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
Flovent
Spiriva vs. Flovent Dosage
Spiriva
Flovent
| 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 |
| 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
| 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
| 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
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