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Advair Diskus vs Symbicort: Which Should You Take?

by The GoodRx Pharmacist on October 6, 2014 at 4:31 pm

Advair Diskus and Symbicort are both maintenance inhalers and often compared—so which one is right for you? You should know that they are both used to treat asthma and COPD, but they also have several differences including active ingredients, directions for use, and insurance coverage.

A quick note about maintenance inhalers:

Both Advair Diskus and the Symbicort metered dose inhaler are maintenance inhalers. They are taken on a daily basis whether or not you have trouble breathing. Advair and Symbicort are NOT to be used for short-term or acute breathing problems such as an asthma attack. You also should NOT skip your maintenance inhaler even if you do not have trouble breathing on a particular day.

How do Advair Diskus and Symbicort work?

Both Advair Diskus and Symbicort are combination drugs that contain a long-acting beta agonist (LABA) and a corticosteroid. The long-acting beta agonists work by relaxing the muscles of the airways within the lungs which leads to easier breathing, while the corticosteroids work to decrease inflammation and swelling in the airways.

What are the active ingredients in Advair Diskus?
Advair Diskus is a combination of the LABA salmeterol and a corticosteroid, fluticasone propionate.

In which strengths and forms is Advair Diskus avaialble?
Advair Diskus is an inhalation powder inhaler that uses foil blister strips containing powder that you breathe in through your mouth. Each dose has a combination of 100 mcg, 250 mcg, or 500 mcg of fluticasone propionate and 50 mcg of salmeterol.

What are the active ingredients in Symbicort?
Symbicort is a combination of the LABA formoterol and a corticosteroid, budesonide.

In which strengths and forms is Symbicort avaialble?
Symbicort is a metered dose inhaler (MDI), the most common type of inhaler. MDIs are pressurized, and deliver a certain amount of medication using a propellant each time you use the inhaler. Each dose of Symbicort has a combination of 80 mcg or 160 mcg of budesonide and 4.5 mcg of formoterol.

So what is the difference between the MDI and Diskus inhalers?

The metered dose inhaler (Symbicort) uses a propellant or mechanism to help disperse the medication so that the liquid particles get into the lungs. The powder for inhalation in the Advair Diskus, on the other hand, does not use a propellant, but rather relies on your ability to inhale the powdered medication in order to get it into your lungs.

How long will it take for Advair Diskus or Symbicort to begin working?
Advair Diskus may begin working within 30 – 60 minutes and Symbicort may begin working within 15 minutes, although results may vary in both cases. Symbicort may begin working more quickly for COPD patients.

What are the advantages of using Symbicort MDI?

  • The MDI is a traditional inhaler and inhalation technique
  • It can be used with a spacer
  • All strengths are indicated for the treatment of asthma and COPD

What are the disadvantages of using Symbicort MDI?

  • It is only indicated for use in patients 12 years and older
  • Hand-breath coordination is required when using a traditional inhaler, which can be troublesome for a new asthma patient
  • Please take a look at the Symbicort website for guidance on how to use the MDI inhaler properly

What are the advantages of using Advair Diskus?

  • Hand-breath coordination is not necessary—you do not need to be able to depress the canister and inhale at the same time
  • The inhaler does not need primed before using or between prolonged periods of usage
  • It is indicated for use in patients 4 years and older
  • It is also indicated for the treatment of asthma and COPD

What are the disadvantages of using Advair Diskus?

  • Advair 250/50 is the only strength indicated for the treatment of COPD
  • Once taken out of the foil package it must be used within 1 month
  • It cannot be used with a spacer
  • The initial instructions for use may be challenging if you have never used a Diskus for inhalation before
  • Please take a look at the Advair Diskus website for the guidance on how to use the Diskus inhaler properly

Is there a price advantage to using either Advair Diskus or Symbicort?

Depending on your pharmacy and dosage, there may not be much of a difference. However, the most common dosage of Symbicort (160/4.5, 120 doses) is slightly less expensive than the most common dosage of Advair Diskus (250/50) if you are paying out-of-pocket.

If your insurance benefits are provided by either Caremark or Express Scripts, please check out our article on the 2015 formulary changes regarding both of these medications, and check with your individual plan as your coverage may be different.

If you are covered, keep in mind that cash or coupon prices don’t reflect your co-pay. It’s always best to check with your insurance first to see if your prescription is covered and what they expect you to pay.

Whether or not you have insurance, the manufacturers of both Advair and Symbicort offer savings programs that may be helpful. You can find the Advair program here, and the Symbicort program here.

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