Flovent vs Albuterol

Are you wondering which asthma inhaler works best for you — Flovent or albuterol? 

Flovent helps control long-term inflammation in your airways. It reduces swelling over time and keeps asthma from flaring up. But it doesn’t give you quick relief during an attack.

On the flip side, albuterol acts fast. It relaxes the muscles around your airways within minutes, allowing your airway to open, making it easier to breathe when you suddenly feel tight or wheezy. Still, it doesn’t treat the underlying inflammation.

In this article, you will learn how Flovent and albuterol work, when to use each one.

🔑 Key Takeaways ➤ Flovent works by calming the swelling inside your airways over time, while albuterol opens your airways quickly when you need fast relief. ➤ Flovent is taken daily to keep asthma under control, but albuterol is used only when you have sudden breathing trouble or before exercise. ➤ Flovent can start to help within a day, but it usually takes a few weeks to reach its full effect. ➤ Albuterol begins working in just a few minutes and its effects last for about four to five hours. ➤ Long-term use of Flovent may cause mouth irritation, throat soreness, or changes in growth for children. ➤ Albuterol can make your hands shake, cause a fast heartbeat, or give you a headache when you use it. ➤ Flovent costs more because you use it daily, while albuterol is cheaper since you only use it as needed.

Mechanism of Action

Flovent reduces airway inflammation for long-term control, while albuterol quickly relaxes airway muscles for short-term relief.

Flovent 

According to literature, fluticasone, known under the brand name Flovent, works as a corticosteroid with powerful local anti-inflammatory effects. It targets the lungs’ airway tissues directly. How does it do that? It decreases the number of inflammatory cells, such as eosinophils, monocytes, mast cells, macrophages, and dendritic cells. Fluticasone lowers the number of these cells and it also reduces the cytokines they release, calming the inflammatory storm inside the airways.

Moreover, fluticasone increases β2-receptors on the airway smooth muscle, making the muscle more responsive to bronchodilators. This also reduces mucus production from the glands, which is vital because excessive mucus can block the airways. 

Interestingly, different fluticasone types matter. Fluticasone furoate, for example, has higher lipophilicity and tissue permeability compared to fluticasone propionate, meaning it sticks around longer and penetrates deeper in the tissues, even though only half the dose is needed to bind the same number of glucocorticoid receptors.

Albuterol

Albuterol, also called salbutamol, works very differently. It acts on β2-adrenergic receptors, causing the smooth muscles in the bronchial tubes to relax. This relaxation opens the airways, making it easier to breathe during an asthma attack or bronchospasm episode. The drug also blocks the release of immediate hypersensitivity mediators, especially from mast cells, which helps prevent airway tightening and swelling.

Albuterol focuses mainly on the lungs’ β2-receptors, with little impact on β1-receptors (those affecting the heart). This specificity is key because it reduces heart-related side effects. The drug’s rapid action on bronchial smooth muscle makes it ideal for quick relief, not long-term control. 

Unlike fluticasone, albuterol does not reduce inflammation or change the underlying immune response. Instead, it provides immediate, short-term relief by reversing muscle tightness in the airways.

Indications and Uses

Flovent is used daily to control long-term asthma inflammation, while albuterol is used as needed for quick relief during sudden breathing problems.

Flovent

Flovent is an inhaled corticosteroid designed for the maintenance treatment of asthma. This means it’s not for when you’re already having an asthma attack. Instead, it’s taken daily to reduce inflammation in the airways, keeping asthma under control over time. 

Flovent is approved for use in adults and children aged 4 years and older. In fact, some patients who depend on oral corticosteroids may eventually reduce or stop those oral medications by using Flovent regularly.

Note that Flovent does not provide quick relief for sudden breathing problems. 

So, if you or someone you know has an asthma attack, you need a fast-acting bronchodilator like albuterol, not Flovent. For people switching from oral steroids, Flovent offers a way to maintain asthma control while lowering the risks linked to long-term oral steroid use, such as bone loss or adrenal suppression. 

Albuterol

Albuterol is a bronchodilator used to treat or prevent bronchospasm. This happens when the airways in the lungs narrow, making it hard to breathe. Albuterol helps people with asthma or chronic obstructive pulmonary disease (COPD). 

