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Inhaled Steroid Drugs: Summary of Recommendations
Inhaled steroids are effective and safe medicines used to treat people with asthma and chronic obstructive pulmonary (lung) disease, COPD. They reduce and can help prevent inflammation, swelling, and mucus buildup in airways and lungs. By doing so, they keep you breathing easier.

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
best buy Beclomethasone 80mcg inhaler QVAR Low 2 $54
Medium 4 to 5 $108
High4 8 $221
best buy 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
best buy Fluticasone 220mcg Flovent HFA Low 1 $49
Medium 2 $99
High 4 $197
best buy 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.
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
best buy Beclomethasone 80mcg (≥ 5 years) QVAR Low 1 to 2 $27
Medium 3 $54
High6 5 to 6 $81
best buy 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
best buy Fluticasone 110mcg (≥ 12 years) Flovent HFA Low 1 $32
Medium 2 to 3 $99
High 7 $224
best buy 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.

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