Advair vs. Symbicort: 8 Ways These Popular Asthma and COPD Inhalers Compare
Key takeaways:
Advair (fluticasone / salmeterol) and Symbicort (budesonide / formoterol) are FDA-approved inhalers that treat asthma and chronic obstructive pulmonary disease (COPD). They each come as brand-name and generic products.
Advair and Symbicort are both first-choice medications when an inhaled steroid alone isn't enough to manage asthma. But Symbicort is sometimes considered the preferred product. Either medication might be used for COPD.
Advair and Symbicort have similar risks and side effects overall. This is because they contain the same types of medications: an inhaled steroid and a long-acting bronchodilator.
Access savings on related medications
Table of contents
Asthma and chronic obstructive pulmonary disease (COPD) have distinct causes and often affect different age groups. But they both can cause wheeziness — making you feel like you can’t catch your breath. So it makes sense that some medications work well for both conditions.
Advair (fluticasone / salmeterol) and Symbicort (budesonide / formoterol) are prescription medications that treat asthma and COPD. They’re combination inhalers that contain two active ingredients: an inhaled corticosteroid (ICS) and a long-acting beta agonist (LABA). This duo helps keep air flowing freely in your lungs when one medication isn’t enough.
While Advair, Symbicort, and other combination inhalers are treated as alternatives to each other in some cases, their specific ingredients and dosages are different. They’re also available in several forms, each with slightly different uses. Here are the top eight ways that Advair and Symbicort stack up.
1. Advair and Symbicort both work to improve breathing
Advair and Symbicort contain similar active ingredients. Their effects are comparable overall.
ICS medications like fluticasone and budesonide decrease inflammation in your lungs. LABAs like salmeterol and formoterol help relax the airways around your lungs. The combination makes it easier to breathe when one medication alone isn’t enough.
Do Advair or Symbicort work for flare-ups?
Advair and Symbicort are maintenance medications. They support well-managed breathing over time. For a breathing emergency or flare-up of symptoms, rescue inhalers like albuterol (Ventolin HFA) are generally better choices.
Chronic obstructive pulmonary disease (COPD) vs. asthma: Read on to discover the main differences between these common breathing conditions.
Finding quick relief: Explore the available options for rescue inhalers and find out which one might be right for you.
Hard to breathe during allergy season? Here’s what to know about allergic asthma.
That being said, Symbicort is sometimes prescribed off-label as a reliever medication to treat flare-ups too. In fact, asthma treatment guidelines recommend this use in certain situations. Advair isn’t recommended for flare-ups because it’s not fast-acting.
2. Available dosage forms slightly differ between Advair and Symbicort
Symbicort and Advair HFA are both available as metered-dose inhalers (MDIs). These L-shaped canisters contain a chemical called hydrofluoroalkane (HFA) — a propellant that pushes the medicine into your mouth and lungs. The inhalers need to be primed before being used for the first time or if there’s a long period between uses. If you have a hard time using an MDI, a device called a spacer can help make it easier.
Advair is also available in another form. Advair Diskus is a dry powder inhaler (DPI) that comes in a disc-shaped device. To use this inhaler, you move a lever to release the medication, breathe in quickly and deeply, and then hold your breath. If you can’t take a quick, deep breath, then Advair Diskus might not be the right inhaler for you.
3. Advair and Symbicort are approved for different groups
Advair Diskus and Symbicort are FDA approved to manage asthma and COPD over time. Advair HFA, however, is only approved for asthma.
Advair and Symbicort are safe to give to kids with asthma, but they’re approved for slightly different age groups:
Advair Diskus: 4 years and older
Symbicort: 6 years and older
Advair HFA: 12 years and older
COPD rarely occurs in children.
Good to know: If you have a dairy allergy, ask your healthcare professional if Advair Diskus is safe for you. Its formulation contains trace amounts of milk.
4. Advair and Symbicort have distinct doses
These inhalers come in several dosages. Here’s a summary of dosages your healthcare professional may recommend.
Inhaler | Doses | Instructions for use |
|---|---|---|
Symbicort (and generic versions: Breyna and budesonide and formoterol fumarate dihydrate) | 80 or 160 mcg of budesonide with 4.5 mcg of formoterol | |
Advair HFA | 45, 115, or 230 mcg fluticasone with 21 mcg of salmeterol | |
Advair Diskus (and generic versions: Wixela Inhub and fluticasone propionate and salmeterol) | 100, 250, or 500 mcg of fluticasone with 50 mcg of salmeterol | 1 puff twice daily |
In general, lower dosages are used to treat asthma in children younger than 12 years old. Asthma dosages for people 12 and older depend on the severity of symptoms.
For COPD, higher inhaler strengths are recommended as starting doses.
Good to know: A medication similar to Advair, called Airduo RespiClick, also exists. It contains the medications fluticasone and salmeterol.
