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Spiriva Handihaler vs. Advair

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Spiriva Handihaler and Spiriva Respimat (tiotropium), and Advair (fluticasone / salmeterol), are FDA approved to treat chronic obstructive pulmonary disease (COPD). Spiriva Respimat and Advair are also approved to treat asthma. But they work differently and have some important differences. Spiriva is an anticholinergic medication that relaxes the airways, making it easier to breathe. It’s typically used once daily. Spiriva Handihaler has a generic version available but Spiriva Respimat doesn’t. Advair combines a corticosteroid (fluticasone) that reduces inflammation and a long-acting beta-agonist (salmeterol) that opens airways. There are two versions available (Advair Diskus and Advair HFA). It’s used twice daily usually and there’s generic versions available.

Spiriva

(tiotropium)

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Advair

(fluticasone / salmeterol)

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Summary for Spiriva Handihaler

Prescription only

Spiriva (tiotropium) is a medication used to help control chronic obstructive pulmonary disease (COPD) and asthma. There are two different Spiriva inhalers: Spiriva Respimat is a metered-dose inhaler, and Spiriva HandiHaler is a device that you place a capsule of medication into before you take the medication. The typical dosage for Spiriva (tiotropium) is two inhalations once a day, but the dose depends on the reason you're using it. Side effects include dry mouth, cough, and upper respiratory tract infections. Only Spiriva HandiHaler is also available as a generic version.

Indications for Spiriva Handihaler

  • Chronic obstructive pulmonary disease (COPD)
  • Asthma in people age 6 years and older - Spiriva Respimat only

Pros and Cons for Spiriva Handihaler

Pros

  • Helps prevent attacks or flare-ups
  • Has few side effects
  • Used once daily
  • Doesn't commonly cause a fast heart rate like some other bronchodilators
  • Available as a lower-cost generic (Spiriva HandiHaler only)

Cons

  • Doesn't work fast enough to be used as a rescue inhaler for attacks
  • Can be difficult for some people to use
  • Can cause dry mouth as a side effect
  • Only Spiriva Respimat can be used for asthma in children 6 years and older
  • Spiriva Respimat is currently only available as brand name

Common Side Effects for Spiriva Handihaler

Spiriva HandiHaler and generic

Spiriva Respimat

  • Sore throat (12%)
  • Cough (6%)
  • Dry mouth (4%)
  • Sinus inflammation (3%)

Warnings for Spiriva Handihaler

  • Not a rescue inhaler
  • Allergic reaction
  • Sudden airway tightening (paradoxical bronchospasm)
  • Worsening glaucoma
  • Urination problems
  • Higher risk for side effects in people with kidney problems

Summary for Advair

Prescription only

Advair is a combination inhaler that contains fluticasone (an inhaled corticosteroid) and salmeterol (a long-acting beta agonist, or LABA). Advair Diskus is used for maintenance treatment of chronic obstructive pulmonary disease (COPD) and asthma in adults and children, where as Advair HFA is for asthma only. Advair (fluticasone / salmeterol) is inhaled through the mouth, typically 1 to 2 puffs twice daily. Some common side effects of this medication include upper respiratory tract infection, sore throat, and headache.

Indications for Advair

  • Maintenance treatment of asthma
  • Maintenance treatment of COPD - Advair Diskus 250/50 only

Pros and Cons for Advair

Pros

  • Works well to lower the risk of asthma or COPD symptoms
  • Combines two medications into a single inhaler for convenience
  • Available as two different types of inhalers (Advair Diskus and Advair HFA)

Cons

  • Can cause fungal infections (thrush) in your mouth and throat
  • Advair Diskus contains lactose, so it might not be safe for people with severe milk protein allergies
  • Doesn't replace your rescue inhaler

Common Side Effects for Advair

Advair Diskus:

  • Upper respiratory infection (up to 27%)
  • Sore throat (up to 13%)
  • Headache (up to 13%)
  • Bronchitis (up to 8%)
  • Cough (up to 6%)
  • Nausea and vomiting (up to 6%)
  • Hoarseness (up to 5%)

Advair HFA:

  • Upper respiratory infection (up to 24%)
  • Headache (up to 21%)
  • Throat irritation (up to 9%)
  • Muscle and bone pain (up to 7%)
  • Nausea and vomiting (up to 5%)

Warnings for Advair

  • Not for use in asthma attack or for worsening breathing
  • Fungal infection in the mouth
  • Narrowing of your airways (bronchospasm)
  • Higher risk of infections
  • Altered stress hormone levels
  • Delayed growth in children
  • Eye and vision problems
  • Heart problems
  • Low potassium levels in the blood
  • Allergic reactions

Prices with our coupons for Spiriva Handihaler vs. Advair

Price Card Drug Icon
Tiotropium1 inhaler / 30 capsules of 18mcg per capsule
$76.57$369.84
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Fluticasone/Salmeterol1 diskus inhaler / 250mcg/50mcg
$65.46$314.99
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