It’s also used to prevent exercise-induced bronchospasm, which is when your airways tighten up during or after exercise. Even children as young as 4 years old can use it. Adults and kids alike take it when they have sudden breathing problems or as a precaution before physical activity.

 The usual dosage is two inhalations every 4 to 6 hours. For exercise prevention, you take two inhalations 15 to 30 minutes before you start. 

However, it’s very important to understand that albuterol does not reduce long-term airway inflammation. It only treats sudden symptoms. If you find yourself needing albuterol more and more often, that’s a warning sign. 

You should talk to your doctor because it could mean your asthma or COPD is getting worse.

Efficacy

Flovent is highly effective for long-term asthma control by improving lung function and reducing symptoms, while albuterol works well for quick, short-term relief but is even more effective when combined with a corticosteroid.

Flovent

A 12-week study tested how well Flovent worked in 304 patients aged 12 and older with moderate asthma. These patients were already using inhaled corticosteroids and beta-agonist bronchodilators. They were divided into groups receiving placebo or Flovent at doses of 100, 250, or 500 micrograms twice daily. In the placebo group, lung function, measured by forced expiratory volume in one second (FEV1), decreased by 0.31 liters. But with Flovent, FEV1 improved by 0.39 L (100 mcg), 0.30 L (250 mcg), and 0.43 L (500 mcg). Each improvement was statistically significant compared to placebo, showing that Flovent helps lungs work better.

Not only that, but fewer patients on Flovent had to leave the study early. 72% of those on placebo were withdrawn due to worsening asthma, while only 13% to 16% of those on Flovent were pulled out. 

This means Flovent helped keep asthma stable and under control. Patients using Flovent also reported fewer symptoms, less need for rescue inhalers, and better scores in both physician and patient assessments. Interestingly, no clear dose-response was seen; the benefits didn’t always increase with higher doses. This suggests that even lower doses of Flovent can provide strong control over asthma.

According to an 8-week study of 627 patients using fluticasone furoate, a related form of Flovent, showed that all tested doses were significantly better than placebo in improving evening pre-dose FEV1. Peak expiratory flow improved across all groups, and there were more symptom-free periods with less need for rescue treatment. Doses under 800 micrograms had a good safety balance, as oral candidiasis (a side effect) was more common only at the highest dose. 

These findings confirm that Flovent improves lung function, reduces symptoms, and offers strong asthma control.

Albuterol 

One study focused on 33 children, aged 6 to 14, who went to the emergency room with acute asthma. The researchers compared albuterol given by nebulizer and by metered-dose inhaler (MDI) with a spacer. They measured things like clinical scores, breathing rates, oxygen levels, and FEV1. 

Surprisingly, they found no difference in how quickly the children improved over a 40-minute period between the two delivery methods. 

This shows that both nebulizers and MDI-spacers work equally well for delivering albuterol in emergencies. However, they did notice that heart rate increased in the nebulizer group but decreased in the MDI-spacer group.

According to another study, the MANDALA Phase 3 trial tested albuterol combined with budesonide versus albuterol alone in adults and children aged 4 years and older with moderate-to-severe asthma. The study found that adding budesonide to albuterol reduced the risk of severe asthma attacks by 28% compared to albuterol alone. Among adults who reported exercise as a trigger, the combination reduced severe attack risk by 43% and lowered the annual severe exacerbation rate by 36%. It even cut the average yearly dose of oral corticosteroids by 52%. 

These findings highlight that while albuterol offers quick relief, combining it with a corticosteroid strengthens protection against future attacks.

According to another study, albuterol’s main strength lies in its fast action during an asthma flare. But pairing it with an anti-inflammatory like budesonide can reduce the overall risk of severe attacks and limit the need for oral steroids. This dual approach—quick bronchodilation plus long-term inflammation control—makes combination rescue inhalers an important tool for patients at higher risk. 

Albuterol alone is excellent for immediate relief, but it lacks the anti-inflammatory effect needed for longer-term control, making combinations more effective in many cases.

Onset and Duration

Flovent starts helping within a day but takes weeks for full effect, while albuterol works in minutes for quick relief but wears off in a few hours.

