Inhaled Steroid Drugs: Summary of Recommendations
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Not everyone with asthma or COPD needs an inhaled steroid. Sometimes, lifestyle adjustments (and especially quitting smoking) work well enough that you won’t need one. On the other hand, far too many people who could benefit from an inhaled steroid are not using one. If your asthma symptoms are persistent and you have frequent asthma attacks, you should be using an inhaled steroid.
Taking effectiveness, safety, dosing convenience, and cost into account, we have chosen the following steroid inhalers as Consumer Reports Best Buy Drugs for treating adult and childhood asthma and adult COPD:- Beclomethasone (QVAR) 80mcg— for adults and children age 5 and over with asthma
- Budesonide (Pulmicort Turbuhaler) 200mcg — for adults with asthma who may prefer a dry powder inhaler and for children with asthma age 6 and over
- Fluticasone (Flovent HFA) 110mcg — for children with asthma age 12 and over
- Fluticasone (Flovent HFA) 220mcg — for children age 12 and over and adults with asthma, and for adults with moderate to severe COPD
- Mometasone (Asmanex Twisthaler) 220mcg — for adults with asthma
All of these medicines at the specified doses are as effective and safe as other inhaled steroids, and well priced compared to them. None of them currently are available as generics, so they can be pricey. For example, if you need a high dose—usually because your asthma or COPD is severe—the cost can be more than $200 or even $300 a month. In this case, talking with your doctor about the most affordable inhaled steroid becomes even more important.
Inhaled Steroids: Drug Comparison
| CR Best Buy | Recommendations: Inhaled Steroids - Adults | |||||
| Generic Name and Dose | Brand Name | Use1 | Puffs Per Day2 | Average Monthly Cost3 | Compare Prices | |
| Beclomethasone 40mcg | QVAR | Low | 4 | $87 |  |
|
| Medium | 9 | $194 | ||||
| High4 | 16 | $347 | ||||
 |
Beclomethasone 80mcg inhaler | QVAR | Low | 2 | $54 | |
| Medium | 4 to 5 | $108 | ||||
| High4 | 8 | $221 | ||||
|
Budesonide 200mcg | Pulmicort Turbuhaler | Low | 2 | $55 | |
| Medium | 4 to 5 | $110 | ||||
| High | 8 | $138 | ||||
| Flunisolide 250mcg | AeroBid | Low | 3 | $83 | |
|
| Medium | 6 | $168 | ||||
| High4 | 11 | $307 | ||||
| Flunisolide 250mcg | AeroBid-M (menthol flavored) | Low | 3 | $83 | |
|
| Medium | 6 | $166 | ||||
| High4 | 11 | $304 | ||||
| Fluticasone 44mcg | Flovent HFA | Low | 4 | $93 | |
|
| Medium | 10 to 11 | $231 | ||||
| High | 19 | $440 | ||||
| Fluticasone 110mcg | Flovent HFA | Low | 1 to 2 | $32 | |
|
| Medium | 4 | $64 | ||||
| High | 8 | $128 | ||||
|
Fluticasone 220mcg | Flovent HFA | Low | 1 | $49 | |
| Medium | 2 | $99 | ||||
| High | 4 | $197 | ||||
|
Mometasone 220mcg inhaler (120 puffs per inhaler)5 | Asmanex Twisthaler | Low | 1 | $27 | |
| Medium | 2 | $54 | ||||
| High | 3 | $80 | ||||
| Triamcinolone 100mcg | Azmacort | Low | 7 | $124 | |
|
| Medium | 15 | $267 | ||||
| High4 | 20-25 | $445 | ||||
(1) The range of low to high use is from the National Asthma Education and Prevention Program (NAEPP) Expert Panel. We use the mid-point of low and medium dosing ranges and an approximation of a reasonable dose in the high dosing range to further classify the number of puffs per day and average monthly cost.
(2) The number of puffs per day reflects the mid-point or a reasonable estimate based on the NAEPP dosing categories.
(3) Prices reflect nationwide retail average for December 2005, rounded to the nearest dollar. This information is derived by Consumer Reports Best Buy Drugs from data provided by Wolters Kluwer Health, Pharmaceutical Audit Suite.
(4) This dosing exceeds the manufacturer’s highest recommended dose, but is consistent with the NAEPP Expert Panel’s classification of a high dose.
(5) This drug comes in an inhaler programmed to deliver a specified number of puffs.
(2) The number of puffs per day reflects the mid-point or a reasonable estimate based on the NAEPP dosing categories.
