Flovent, QVAR, Pulmicort, Alvesco, or Asmanex

What is the Best Inhaled Steroid for Asthma?

Flovent, QVAR, Pulmiocrt, Asmanex and Alvesco are inhaled steroids used to control the symptoms of asthma. © Daniel More, MD

Should I Use Flovent, QVAR, Pulmicort, Alvesco, or Asmanex?

Asthma is one of the most common chronic diseases and affects more than 20 million Americans. Asthma usually involves inflammation and swelling of the lining of the airways of the lungs, which irritates the smooth muscle around the lungs. When irritated, this smooth muscle contracts around the airways of the lungs, leading to the symptoms of asthma –- coughing, wheezing, shortness of breath and chest tightness.

What are Inhaled Steroids?

There are two different types of medications that are used to treat asthma -– rescue inhalers and controller therapies. All people with asthma need an as-needed rescue inhaler, such as various brands of albuterol and Xopenex (levalbuterol), which treat the immediate symptoms of asthma by relaxing the smooth muscles around the airways. Most people with asthma, however, also need to take a daily controller therapy to treat the underlying inflammation of the airways. The preferred controller therapy for most people with asthma, according to the National Heart, Lung, and Blood Institute 2007 Guidelines for the Management of Asthma, is an inhaled steroid.

What Inhaled Steroids are Available?

There are a number of inhaled steroids on the market available for the long-term control of asthma symptoms. These include Flovent (fluticasone), QVAR (beclomethasone), Pulmicort (budesonide), Alvesco (ciclesonide) and Asmanex (mometasone).

These are all brand name medications; there are no generic versions available. While these inhaled steroids tend to all work in the same way and have about the same efficacy as one another, there are some subtle differences between these medications that set them apart:

  • Flovent is available in two forms, a metered dose inhaler version, and a diskus version.
  • QVAR has a smaller particle size that is able to get deeper into the lung, which may make this inhaled steroid more efficient at treating asthma. In addition, QVAR is usually one of the lowest-cost inhaled steroids on the market.
  • Pulmicort is the preferred inhaled steroid for use during pregnancy, given its pregnancy category "B" rating.
  • Alvesco has been touted as having less steroid side effects since it is metabolized to its active steroid form inside the lung.
  • Asmanex is indicated for once-daily use, which makes this inhaled steroid convenient to use.

Check with your doctor to see if an inhaled steroid is needed to control your asthma, and which inhaled steroid is best for you.

Find out which medicine is best for the treatment of asthma.


Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma. Accessed January 24, 2016.

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