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Albuterol vs. fluticasone for managing your asthma

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They’re both effective medications for treating symptoms, and each can play a different role in helping you breathe better
Written by Rosemary Black
Updated on December 8, 2022

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 attack. “With asthma, the airways are chronically inflamed,” explains 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 says.

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,” says Dr. Carr.

Asthma medications do a great job of managing those unpleasant symptoms. The medications fall into 2 types, says Sherry Farzan, MD, an allergist with Cohen Children’s Medical Center in Queens, New York. Rescue medications are one type, and controller medications are the other.

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

Fluticasone is a controller medication for long-term use. In fact, you’re supposed to take it every day in order to keep your air passages healthy. Fluticasone is so effective that your lungs will actually start to work normally again.

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

Recommended reading: Is your asthma medication working hard enough?

How albuterol manages asthma symptoms

Albuterol is a bronchodilator (Proair® HFA, Ventolin® HFA, Proventil® HFA). 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 explains. The best time to use it is when you start coughing, wheezing or feeling short of breath, she notes. After 1 or 2 puffs, your symptoms improve within minutes.

It also wears off quickly, says Dr. Carr. You can expect the effects to wear off after about 4 hours.

You’re not supposed to use it regularly either, notes 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 trouble breathing.

The side effects of albuterol

The most common side effect is feeling jittery, says Dr. Carr. Others include:

  • Racing heart
  • Shaky hands
  • Feeling hyper

The side effects don’t last long, says Dr. Boxer. If you can’t tolerate the side effects, there are other bronchodilators that can work, too. Just mention it to 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 symptoms.

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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, says Dr. Carr. “It prevents the airways from getting tight and twitchy, so the person feels better every day,” she says.

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:

  • A sore throat
  • Hoarseness
  • Headaches
  • 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, notes Dr. Carr. And children who use fluticasone inhalers may grow more slowly, says Dr. Farzan.

Albuterol versus fluticasone. Which one is right for you?

Probably both, says 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.

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, says Dr. Carr. “It’s often given in combination with another airway opener called ipratropium,” she says. “Just like with asthma, these medications wear off quickly.”

If you have moderate or severe COPD, a doctor might add fluticasone in combination with other medications. That might treat frequent flare-ups caused by inflamed air passages, Dr. Carr explains. But it’s not for everyone with COPD, she warns. “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. What a relief!

No matter how you manage your asthma, Optum Perks wants to help you save at the pharmacy. Here’s how it works.

Additional sources:
Asthma medications you inhale: American Academy of Allergy, Asthma & Immunology
Fluticasone facts: Mayo Clinic
All about albuterol: National Library of Medicine