Arnuity Ellipta alternatives: What can I take instead of Arnuity Ellipta?

Compare Arnuity Ellipta alternatives | Flovent | Pulmicort Flexhaler | Asmanex HFA | Qvar RediHaler | Alvesco | Natural alternatives | How to switch meds

Arnuity Ellipta, the brand name for GSK’s fluticasone furoate inhalation powder, is a prescription medicine approved by the U.S. Food and Drug Administration (FDA) for the control and prevention of asthma in adults and children aged 5 years and older. Arnuity is not used to treat sudden symptoms of asthma. Arnuity Ellipta comes in three different strengths: 50 mcg per inhalation, 100 mcg per inhalation, and 200 mcg per inhalation. It should be taken once a day, at the same time each day.

Arnuity Ellipta is in a class of medicines known as inhaled corticosteroids (ICSs). ICS medicines are anti-inflammatory drugs that help prevent symptoms of asthma by reducing airway inflammation which can make airways more sensitive and more narrow than usual, causing breathing problems. The exact mechanism of how ICSs work for asthma is not known.

While Arnuity Ellipta is an effective treatment for many people, it may not be the best option for all those who have severe asthma symptoms. For various reasons, such as cost, side effect profile, hypersensitivity to the active or inactive ingredients, or difficulties with the use of the inhaler, an alternative ICS may be necessary.

What can I take in place of Arnuity Ellipta?

There are several other ICS inhalers available that contain the same active ingredient (fluticasone) as Arnuity Ellipta but may have slightly different delivery systems. There are also other ICS inhalers containing different corticosteroid drugs. These alternative ICS inhalers share common side effects such as fungal infections (oral thrush), hoarse voice, upper respiratory infections, sinus infections, and headaches. However, some alternatives have additional concerns that should be considered before switching from Arnuity Ellipta.

Other alternatives to Arnuity Ellipta

In addition to corticosteroid inhalers, there are several other classes of asthma inhaler drugs:

• Anticholinergics
  • Spiriva Respimat (tiotropium bromide)
  • Incruse Ellipta (umeclidinium)
• Mast cell stabilizer 
  • Cromolyn sodium
• Long-acting beta agonists (LABAs)  
  • ProAir HFA (albuterol sulfate)
  • Serevent (salmeterol) 
  • Ventolin HFA (albuterol)
• Combination drug inhalers 
  • Advair Diskus and Advair HFA (fluticasone and salmeterol)
  • Anoro Ellipta (umeclidinium and vilanterol)
  • Bevespi Aerosphere (glycopyrrolate and formoterol fumarate)
  • Breo Ellipta (fluticasone furoate and vilanterol) 
  • Dulera (mometasone and formoterol)
  • Stiolto Respimat (tiotropium bromide and olodaterol)
  • Symbicort (budesonide and formoterol)

Although several of the combination drug inhalers include a corticosteroid as one of the components, the additional ingredients may result in different side effect profiles. This article will focus on the single-ingredient inhaled corticosteroids listed in the chart above.

Top 5 Arnuity Ellipta alternatives

The following are some of the most common alternatives to Arnuity Ellipta.

1. Flovent

Flovent HFA and Flovent Diskus both contain fluticasone, the same corticosteroid as Arnuity Ellipta. The difference between the two devices is the HFA has a propellant called hydrofluoroalkane (HFA) that delivers the active drug to the lungs and the Diskus is a powder inhaler and does not use a propellant.

In clinical studies comparing  Flovent Diskus to Arnuity Ellipta, both were found to be equally effective at controlling and preventing asthma symptoms. Arnuity Ellipta is only inhaled once per day whereas both Flovent HFA and Diskus are inhaled twice daily. Flovent HFA and Diskus are approved for use in children as young as four years of age while Arnuity Ellipta is approved for use in children 5 years and older. The side effect profiles are similar for the three drugs and include sore throat, hoarseness, oral thrush, upper respiratory tract infection, headache, sinusitis, and toothache. All are intended to prevent asthma attacks and are not to be used to treat an asthma attack that has already begun.

