs roughly $50 to $150 a month without insurance

Common Symptoms and Related Diseases You Can Explore

Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.