Advair Vs. Breo: What Is The Difference?

In our latest question and answer, the pharmacist discusses the difference between two COPD medications, Advair and Breo.

Feb 17, 2018

Sam asked

I have used Breo for 6 months. i am now traveling and forgot the Breo but I do have Advair from 6 mos ago. Can I use that for 3 days?


While Breo and Advair are similar and contain the same type of medications, they are not considered interchangeable. If you are in a bind and have no access to your prescribed Breo, it may be okay to temporarily substitute Advair but it would be prudent to speak with your doctor first to ensure there are no contraindications for your particular situation. 

Advair - Breo Comparison


Advair is a two-drug combination product which contains:

  • Fluticasone propionate
  • Salmeterol HCl

Fluticasone propionate is classified as a corticosteroid, chemical compounds that mimic the effects of the steroids the body normally makes in the cortex of the adrenal glands. Fluticasone propionate has anti-inflammatory and immunosuppressive effects.

Salmeterol is a long acting agonist at beta-2-adrenergic receptors, also known as a 'LABA'. This means it activates a specific type of receptor that is usually activated by epinephrine (adrenaline). Activation of beta-2-receptors produces different effects depending on where the receptors are. In this case, the location is the lungs, where activation causes smooth muscle relaxation in bronchial passageways, allowing them to dilate, increasing airflow.

The usual dose of Advair is one inhalation twice daily. It is available in strengths (expressed as mcg of fluticasone/mcg of salmeterol) of:

  • 100/50
  • 200/50
  • 500/50

All three strengths are FDA-approved for treatment of asthma in patients 4 years of age and older. The 250/50 strength is also approved for maintenance therapy of chronic obstructive pulmonary disease (COPD).


Breo is very similar to Advair in that it contains an inhaled corticosteroid (fluticasone furoate) and a long acting beta-2-agonist (vilanterol). Although these are different active ingredients from those in Advair, they are the same type of drug, and can be expected to act similarly to one another.

You may notice that while Breo contains fluticasone furoate instead of the fluticasone propionate that is contained in Advair. Although their name is similar, they are two distinct drug molecules. Studies have shown that fluticasone furoate binds more strongly to the site of action (glucocorticoid receptors) than fluticasone propionate. It is unknown if this stronger binding makes it more effective.

Breo is available in two strengths (expressed as mcg of fluticasone/mcg of vilanterol):

  • 100/25
  • 200/50

Both are FDA approved for once-daily treatment of asthma in patients 18 and older. The 100/25 strength is also approved for once-daily maintenance treatment of COPD.


Advair and Breo are very similar medications. Highlights of their differences include:

  • Advair contains fluticasone propionate and salmeterol HCl
  • Breo contains fluticasone furoate and vilanterol
  • Fluticasone furoate binds more strongly to glucocorticoid receptors than fluticasone propionate
  • Advair is dosed twice daily
  • Breo is dosed once daily

Advair and Breo are not considered interchangeable by the FDA. They are however, extremely similar and it is reasonable that one may be substituted for another temporarily if necessary. Be sure to reach out to your doctor to confirm this is safe for you to do in your situation.

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