Albuterol vs. fluticasone for managing your asthma

If you’ve had an asthma attack, you know how scary it can feel. Your chest gets tight. You can’t get enough air, no matter how hard you breathe. You start to wheeze and cough.

Anything can set off an asthma attack. “With asthma, the airways are chronically inflamed,” explained Tara F. Carr, MD. She’s an allergy specialist and an associate professor of medicine at the University of Arizona College of Medicine in Tucson. That makes your airways hypersensitive to pollen, dust, smoke, and other irritants, she said.

Once something triggers a reaction in your airways, the muscles surrounding them get narrower. “This causes shortness of breath, heaviness of the chest, wheezing and coughing,” said Dr. Carr.

Asthma medications do a great job of managing those unpleasant symptoms. The medications fall into two types, explained Sherry Farzan, MD, an allergist with Cohen Children’s Medical Center in Queens, New York: rescue medications and controller medications.

Albuterol is a rescue medication. Rescue medications offer quick relief so that you can breathe easier. They’re for short-term relief.

Fluticasone is a controller medication. Typically, you take a controller asthma medication daily and use it long term to keep your air passages healthy and open. Fluticasone is so effective that your lungs may actually start to work normally again.

Chances are your doctor will recommend that you use both albuterol and fluticasone to control your asthma symptoms. Here’s what you should know about each of them, including their side effects.

How albuterol manages asthma symptoms

Albuterol (Proair HFA, Ventolin HFA, Proventil HFA) is a bronchodilator. It comes in a powder or liquid form inside an inhaler. Once you breathe in the medication, it relaxes the muscles surrounding the air passages to your lungs, Dr. Farzan explained. The best time to use albuterol is when you start coughing, wheezing or feeling short of breath, she noted. After 1 or 2 puffs, your symptoms should improve within minutes.

Albuterol also wears off quickly, said Dr. Carr. You can expect its effects to wear off after about 4 hours.

You’re not supposed to use albuterol regularly, noted Mitchell Boxer, MD. He’s an asthma specialist at Northwell Health in New Hyde Park, New York. People generally use it before they come into contact with an allergy trigger that sets off their symptoms. You can also take albuterol 15 to 30 minutes before exercising to avoid difficulty in breathing.

Need a prescription or refill? You can get discreet and expert on-demand care in as little as 15 minutes. For $29, answer a few questions online and get a treatment plan from a US-licensed healthcare professional. Get started here.

The side effects of albuterol

The most common side effect of albuterol is feeling jittery, said Dr. Carr. Other albuterol side effects include:

• racing heart
• shaky hands
• feeling “hyper”

The side effects don’t last long, added Dr. Boxer. If you can’t tolerate the side effects of albuterol, there are other bronchodilators that can work, too. Discuss this with your doctor.

Also, a word of warning from Dr. Carr, “If you use albuterol too long or too often, eventually, it won’t work as well on your asthma symptoms.”

How fluticasone manages asthma symptoms

Fluticasone (Flovent) is in a class of medications called corticosteroids. These anti-inflammatory steroids reduce inflammation brought about by asthma, said Dr. Carr. “It prevents the airways from getting tight and twitchy, so the person feels better every day,” she said.

This asthma medication comes in an aerosol form that you breathe in through an inhaler. It’s meant to be used every day, even twice a day. You need fluticasone to control your asthma over the long term.

The side effects of fluticasone

The most common side effects, which are rare, include:

• sore throat
• hoarseness
• headache
• oral thrush (a fungal infection in the mouth)

To prevent a sore throat or thrush, rinse out your mouth after inhaling fluticasone, these doctors suggest.

Rarer side effects include thinning hair or weight gain. Usually, that happens to people who take high doses of fluticasone for a long time, noted Dr. Carr. And children who use fluticasone inhalers may grow more slowly, said Dr. Farzan.

Albuterol versus fluticasone. Which one is right for you?

Probably both, said Dr. Carr. But it depends on how severe your asthma is.

If your asthma just acts up occasionally, you may need to use albuterol only when you feel symptoms coming on. If you have asthma attacks regularly, you’ll need fluticasone every day to prevent symptoms, plus albuterol as needed.

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.

Will these medications work for people with COPD?

When you have chronic obstructive pulmonary disorder (COPD), you have long-term lung damage. Breathing becomes a chronic problem because your lungs can’t move air in and out normally. If you start to wheeze, albuterol can help, explained Dr. Carr. “It’s often given in combination with another airway opener called ipratropium,” she said. “Just like with asthma, these medications wear off quickly.”

If you have moderate or severe COPD, your doctor might prescribe fluticasone in combination with other medications. That might treat frequent flare-ups caused by inflamed air passages, Dr. Carr explained. But it’s not for everyone with COPD, she cautioned. “A medication like fluticasone could increase the risk of pneumonia.”

Whether you have asthma or COPD, it makes sense to ask your doctor about albuterol and fluticasone. Used together or alone, you’ll breathe easier.