Albuterol vs. Symbicort: Uses, Side Effects, and More
Key takeaways:
Albuterol (Ventolin HFA, ProAir RespiClick) is a rescue inhaler. It can help you breathe easier if you have asthma or chronic obstructive pulmonary disease (COPD) and need quick relief from wheezing or shortness of breath.
Symbicort (budesonide / formoterol) is a maintenance inhaler that you use daily — even if you aren’t actively experiencing symptoms. It helps manage asthma and COPD symptoms over time.
Asthma experts sometimes recommend using Symbicort as a rescue inhaler, too. This two-in-one approach is dubbed as single maintenance and reliever therapy, or “SMART.”
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If you have asthma or chronic obstructive pulmonary disease (COPD), you understand how bothersome these conditions can be. They both cause breathing troubles, and inhalers are go-to medications that help prevent and treat symptoms.
Not all inhalers are the same, though. Some inhalers are used daily to prevent breathing troubles from happening in the first place. Others are only used to provide quick relief once you’re experiencing symptoms.
Depending on your situation, it may be tough to know which inhaler is best to use. This is especially true if you’re having active symptoms and you need relief — and fast. Two common inhalers you may have heard of are albuterol (Ventolin HFA, ProAir RespiClick) and Symbicort (budesonide / formoterol). But how do they compare?
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Here, we’ll talk about albuterol and Symbicort — what they are, how they work, and what they’re used for.
Albuterol overview
Albuterol is a rescue inhaler. It can provide quick relief if you’re experiencing wheezing or shortness of breath. Quick relief is important when you have an asthma attack, or if breathing suddenly becomes difficult.
Certain things around you can also make it harder to breathe. These are called triggers, and may include smoke, dust, or even your pet’s fur. Some people need breathing help from a rescue inhaler if exposure to a trigger makes it harder to breathe. Rescue inhalers may also be used shortly before you engage in physical activity.
Albuterol inhalers have several names. You may see albuterol filled as a generic product, or you could see it filled as a brand-name inhaler. Two commercially available brand-name albuterol inhalers are Ventolin HFA and ProAir Respiclick.
Keep in mind: Albuterol can’t manage asthma or COPD-related breathing symptoms over time. It’s not a maintenance inhaler.
How does albuterol work?
Rescue inhalers like albuterol work by targeting receptors (chemical binding sites) in the lungs called beta-2 receptors. They bind to these receptors and cause smooth muscles in your airways to relax. This helps more air enter the lungs.
Rescue inhalers are called short-acting beta-agonists (SABAs) because of how they work. Each dose works quickly and lasts for about 4 to 6 hours.
What are the common side effects of albuterol?
Possible albuterol inhaler side effects include:
Headache
Dizziness
Sore throat
Runny nose
Fast heart beat
Tremors and shakiness
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Are there any other rescue inhalers?
Albuterol inhalers are common. But they’re not the only rescue inhalers available. Some rescue inhalers contain an ingredient called levalbuterol instead. Levalbuterol inhalers are available as a generic product, but you can also find them as brand-name Xopenex HFA. Albuterol is also found in Airsupra, a rescue inhaler that typically does not cause drowsiness.
Overall, albuterol is more commonly used than levalbuterol. Albuterol can be given to younger children and it’s more widely available at pharmacies.
Symbicort overview
Symbicort is a combination inhaler that manages asthma symptoms and COPD symptoms over time. It’s considered to be a maintenance treatment for both conditions. Symbicort is inhaled directly into the lungs, and it's usually used 2 times per day. It’s approved for adults and kids ages 6 and older.
Many people use the brand name version of Symbicort. But you can also find it is available as generic budesonide / formoterol. There’s also a “branded generic” available called Breyna.
How does Symbicort work?
Symbicort has two active ingredients — budesonide and formoterol. These two medications work together to improve breathing and lung function over time.