(3) Prices reflect nationwide retail average for December 2005, rounded to the nearest dollar. This information is derived by Consumer Reports Best Buy Drugs from data provided by Wolters Kluwer Health, Pharmaceutical Audit Suite.
(4) This dosing exceeds the manufacturer’s highest recommended dose, but is consistent with the NAEPP Expert Panel’s classification of a high dose.
(5) This drug comes in an inhaler programmed to deliver a specified number of puffs.
| CR Best Buy | Inhaled Steroids - Children | |||||
| Generic Name & Strength (Approved Ages)1 | Brand Name | Dose2 | Puffs Per Day3 | Average Monthly Cost4 | Compare Prices | |
| Beclomethasone 40mcg (≥ 5 years) | QVAR | Low | 3 | $72 | |
|
| Medium | 6 | $130 | ||||
| High6 | 11 | $238 | ||||
|
Beclomethasone 80mcg (≥ 5 years) | QVAR | Low | 1 to 2 | $27 | |
| Medium | 3 | $54 | ||||
| High6 | 5 to 6 | $81 | ||||
|
Budesonide 200mcg (≥ 6 years) | Pulmicort Turbuhaler | Low | 1 to 2 | $28 | |
| Medium | 3 | $83 | ||||
| High6 | 5 to 6 | $166 | ||||
| Budesonide 0.25mg/2ml (1-8 years) | Pulmicort Respules5 | Low | 2 | $354 | |
|
| Medium | 4 | $708 | ||||
| High6 | 8 | $1,416 | ||||
| Budesonide 0.5mg/2ml | Pulmicort Respules5 | Low | 1 | $208 | |
|
| Medium | 2 | $416 | ||||
| High6 | 4 | $832 | ||||
| Flunisolide 250mcg (≥ 6 years) | AeroBid | Low | 2 to 3 | $56 | |
|
| Medium | 4 to 5 | $84 | ||||
| High6 | 7 to 8 | $195 | ||||
| Flunisolide 250mcg (≥ 6 years) | AeroBid-M (menthol flavored) | Low | 2 to 3 | $55 | |
|
| Medium | 4 to 5 | $83 | ||||
| High6 | 7 to 8 | $193 | ||||
| Fluticasone 44mcg (≥ 12 years) | Flovent HFA | Low | 3 | $69 | |
|
| Medium | 7 | $162 | ||||
| High | 13 | $301 | ||||
|
Fluticasone 110mcg (≥ 12 years) | Flovent HFA | Low | 1 | $32 | |
| Medium | 2 to 3 | $99 | ||||
| High | 7 | $224 | ||||
|
Fluticasone 220mcg (≥ 12 years) | Flovent HFA | Low | 1 to 2 | 49 | |
| Medium | 3 | $98 | ||||
| Triamcinolone 100mcg (≥ 6 years) | Azmacort | Low | 6 | $107 | |
|
| Medium | 10 | $178 | ||||
| High6 | 18 | $320 | ||||
(1) Ages approved by the Food and Drug Administration.
(2) The range of low to high use is from the National Asthma Education and Prevention Program (NAEPP) Expert Panel. We use the mid-point of low and medium dosing ranges and an approximation of a reasonable dose in the high dosing range to further classify the number of puffs per day and average monthly cost.
(3) The number of puffs per day reflects the mid-point or a reasonable estimate for the NAEPP dosing categories.
(4) Prices reflect nationwide retail average for January 2008, rounded to the nearest dollar. This information is derived by Consumer Reports Best Buy Drugs from data provided by Wolter Kluwer Health, Pharmaceutical Audit Suite®.
(5) This drug is packaged in a nebulizer, an alternative type of inhaler.
(6) This dosing classification exceeds the manufacturer's highest recommend dose, but is consistent with the NAEPP Expert Panel Report's classification of a high dose.
(2) The range of low to high use is from the National Asthma Education and Prevention Program (NAEPP) Expert Panel. We use the mid-point of low and medium dosing ranges and an approximation of a reasonable dose in the high dosing range to further classify the number of puffs per day and average monthly cost.
(3) The number of puffs per day reflects the mid-point or a reasonable estimate for the NAEPP dosing categories.
(4) Prices reflect nationwide retail average for January 2008, rounded to the nearest dollar. This information is derived by Consumer Reports Best Buy Drugs from data provided by Wolter Kluwer Health, Pharmaceutical Audit Suite®.
(5) This drug is packaged in a nebulizer, an alternative type of inhaler.
(6) This dosing classification exceeds the manufacturer's highest recommend dose, but is consistent with the NAEPP Expert Panel Report's classification of a high dose.
Download- Full Report (285k PDF)
- 2–Page summary (373k PDF)
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