Flovent

One analysis, which included data from eight clinical trials with 1,461 patients, found that improvements in peak expiratory flow (PEF), asthma symptoms, and reduced albuterol use were seen as early as day one after starting fluticasone. While some effects appear quickly, the full benefit takes longer. For example, they observed the best improvement in PEF and FEV1 within about three weeks. Also, the time to reach 90% of the best observed effect was around 22 days for PEF and less than three weeks for FEV1. 

So, while fluticasone begins helping within a day, patients should know they need to continue treatment consistently to get the full effect over several weeks.

Albuterol

According to literature, albuterol provides a very fast onset of action when inhaled. Inhaled albuterol usually starts working within just a few minutes. 

How does that compare to the oral form? Well, the oral tablets take much longer — about 30 minutes — before you feel the effects. The inhaled form is designed for quick relief during asthma attacks or sudden shortness of breath. 

However, the relief doesn’t last very long. The half-life of inhaled albuterol is around 3.8 to 5 hours, meaning its effects taper off relatively soon, making it useful mainly as a rescue medication. For extended relief, other medications are often needed alongside albuterol.

Side Effects

Flovent’s side effects mostly involve the mouth, bones, hormones, and immune system over long-term use, while albuterol’s side effects mainly affect the nerves, heart, and breathing in the short term.

Flovent 

Flovent has several types of side effects. 

For mouth and throat problems:

• White patches in the mouth or throat (thrush)
• Sore throat
• Trouble swallowing
• Mouth irritation
• Hoarseness or voice changes
  

Eye problems:

• Blurred vision
• Eye pain
• Blindness (rare)
• Redness or discharge of the eye or eyelid
  

Bone and growth issues:

• Bone pain
• Bone fractures
• Growth reduction in children or teenagers
• Decrease in height (long-term use)
  

Hormonal and body changes:

• Excess facial hair in women
• Fullness or roundness of the face, neck, and trunk
• Lack of menstrual periods
• Muscle wasting
• Weight gain
  

Heart and blood pressure:

• Heart problems
• Fast heartbeat
• High blood pressure
  

Immune and allergy reactions:

• Hives
• Skin rash
• Swelling of the face, lips, or eyelids
• Allergic reactions, sometimes life-threatening
  

General body reactions:

• Fever
• Nausea
• Vomiting
• Diarrhea
• Aches and pains
• Headache
• Dizziness
• Unusual tiredness or weakness
  

Mental and mood effects:

• Aggression
• Agitation
• Restlessness
• Mental depression (in overdose cases)
  

Other rare effects include:

• Cough
• Vaginal discharge and itching
• Painful urination

Albuterol 

Here are some of the reported side effects of Albuterol:

Nervous system effects:

• Shakiness or trembling in hands, arms, legs, or feet
• Nervousness
• Restlessness
• Irritability
• Dizziness
• Headache
• Sleeplessness or trouble sleeping
  

Heart and circulatory effects:

• Fast, pounding, or racing heartbeat (tachycardia)
• Palpitations
• Chest tightness
• High or low blood pressure (rare)
  

Respiratory and troat effects:

• Hoarseness
• Cough
• Wheezing
• Difficulty breathing
• Noisy breathing
• Throat irritation
  

Skin and allergy reactions:

• Hives
• Large swelling on the face, lips, tongue, or throat
• Skin rash
• Redness of the skin
  

Digestive and other body effects:

• Nausea
• Muscle cramps
• Back pain
• Taste changes
• Mouth irritation
• Increased appetite (sometimes reported)
  

Rare or severe reactions:

• Chest pain
• Paradoxical bronchospasm (airways tightening instead of opening)
• Hypokalemia (low potassium levels, reported in some studies)
• Hyperglycemia (high blood sugar, reported in some cases)

Cost

Based on Cost Plus Drugs prices, Flovent costs much more because it’s a daily preventive inhaler, while albuterol is far cheaper as a quick-relief medicine used only when needed.

Medication	Dose/Form	Cost at Cost Plus	Retail Price	Savings
Fluticasone Propionate HFA	110 mcg/act, 1 inhaler	$185.03	$227.77	$42.74
Albuterol HFA	90 mcg, 1 inhaler	$27.42	$55.79	$28.37

Flovent 

Flovent is one of the most expensive inhalers they offer. 

