Asmanex and Flovent are not the same medication. They contain different active ingredients and are made by different manufacturers, but they belong to the same drug class (inhaled corticosteroids) and serve the same purpose: long-term asthma control. If your doctor is switching you from one to the other, or if you’re comparing options, the differences are worth understanding.
Different Active Ingredients, Same Drug Class
Asmanex contains mometasone furoate, while Flovent contains fluticasone propionate. Both are corticosteroids designed to reduce inflammation in the airways when inhaled daily, but they are chemically distinct compounds. Think of them as two different medications that do the same job, similar to how ibuprofen and naproxen are both anti-inflammatory painkillers but aren’t identical drugs.
Because they share a drug class, they carry similar benefits and similar risks. Both are controller medications, meaning they prevent asthma symptoms over time rather than providing quick relief during an attack. Neither replaces a rescue inhaler.
How Their Effectiveness Compares
In an eight-week clinical trial of 167 adults and adolescents with moderate persistent asthma, mometasone (Asmanex) taken once daily and fluticasone (Flovent) taken twice daily produced comparable improvements in lung function. The difference in airflow measurements between the two groups was not statistically significant. Physicians rated 62% of the mometasone group as “improved” or “much improved,” compared with 47% of the fluticasone group. Patients also reported higher satisfaction with the Asmanex device, with 47% saying they “liked the inhaler a lot” versus 22% in the Flovent group.
In practical terms, both medications control asthma effectively. The choice between them often comes down to dosing convenience, inhaler preference, insurance coverage, and how well you tolerate each one.
Dosing Frequency
One of the most noticeable differences is how often you use each inhaler. The Asmanex Twisthaler can be taken once daily (in the evening) for many patients, particularly children ages 4 to 11 who use the 110 mcg strength. The Asmanex HFA version, however, is typically used as two puffs twice a day for those 12 and older.
Flovent, in both its metered-dose and dry powder forms, is generally dosed twice daily, with one or two inhalations each time. For people who struggle to remember a second daily dose, the once-daily option with the Asmanex Twisthaler can be a meaningful advantage.
Inhaler Devices and How They Work
Both Asmanex and Flovent come in two device formats: a metered-dose inhaler (the pressurized canister type) and a dry powder inhaler. But the specific devices differ.
- Asmanex Twisthaler: A dry powder inhaler that you activate by twisting the cap. It’s breath-actuated, meaning the powder releases when you inhale forcefully. No propellant involved.
- Asmanex HFA: A standard pressurized metered-dose inhaler.
- Flovent Diskus: A dry powder inhaler with a different design. You slide a lever to load each dose, then inhale.
- Flovent HFA: A pressurized metered-dose inhaler, similar in concept to the Asmanex HFA.
Dry powder inhalers require a stronger, faster breath to pull the medication into your lungs, which can be difficult for very young children or people having a severe flare. Metered-dose inhalers use a propellant to push medication out and work best with a spacer device, which helps more of the drug reach the lungs instead of coating the back of your throat.
Age Approvals
The approved age ranges differ slightly. Asmanex Twisthaler is approved for children 4 and older, while Asmanex HFA is approved for ages 5 and up. Flovent products have historically been approved for children as young as 4 (Diskus) and 4 or older for the HFA version, depending on the strength. If you’re choosing an inhaler for a young child, the specific age cutoff matters and your pediatrician can confirm which options are appropriate.
Flovent’s Discontinuation
An important reason many people are comparing these two medications right now: GlaxoSmithKline stopped producing brand-name Flovent in January 2024. Both Flovent HFA and Flovent Diskus were discontinued. An authorized generic version of fluticasone propionate (the same drug, same device, different label) has been made available, and it’s often less expensive than the brand name was.
If you were on Flovent and your pharmacy can no longer fill it, you have two paths. You can switch to the authorized generic fluticasone inhaler, which is essentially identical to what you were using. Or your doctor may switch you to a different inhaled corticosteroid like Asmanex. Both are reasonable options, but they aren’t interchangeable without a new prescription since the active ingredients and dosing differ.
Side Effects
Because both drugs are inhaled corticosteroids, they share the same general side effect profile. The most common issues are mouth and throat irritation and oral thrush (a yeast infection in the mouth that shows up as white patches). These happen because some of the medication deposits in your mouth and throat instead of reaching your lungs.
You can reduce the risk by rinsing your mouth with water and spitting after every use. If you’re using a metered-dose inhaler version of either drug, a spacer device also helps by catching larger medication particles before they hit the back of your throat. Hoarseness is another possibility with long-term use of any inhaled steroid, though it typically resolves if the medication is stopped or the dose is lowered.
Serious systemic side effects (the kind associated with oral steroids, like bone thinning or immune suppression) are uncommon with inhaled corticosteroids at standard doses because the medication acts locally in the lungs rather than circulating throughout the body.
Switching Between the Two
If your doctor switches you from Flovent to Asmanex (or vice versa), the doses won’t be a one-to-one match. Each medication has its own potency profile, and dose equivalency charts exist specifically to help clinicians convert between different inhaled steroids. You won’t simply take the same microgram number. The Asmanex Twisthaler 220 mcg, for example, delivers 200 mcg of mometasone per puff, which is not equivalent to 200 mcg of fluticasone.
During a transition, pay attention to how well your asthma is controlled in the first few weeks. If you notice more coughing, nighttime symptoms, or increased rescue inhaler use, let your prescriber know so the dose can be adjusted.