Flovent, one of the most commonly prescribed inhaled medications for childhood asthma, is no longer manufactured in the United States.
This preventive medication is usually taken daily to control symptoms in people with asthma.
Dr. Laura Conrad, Attending Physician in the Department of Pulmonary and Sleep Medicine at Children’s Hospital Montefiore Medical Centerdescribes how Flovent was used to treat childhood asthma.
“Flovent is in a class of drugs we call inhaled corticosteroids, commonly referred to as controller treatments,” Conrad told USA TODAY. “These drugs help reduce inflammation in the airways in the lungs of children with asthma. This can reduce the chance of an asthma attack occurring, especially if the child is exposed to asthma triggers such as colds or allergens. It helps prevent.”
GlaxoSmithKline (GSK)The drug company that made the inhaler launched it over the counter on January 1, replacing it with a generic version of fluticasone.
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Generic inhaler option fluticasone is the same as Flovent, pediatricians say
Fluticasone propionate, also known by the trade name Flonase, is a glucocorticoid used to treat asthma, inflammatory pruritic skin disorders, and nonallergic rhinitis. drug bank.
“Fluticasone is a Flovent drug. It’s just a generic version of the same drug,” Conrad said. “It should be a one-for-one exchange. The question arises in terms of what alternative treatments are listed in the insurance prescription for the child. This is where things get a little complicated. ”
Fluticasone is the preferred treatment, but several factors can affect the type of medication your child receives, including insurance coverage, medical history, and severity of asthma symptoms. Some parents give their children other alternative medications to treat asthma, but some say they are not as effective.
Parents respond to finding alternatives
By the end of 2023, doctors began switching patients from Flovent to other drugs. However, some parents expressed concerns about the newly prescribed alternative drugs.
In October 2023, a mother took to TikTok to find answers to her daughter’s questions about the new drug montelukast. Montelukast is a pill used to treat and prevent asthma. According to the Mayo Clinic, this reduces the symptoms and frequency of acute asthma attacks.
“My 4-year-old was prescribed montelukast yesterday,” Daniela Seijas said. post.
“This should help her control her asthma and keep it at bay so she won’t have to use her emergency inhaler as often,” Seijas continued. .
At the time of this post, Seijas said her daughter had been using an emergency inhaler frequently for two weeks.
“In the past she had used Flovent. At this time [her] The doctor didn’t prescribe it for reasons I don’t know. ” she said.
Seijas went online and discovered that Flovent would be discontinued by the end of the year.
“Montelukast has a black box warning,” Seijas said. “So where do we go from here?”
A black box warning is when a serious reaction or side effect that can lead to death or serious injury may occur.
According to , montelukast can cause serious or life-threatening mental health changes while taking this drug or after stopping treatment. medicine plus.
Dr. Conrad explains why pediatricians prescribe this drug to young children with asthma.
“Montelukast is a leukotriene inhibitor and works differently than inhaled corticosteroids. [a pediatrician prescribes] use it, we usually [prescribe] Used as an adjunct to inhaled corticosteroids. At least that’s what asthma guidelines currently recommend. For children with asthma or allergies, it can be a good idea as an additional medication. ” she said. However, since Flovent is not an inhaled corticosteroid, it may not be sufficient to control the child’s asthma, so it may not be a one-for-one exchange with Flovent. ”
Leukotriene inhibitors are another treatment that can be prescribed to patients with exercise-induced asthma and have been reported to be effective in children when oral treatment is preferred over inhaled medications. american family doctor.
Another mother of three who has used Flovent in the past shares her thoughts on TikTok about another alternative drug given to one of her daughters.
She talks about the inhaler Asmanex prescribed to her daughter. Asmanex is used to prevent or reduce the frequency and severity of asthma attacks. drug.com state. Her worried mother questioned the studies that looked at the drug’s side effects.
“So out of 100 people, if my calculations are correct, only one person for whom this drug was tested would fall under that umbrella, and my daughter would fall under that umbrella. And 29% are Black. We can also infer that it is,” my mother said in it. post. “That’s my problem. So aren’t we looking at the side effects and how it affects the children? We’re not looking at whether the children are participating in the study or not? Is that so?”
At the end of her post, the mother mentions the drug Flovent, which she says has worked for all her children.
“The medicine we know is effective and has few side effects, so insurance no longer covers it,” the mother said.
Insurance coverage creates challenges
Not all children prescribed Flovent are prescribed a one-for-one replacement, such as fluticasone, the generic version of Flovent. Dr. Conrad said doctors have many treatment options to choose from, but they shouldn’t recommend all of them.
“Flovent and its generic version fluticasone are delivered through what’s called a metered dose inhaler and are used with a spacer. These pumps are very easy to use for young children,” says Conrad. “However, some formulations include what are called dry powder inhalers or exhalation-actuated pumps, which require you to take a deep breath and then hold your breath to properly deliver the drug to your lungs. But this is not something that young children can really do well.” ”
Dr. Conrad says he needs to see the patient before officially recommending a specific treatment, but he suggests using a nebulizer like Pulmicort if the parents are willing.
Conrad says parents need to stay on top of the process to ensure their children have access to alternative medications without interruption.
“I understand parents’ concerns. This is obviously frustrating and especially at this time of year, in the middle of cold and flu season, when the ideal controller medication is not readily available. “Maybe,” Conrad said. “We encourage parents to notify their doctor immediately if they are having trouble obtaining medication and to work closely with their child’s doctor to develop a plan that is as minimally disruptive as possible for their child’s management. ”
