Breo Ellipta vs. Advair: 6 Things to Consider When Comparing These Inhalers

Asthma inhalers can help reduce daily asthma symptoms, prevent future asthma attacks, and lower the chance of long-term lung damage. But with so many inhalers on the market, it can be confusing to know which one is best for you.

Here, we’ll compare two of the most common long-acting maintenance inhalers: Breo Ellipta (fluticasone / vilanterol) and Advair (fluticasone / salmeterol).

1. Breo Ellipta and Advair contain similar medications

Breo Ellipta and Advair are prescription inhalers that treat asthma. Both of these inhalers help prevent asthma attacks and decrease daily symptoms. Breo Ellipta and one type of Advair inhaler — Advair Diskus — are also approved for chronic obstructive pulmonary disease (COPD).

Both inhalers contain two medications:

1. An inhaled corticosteroid (ICS) to reduce inflammation in the airway. Both inhalers contain fluticasone.

2. A long-acting beta-agonist (LABA) to keep the airways relaxed and open. Breo Ellipta contains vilanterol, while Advair contains salmeterol.

Good to know: Breo Ellipta and Advair aren’t quick-relief (rescue) inhalers. They don’t work for acute flare-ups of asthma or COPD. Instead, you’ll use these inhalers every day, even if you have no symptoms.

2. Breo Ellipta and Advair are approved for different age groups

These inhalers are FDA approved for different age groups, which may determine which one you’re prescribed:

• Breo Ellipta is approved for adults (COPD and asthma) and children ages 5 and older (asthma only).

• Advair Diskus is approved for adults (COPD and asthma) and children ages 4 and older (asthma only).

• Advair HFA is approved for adults and children ages 12 and older (asthma only for all age groups).

3. Breo Ellipta and Advair are similarly effective

When it comes to Breo Ellipta versus Advair, experts consider them similarly effective. Treatment guidelines for asthma and COPD don’t recommend one over the other. Clinical studies comparing Breo Ellipta and Advair also found them similarly effective at improving lung function for people living with asthma or COPD.

However, one real-world study looked at adults who still had asthma symptoms while using Advair. Some people switched to Breo Ellipta while others continued using Advair. After about 6 months, the group who switched to Breo Ellipta had better symptom control, fewer asthma attacks, and felt better about their daily life.

Keep in mind that the best inhaler for you may vary based on your lung function, symptom severity, and other factors. Your healthcare team can help you find the right fit for your needs.

EXPERT PICKS: WHAT TO READ NEXT

• How does asthma differ from COPD? Both lung conditions can cause similar symptoms and some treatments overlap, but there are important differences between COPD and asthma.

• Some medications can cause or worsen breathing problems. Learn about medications that may harm your lungs.

• Is vaping over smoking better for you? Quitting smoking is one of the best things you can do for your lung health. But vaping isn’t a good way to quit cigarettes.

4. Breo Ellipta and Advair have different doses and dosage forms

One important difference between these inhalers is that you use Breo Ellipta once daily, while Advair requires twice-daily doses, spaced 12 hours apart.

The reason for this difference is that the type of fluticasone in Breo Ellipta (fluticasone furoate) lasts longer and is more potent than the type of fluticasone in Advair (fluticasone propionate). This difference is behind Breo Ellipta’s once-daily dosing.

Another important difference is that Advair comes in two different forms, while Breo Ellipta only comes one way. Both Breo Ellipta and Advair Diskus come as dry powder inhalers (DPIs). DPIs contain powdered medication, and the force of your inhalation pulls the dose into your lungs.

But Advair HFA comes as a metered-dose inhaler (MDI). MDIs contain a canister with a propellant. When you press down on the canister, the medication comes out in a spray. You’ll coordinate your breathing with the spray to inhale the medication into your lungs.

Both types of inhalers have pros and cons to consider. Many people find DPIs easier to use than MDIs. This is because DPIs don’t require you to time your breathing with the spray like MDIs do. But in order to use a DPI correctly, you’ll need to take a deep, forceful breath in. For some people, this may be difficult. If this is the case for you, an MDI may be a better option.