5. Advair and Symbicort improve breathing in similar ways
Advair and Symbicort are both first-choice asthma medications for people who need more than a steroid-only inhaler. But Symbicort is sometimes preferred over Advair because it can double as a rescue inhaler, providing quick relief when needed.
Some research even suggests that Symbicort is more effective for asthma. But other studies looking at real-world data find that Advair and Symbicort are similarly effective. The most effective maintenance breathing treatment for you is the one you take consistently. So regardless of which inhaler you use, be sure to follow your prescription’s instructions every day.
For COPD, inhalers like Advair and Symbicort aren’t generally first-choice options. Your healthcare professional might recommend one of them for you if you’re having frequent breathing flare-ups in addition to higher levels of eosinophils — a type of white blood cell linked to inflammation. Research shows Advair and Symbicort work just as well for COPD. Health experts don’t prefer one inhaler over the other for this purpose.
6. Advair and Symbicort have a comparable safety record
Advair and Symbicort have similar safety profiles. There aren’t any big differences here.
For instance, one large review published in 2023 compared different ICS-LABA combination inhalers for asthma. Seven of the studies covered in the review directly compared the safety of the ingredients used in Advair and Symbicort. They found no significant differences in safety.
However, some research shows that fluticasone — the steroid ingredient in Advair — might have a higher risk of pneumonia in people with COPD. A healthcare professional can help you weigh this risk when choosing which inhaler is right for you.
7. Their common side effects aren’t much different
Inhaled medications are generally better tolerated than oral medications. Less medication enters your bloodstream, and this reduces the chance of whole-body side effects. Advair side effects and Symbicort side effects, though, are still possible. The most common ones include:
Sore throat or hoarseness
Headache
Stomach upset
Respiratory or sinus infections
Oral thrush (yeast infection in your mouth and/or throat)
Muscle or back pain
Rare but serious side effects include weaker bones, a fast heart beat, and eye problems such as glaucoma. For children, some growth delays have been reported. You can lower your risk for side effects by rinsing your mouth and spitting after each dose.
8. Their drug interactions have a lot of overlap
Advair and Symbicort have similar drug interactions. Some medications enhance their effects too much, while others make them less effective. And certain rare interactions can cause dangerously low potassium levels and changes to your heart’s electrical activity.
Be sure to tell your healthcare professional if you’re taking any of these medications:
Antibiotics like clarithromycin (Biaxin XL)
Antifungals like ketoconazole
Ritonavir-containing medications like Paxlovid (nirmatrelvir / ritonavir)
Monoamine oxidase inhibitors (MAOIs) like selegiline (Emsam, Zelapar)
Tricyclic antidepressants like amitriptyline
Beta blockers like propranolol
Diuretics like furosemide (Lasix)
Other medications that aren’t on this list can also cause these effects. Make sure to give your healthcare team a complete list of all the over-the-counter and prescription medications you take, including any supplements or herbal products.
Can Advair and Symbicort be used together?
No, you shouldn’t use Advair and Symbicort together. Remember that they both have the same types of ingredients — an ICS and a LABA. Taking them together can increase your risk of side effects without added benefit.
How to save on Advair and Symbicort
Advair and Symbicort are available as brand-name medications. But you can also find them as lower-cost generics. GoodRx can help you navigate ways to save on your prescription.
Take advantage of voluntary price caps: The manufacturers of brand-name Advair and Symbicort — GSK and AstraZeneca, respectively — offer a $35 monthly price cap for those who qualify.
Save with GoodRx: GoodRx can help you save on the average retail prices of generic Advair and Symbicort. The price of generic Advair Diskus at certain pharmacies is as low as $56.66 with a free GoodRx discount (or as low as $56.66 for Wixela). Generic Advair HFA’s price may be as low as $235.07. Generic Symbicort’s price at certain pharmacies is as low as $97.09 with a free GoodRx discount (or as low as $98.00 for Breyna).
Save with patient assistance programs: If you’re uninsured or underinsured, you may be eligible for Advair or Symbicort patient assistance programs, which offer the medications at no charge.
Want to learn more about inhaler costs? Here are our comprehensive guides to asthma inhaler savings and COPD inhaler savings.
The bottom line
Advair Diskus (fluticasone / salmeterol) and Symbicort (budesonide / formoterol) are combination inhalers that are FDA approved for asthma and COPD; Advair HFA (fluticasone / salmeterol) is only approved for asthma. Symbicort may be a preferred option for asthma, but they’re similarly effective when it comes to COPD.
Advair and Symbicort have similar side effects and interactions. But the risk for pneumonia might be slightly higher with Advair in people with COPD. Whether you use Advair or Symbicort, sticking to your day-to-day schedule will help you get the most benefit from your treatment.
Why trust our experts?
References
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