Unlike Arnuity Ellipta, Flovent HFA has a generic option available called fluticasone propionate HFA which may be a less expensive option. 

2. Pulmicort Flexhaler

Pulmicort Flexhaler contains budesonide as a powder in a hand-held device called a dry powder inhaler (DPI). The medication is delivered to the lungs by inhaling through the device in a strong and steady manner.

The Pulmicort Flexhaler is inhaled twice daily as opposed to Arnuity Ellipta which is only inhaled once per day. Pulmicort Flexhaler is approved for use in children 6 years of age and older while Arnuity Ellipta is approved for use in children as young as 5 years. The side effects are similar for both and include inflammation of the nose and throat, nasal congestion, sore throat, nasal allergies, upper respiratory tract infection, and oral thrush. Both medicines are intended to prevent asthma attacks and are not to be used to treat an asthma attack that has already begun.

3. Asmanex HFA

Asmanex HFA contains mometasone furoate in an aerosol spray inhaler. Asmanex HFA is inhaled twice daily as opposed to Arnuity Ellipta which is only inhaled once per day. Asmanex HFA is approved for use in patients 12 years of age and older while Arnuity Ellipta is approved for use in children as young as 5 years. The side effects are similar for both and include inflammation of the nose and throat, nasal congestion, sore throat, nasal allergies, upper respiratory tract infection, and oral thrush. Both medicines are intended to prevent asthma attacks and are not to be used to treat an asthma attack that has already begun.

4. Qvar RediHaler

Qvar RediHaler contains beclomethasone dipropionate in an aerosol spray inhaler. Qvar RediHaler is inhaled twice daily as opposed to Arnuity Ellipta which is only inhaled once per day. Qvar RediHaler is approved for use in patients as young as 4 years of age while Arnuity Ellipta is approved for use in children as young as 5 years. The side effects are similar for both and include inflammation of the nose and throat, nasal congestion, sore throat, nasal allergies, upper respiratory tract infection, and oral thrush. Both medicines are intended to prevent asthma attacks and are not to be used to treat an asthma attack that has already begun.

5. Alvesco

Alvesco contains ciclesonide in an aerosol spray inhaler. Alvesco is inhaled twice daily as opposed to Arnuity Ellipta which is only inhaled once per day. Alvesco is approved for use in patients 12 years of age and older while Arnuity Ellipta is approved for use in children as young as five years. The side effects are similar for both and include inflammation of the nose and throat, nasal congestion, sore throat, nasal allergies, upper respiratory tract infection, and oral thrush. Both medicines are intended to prevent asthma attacks and are not to be used to treat an asthma attack that has already begun.

Natural alternatives to Arnuity Ellipta

At this time there is no cure for asthma. Any alternative treatments or supplements that claim to cure asthma should be avoided. With that said, some natural therapies may help reduce the symptoms of asthma. Natural relaxation exercises like deep breathing, progressive muscle relaxation, guided imagery, and yoga may help relieve stress that might otherwise lead to an asthma attack.

Although studies on alternative treatments for asthma have been limited, certain diets such as the Mediterranean diet and DASH (Dietary Approaches to Stop Hypertension) diet may help alleviate asthma symptoms by reducing inflammation in the body. Weight loss may improve lung function and avoiding foods that trigger allergies may reduce asthma symptoms. Caffeine is a mild bronchodilator and may help to open airways. It is important to remember that the best treatment for an acute asthma attack is a quick-acting rescue inhaler such as albuterol.

How to switch to an Arnuity Ellipta alternative

Because of the number of different ICS inhaler options, those with asthma may make the decision to switch inhalers. Reasons for changing inhalers include allergic reactions, worsening asthma symptoms, adherence issues, poor inhaler technique, adverse events, patient preferences, and cost considerations. The decision to switch from Arnuity Ellipta to another ICS inhaler should be made in consultation with the prescribing healthcare provider to ensure getting the appropriate medical advice and proper training on the use of the new inhaler.