Flovent asthma inhaler discontinued, parents seek alternatives

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Flovent, one of the most commonly prescribed childhood asthma inhalers, is no longer being manufactured in the United States.

This preventative medication is usually taken every day to help keep an asthma patient’s symptoms under control.

Dr. Laura Conrad, an attending Physician in the Division of Respiratory and Sleep Medicine at Children’s Hospital at Montefiore Medical Center, explains how Flovent was used to treat childhood asthma.

“Flovent is in the class of medications that we call inhaled corticosteroids, which we commonly referred to as controller medications,” Conrad told USA TODAY. “These medications help to reduce inflammation in the airways of the lungs of children with asthma. This helps to prevent asthma attacks from happening, particularly when children are exposed to asthma triggers such as the common cold or allergens.”

GlaxoSmithKline (GSK), the pharmaceutical company that manufactured the inhaler, took if off the shelves on Jan. 1 and replaced it with a generic version, Fluticasone.

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Generic inhaler option Fluticasone is same as Flovent, a pediatrician says

Fluticasone Propionate, also known by the brand name Flonase, is a glucocorticoid used to treat asthma, inflammatory pruritic dermatoses, and nonallergic rhinitis, according to Drug Bank.

“Fluticasone is the medication in Flovent. It’s just the generic version and the same medication,” Conrad said. “It should be a one-for-one swap. The issue arises in what alternative therapies are listed on the formularies for insurance for the children. This is where things get a little bit more complicated.”

Although Fluticasone is the preferred medical treatment, some factors like insurance coverage, medical history and severity of asthma symptoms can play a role in the type of medication children will receive. Some parents say their children are given other alternative medicines to help with their asthma that don’t work as effectively.

Parents react to finding alternatives

By the end of 2023, doctors began to switch their patients from Flovent to other medications. However, some parents expressed their concerns with the newly prescribed alternatives. 

In October 2023, one mom took to TikTok to find answers to her questions about her daughter’s new medication, Montelukast. Montelukast is tablet used to treat and prevent asthma. It will decrease the symptoms and the number of acute asthma attacks, the Mayo Clinic said. 

“My four-year-old was prescribed yesterday Montelukast,” Daniela Seijas said the post. 

“This is supposed to like help her control her asthma and keep it at bay, so that way she doesn’t have to use her rescue inhaler so often,” Seijas continued.

At the time of the post, Seijas said her daughter had used her rescue inhaler often during a two week period. 

“In the past she has used Flovent. This time [her] doctor, I don’t know why, didn’t prescribe it.” she said.

When Seijas went online, she saw that Flovent was being discontinued by the end of the year. 

“Montelukast has a black box warning,” Seijas said. “So where do you go from here?” 

A black box warning is when a serious or adverse reactions can occur, leading to death or serious injury. 

Montelukast may cause serious or life-threatening mental health changes while you are taking this medication or after treatment has stopped, according to MedicinePlus. 

Dr. Conrad explains why a pediatrician might prescribe this medication to a young child with asthma.

“Montelukast is a leukotriene inhibitor it works differently than the inhaled corticosteroid. When [a pediatrician prescribes] use it, we generally [prescribe] it as an adjunct to an inhaled corticosteroid. At least that’s how the asthma guidelines recommend using it at this time,” she said. “It can be a good idea additional medication for children who have asthma and allergies. But it may not be a one-for-one swap with Flovent because it’s not an inhaled corticosteroid may not be enough to control that child’s asthma.”

Leukotriene inhibitors is another treatment patients can be prescribed if they have exercise-induced asthma or benefit children when oral therapy is preferred to inhalers, according to the American Family Physician.

Another mom, who has three children that have used Flovent in the past, shares her thoughts on TikTok about a different alternative medication one of her daughters was given.

She discusses Asmanex, the inhaler her daughter was prescribed. Asmanex, is used to prevent or reduce the frequency and seriousness of asthma attacks, Drugs.com states. The concerned mom raised questions about a study that tested side effects for the medication.

“So out of 100 people, if I’m doing my math right only one person that this medication was tested on would fit under the umbrella, my daughter would fit under that umbrella, and that’s even guessing that 29% were black.” the mom said in the post. “That’s my issue. So are we not looking at side effects and how they affect our kids? Are we not checking to make sure that our children are part of the study?”

The mom ends the post referencing Flovent, a medication she says worked for all of her children.

“The medication that we know has been working and the side effects are low, insurance stops covering,” the mom said.

Insurance coverage creates challenges

Children who were prescribed Flovent are not all being prescribed a one-to-one swap like the generic to Flovent, which is Fluticasone. Dr. Conrad says there are many treatment options doctors can choose from, but not all of them should be recommended.

“Flovent and its generic version Fluticasone are delivered via something called a metered dose inhaler, and it’s used with a spacer. These pumps are very easy to use for young children,” Conrad says. “However, some formularies have what we call dry powder inhalers or breath actuated pumps. These require taking a deep breath and holding your breath after to appropriately deliver that medicine to the lungs, which is not something that young children are really able to perform well.”

Although Dr. Conrad would have to see a patient to formally recommend a specific treatment, she suggests that if parents are willing, to use a nebulizer like Pulmicort.

Conrad says that parents need to stay on top of the process in order to make sure their children get an alternative medication without any disruptions.

“I totally understand parents’ concern. This is obviously frustrating, and it can be worrisome to not have your ideal controller medication readily accessible, especially this time of year when we’re in the middle of cold and flu season,” Conrad said. “I would recommend for parents to notify their doctor as soon as they’re having issues obtaining their medication and to work closely with their child’s doctor to develop a plan that will be the least disruptive as possible to their child as management.”



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