5. Breo Ellipta and Advair have similar side effects?

Since Breo Ellipta and Advair contain similar ingredients, their side effects are largely the same. These include:

• Upper respiratory tract infections, such as the common cold

• Thrush (fungal infection of the mouth and throat)

• Hoarseness and voice changes

• Headache

• Dizziness

Rare, but serious side effects are also possible, including:

• Increased potassium and blood sugar levels: Your prescriber may have you go for blood tests from time to time to monitor for these changes.

• More serious lung infections: This includes lower respiratory tract infections, such as pneumonia.

• Heart problems: This could include blood pressure changes, a faster heart rate, or an abnormal heartbeat. If you have an existing heart problem, such as an arrhythmia or high blood pressure, this risk is higher.

• Weaker bones in adults and slowed growth in children: These are possible side effects of oral corticosteroids. They’re less likely with inhaled corticosteroids, but your healthcare team will still monitor for these changes.

• Eye problems: This could include glaucoma, cataracts, or dry eye. If you develop any vision changes while using these inhalers, let your prescriber know right away.

• Paradoxical bronchospasm: This unexpected tightening of the airways makes breathing difficult and requires immediate use of a rescue inhaler, such as albuterol (Ventolin HFA). If this side effect happens and you don’t have a rescue inhaler available, call 911 or go to your nearest emergency room.

6. Breo Ellipta and Advair interact with similar medications

Even though Breo Ellipta and Advair are inhaled into the lungs, they can still interact with oral medications.

Talk to your prescriber before using Breo Ellipta or Advair if you’re taking:

• Beta blockers, such as carvedilol (Coreg)

• Monoamine oxidase inhibitors (MAOIs), such as selegiline (Emsam, Zelapar)

• Tricyclic antidepressants, such as amitriptyline

• Diuretics (water pills), such as furosemide (Lasix)

• Some antifungals, such as ketoconazole

• Some antibiotics, such as clarithromycin

• Some HIV medications, such as ritonavir (Norvir)

This isn’t a complete list of interactions. So be sure to share your updated medication list with your prescriber and pharmacist before starting treatment with an inhaler. They can check for medication interactions and make changes if needed.

Good to know: DPIs like Breo Ellipta and Advair Diskus may contain lactose, a sugar found in cow’s milk. So people with a severe milk protein allergy should avoid these inhalers. Advair HFA doesn’t contain lactose, so it may be a good alternative.

How to save on Breo Ellipta and Advair

There are ways to save on Breo Ellipta and Advair. Both are available as lower-cost generics. GoodRx can help you find ways to save on your prescription.

• Save with manufacturer price caps. GSK, the manufacturer of both Breo Ellipta and Advair, offers these inhalers at no more than $35 per month. This price cap applies to those both with and without insurance (except for those enrolled in Medicaid, Medicare, or Tricare).

• Save with GoodRx. GoodRx can help you save on the cost of generic Advair and Breo Ellipta. The price of generic Advair Diskus is as low as $56.66 at certain pharmacies with a free GoodRx discount. Generic Advair HFA’s cost may be as low as $231.64. And you may pay as little as $226.62 for generic Breo Ellipta.

• Save with patient assistance programs. If you’re uninsured or underinsured, Advair and Breo Ellipta both offer patient assistance programs that offer the medication free of cost to those who qualify.

What are some alternatives to Breo Ellipta and Advair?

Some alternatives to Breo Ellipta and Advair include:

• Symbicort (budesonide / formoterol)

• Breyna (budesonide / formoterol) — a branded generic version of Symbicort

• Dulera (mometasone / formoterol)

• AirDuo (fluticasone / salmeterol)

These combination inhalers all contain a corticosteroid and a LABA. In fact, AirDuo contains the same ingredients as Advair.

Fluticasone (Flovent Diskus, Flovent HFA) and salmeterol (Serevent Diskus) are also available on their own as single-medication inhalers. But using a single combination inhaler is simpler and less expensive than using two separate inhalers in most cases.

Why trust our experts?

Written by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Our editorial standards

Meet our experts