What sets apart Alvesco and Advair? (+3 key differences)

In this article, we will discuss the difference between Alvesco and Advair, the key differences between Advair and Alevsco, FDA-approved clinical uses, mechanisms of action, side effect profiles and withdrawal risks. In addition, how to choose between Alvesco and Advair will also be discussed.  

What sets apart Alvesco and Advair?

Alvesco and Advair are both inhaled medications used to treat asthma. However, both medications differ in their active pharmaceutical ingredients, their mechanisms of action, their FDA-approved uses and action, side effects profile and withdrawal symptoms.

Alvesco is the brand name for a corticosteroid called ciclesonide. It is an inhaled medication used for the opening of airways to treat asthma in individuals older than 12 years (1).

Advair is the brand name for a combination medication. It contains fluticasone propionate, a corticosteroid and salmeterol, a long-acting beta agonist. They are used to treat and manage asthma and chronic pulmonary obstructive disorder (COPD)(2) (3).

FDA-approved clinical uses

Alvesco and Advair are both FDA-approved for the treatment of asthma. However, the specific indications of both these medications differ slightly.

Alvesco, ciclesonide is a corticosteroid that is approved for the treatment of asthma in patients aged 12 or more. It helps with the treatment by reducing airway inflammation. It is a prophylactic treatment therapy. It controls asthma with less suppression of HPA function as compared to similar doses of prednisone (4). 

Advair, a combination medication is used to treat asthma in patients of age 4 or more. In addition to the treatment of asthma, it is also used for the management of COPD, emphysema and chronic bronchitis in patients who are 9 years of age or older (5). 

However, both are used for the treatment of asthma as they both contain corticosteroid that helps with the inflammation of airways.

Mechanism of action

Alvesco, containing ciclesonide works by getting converted into an active metabolite in the lungs as it is inhaled. This metabolite binds to the glucocorticoid receptor as it has anti-inflammatory properties. After binding to the receptor, the metabolite reduces the release and synthesis of inflammatory modulators that help with the inflammation mechanisms (6). 

On the other hand, Advair has two drugs that both work differently to provide relief. Fluticasone propionate is similar in action to ciclesonide. It is a long-term anti-inflammatory drug (7).  However, salmeterol is a long-acting bronchodilator that helps in opening up the airways by dilation of the muscles. It binds to beta-2 adrenergic receptors (8).

Side effect profile

Alvesco and Advair both affect the throat causing hoarseness and throat irritation. Whereas, the side effect profile of Alvesco is generally milder as compared to the side effect profile of Advair. This might be attributed to the single-ingredient formulation of Alvesco and lower systemic exposure (9) (10). 

Side effects Alvesco Advair
Cough Uncommon Common
Nausea Uncommon Common
Trouble breathing Common Common
Skin rash Uncommon Common

This is not a detailed list of the side effects of Advair and Alvesco. The incidence of side effects varies among individuals due to various factors.  


Advair and Alvesco, both require a gradual tapering of doses for a safe and effective treatment strategy. Alvesco may have a lower risk of withdrawal symptoms due to its product nature and lower systemic exposure. 

It is important to withdraw these drugs under the supervision of an experienced healthcare provider. They might suggest you use some alternative medication that may have a lower withdrawal risk before completely stopping either of the two drugs (11) (12). 

Dosage and administration

Alvesco is available in three strengths: 80mcg, 160mcg and 320 mcg. The most commonly used strength is 160mcg commonly required by adults. It is taken once daily through a metered dose inhaler (MDI).

Advair is available in four different strengths: 50/250 mcg, 100/250 mcg, 125/250 mcg and 250/250 mcg. The required dose depends upon the condition of the patient. The most commonly used strength is 100/250 mcg taken twice daily. It is inhaled through a diskus (A dry powder inhaler) or a HFA (hydroflouroalkane inhaler).

How to choose between Advair and Alvesco?

Alvesco and Advair are both used to treat asthma. However, the selection of the drug depends upon multiple factors including the needs of the patient.

  • In case of a mild condition of asthma that is well-controlled, a single daily dose of Alvesco’s long-term anti-inflammatory effect may suffice. It also has a milder side effect profile. 


  • However, if the condition of the patient is serious, there are frequent attacks or persistent inflammation, then your doctor might prescribe you Advair for immediate relief and its long-term control. 

The decision of the selection of the best treatment therapy should be made by your doctor after a discussion on the severity of the condition of the patient.

In my opinion, Alvesco and Advair are both effective treatments for asthma, but there are some significant differences between the two medications. The major differences are the one in the mechanism of action, side effect profile and withdrawal symptoms. Your prescribed medication depends upon your condition and the severity of the symptoms.   


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