1. EoE cannot be treated with a DPI (dry powder inhaler). You CAN use Flovent HFA (swallowed). You cannot use Flovent Diskus (a DPI). Deposition in the gut is pathetic with the DPI. It's like taking a placebo. Deposition is very good with the HFA formulation if you have good technique. We teach people in clinic how to swallow Flovent.

2. You should continue your inhaled corticosteroid for asthma during the COVID-19 pandemic. Uncontrolled asthma is a risk factor for severe disease/hospitalization with SARS-CoV2 infection. So don't stop Flovent for sure (or at least get 2 meds, ie Flovent HFA swallowed for EoE and another ICS for asthma). For patients who have both asthma and EoE, we often use high dose Flovent, so 220mcg 2 puffs swallowed once daily and 2 puffs inhaled once daily. Saves money.

3. Flonase doesn't work for EoE. You would have to squirt half a bottle and swallow to get close to the fluticasone deposition in the esophagus.

4. Other options that are often less expensive than Flovent HFA: mometasone (generic Asmanex HFA) or budesonide (generic Pulmicort Respules). We use both in EoE regularly with success. Note that all of these are off-label uses. An allergist is more likely to do these options compared to a gastroenterologist.