For example, a single 110 mcg/actuation inhaler costs about $185, even after savings compared to retail prices. Manufacturing alone costs around $156, with added markup and pharmacy labor raising the total. 

This high price reflects that Flovent is a preventive medication used daily to control inflammation and prevent asthma attacks. The cost may feel steep, but it matches the more complex production process and long-term control benefits.

Albuterol 

On the other hand, Albuterol is much more affordable. A single 90 mcg inhaler costs around $27, which is a big difference compared to Flovent. Manufacturing costs are lower, about $19, and the overall price stays down thanks to simpler production and the fact that it’s a fast-acting rescue medication used only when needed. 

For many families, this makes Albuterol a more budget-friendly option for short-term asthma relief.

Wrap Up

Flovent works in the background, slowly reducing swelling in your airways and keeping symptoms from building up. It’s your daily defense. 

Albuterol, in contrast, is your fast-acting tool for sudden flare-ups. It relaxes tight airway muscles in minutes but doesn’t treat the root cause. If you only rely on albuterol, you’re treating the symptoms, not the problem. That’s why doctors often prescribe both. One controls. The other relieves. 

Still unsure which one you need more? Think about how often you’re reaching for quick relief. If it’s frequent, your long-term control might need attention. 

Frequently Asked Questions

Can I use Flovent during an asthma attack?

No. Flovent is for daily control, not emergencies. Always keep Albuterol on hand for sudden attacks.

Can kids use these inhalers?

Yes. Both are approved for children 4 years and older. Always follow your child’s doctor for dosing and technique.

Do I need to rinse my mouth after Flovent?

Yes. Rinsing and spitting water after each use helps prevent yeast infections (thrush) in your mouth.

Sources

• Remien, K., Patel, P., & Bowman, A. (2024). Fluticasone. In StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK542161/

• Johnson, D. B., Merrell, B. J., & Bounds, C. G. (2024). Albuterol. In StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482272/

• Wolfe, J. D., Selner, J. C., Mendelson, L. M., Hampel, F., Jr., & Schaberg, A. (1996). Effectiveness of fluticasone propionate in patients with moderate asthma: A dose-ranging study. Clinical Therapeutics, 18(4), 635–646. https://doi.org/10.1016/s0149-2918(96)80214-1

• Busse, W. W., Bleecker, E. R., Bateman, E. D., Lötvall, J., Forth, R., Davis, A. M., Jacques, L., Haumann, B., & Woodcock, A. (2012). Fluticasone furoate demonstrates efficacy in patients with asthma symptomatic on medium doses of inhaled corticosteroid therapy: An 8-week, randomised, placebo-controlled trial. Thorax, 67(1), 35–41. https://doi.org/10.1136/thoraxjnl-2011-200308

• Kerem, E., Levison, H., Schuh, S., O’Brodovich, H., Reisman, J., Bentur, L., & Canny, G. J. (1993). Efficacy of albuterol administered by nebulizer versus spacer device in children with acute asthma. The Journal of Pediatrics, 123(2), 313–317. https://doi.org/10.1016/S0022-3476(05)81710-X

• Chipps, B. E., Albers, F. C., Reilly, L., Johnsson, E., Cappelletti, C., & Papi, A. (2021). Efficacy and safety of as-needed albuterol/budesonide versus albuterol in adults and children aged ≥4 years with moderate-to-severe asthma: Rationale and design of the randomised, double-blind, active-controlled MANDALA study. BMJ Open Respiratory Research, 8(1), e001077. https://doi.org/10.1136/bmjresp-2021-001077

• Woodcock, A., Bateman, E. D., Busse, W. W., Lötvall, J., Snowise, N. G., Forth, R., Jacques, L., Haumann, B., & Bleecker, E. R. (2011). Efficacy in asthma of once-daily treatment with fluticasone furoate: A randomized, placebo-controlled trial. Respiratory Research, 12, Article 132. https://doi.org/10.1186/1465-9921-12-132

• Szefler, S. J., Boushey, H. A., Pearlman, D. S., Furlonge, A., Shah, T., & Knobil, K. (1999). Time to onset of effect of fluticasone propionate in patients with asthma. Journal of Allergy and Clinical Immunology, 103(5), 780–788. https://doi.org/10.1016/S0091-6749(99)70416-6