Budesonide is a corticosteroid, while formoterol is a long-acting beta-agonist (LABA). Corticosteroids reduce inflammation in the lungs; LABAs help the airways relax and relieve chest tightness, coughing, and wheezing.
What are the common side effects of Symbicort?
Possible Symbicort side effects include:
Headache
Inflammation in the nose and throat
Sinus pain
Stuffy nose
Back pain
Stomach discomfort
Vomiting
A higher risk for infections in the mouth and throat (thrush)
If you use Symbicort, do you also need a rescue inhaler?
Yes, this is often the case. If your healthcare professional prescribes Symbicort, you may also need a separate rescue inhaler, such as albuterol, for quick relief.
Can Symbicort be used as a rescue inhaler?
Symbicort isn’t FDA approved as a rescue inhaler. But your healthcare professional may instruct you to use Symbicort as both your rescue and maintenance inhaler. This approach is sometimes referred to as single maintenance and reliever therapy (SMART). This means that you would use Symbicort to provide quick relief in addition to your daily doses.
However, this method is considered an off-label use. You shouldn’t try it unless instructed by your healthcare professional.
Is there any research about using Symbicort as a rescue inhaler?
Using Symbicort as a SMART inhaler may be helpful if you only sometimes need to use a rescue inhaler. Dulera (mometasone / formoterol) is another SMART inhaler option.
Organizations like the Global Initiative for Asthma recommend SMART therapy in certain situations because studies show a lower risk of having asthma attacks with one SMART inhaler compared to juggling two different inhalers.
If you have asthma and want to learn more about SMART, talk to your healthcare professional for more information. It’s important that you don’t make any changes to your asthma medications before speaking with them.
Good to know: At this time, SMART isn’t recommended for people living with COPD. It also isn’t recommended for people who have breathing issues caused by triggers that aren’t asthma related.
Frequently asked questions
Yes, generally speaking. Healthcare professionals often prescribe Symbicort and albuterol together. However, if your prescriber wants you to use Symbicort as a SMART inhaler, you likely won’t need to use albuterol at all.
There’s no set time frame. Symbicort is a maintenance inhaler, which means it’s intended to be used for an extended period of time. Asthma and COPD are chronic conditions, so Symbicort may become a regular part of your treatment plan for years to come.
No, Symbicort isn’t usually screened on drug tests. Most drug tests are designed to identify illicit substances or controlled medications, such as opioids and benzodiazepines. One of Symbicort’s active ingredients, budesonide, is a steroid, but it’s not an anabolic steroid (the kind that increases muscle mass). Anabolic steroids may show up on a drug test, but they’re completely different from budesonide.
You should use your albuterol inhaler whenever you experience sudden breathing issues, such as shortness of breath. The instructions on your inhaler will likely direct you to administer two inhalations every 4 to 6 hours as needed. However, speak to your healthcare professional if you’re using albuterol more than twice a week. This may be a sign that your asthma or COPD isn’t sufficiently managed with your current medication(s).
The bottom line
Albuterol (Ventolin HFA, ProAir RespiClick) is a rescue inhaler that can provide quick relief from wheezing or shortness of breath. Symbicort (budesonide / formoterol) is FDA approved to help manage asthma or COPD over time. But, in some cases, your healthcare professional may recommend that you use Symbicort as both a rescue and maintenance inhaler. If you have any questions about either inhaler, it’s recommended to talk to your pharmacist or prescriber.
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References
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Global Initiative for Asthma. (2024). 2024 GINA main report.
Global Initiative for Asthma. (2024). Summary guide for asthma management and prevention.
Global Initiative for Chronic Obstructive Lung Disease. (2024). 2024 GOLD report.
Hsu, E., et al. (2023). Beta2-Agonists. StatPearls.
MedlinePlus. (2015). Budesonide oral inhalation.
MedlinePlus. (2024). Formoterol oral inhalation.
Mylan Pharmaceuticals. (2020). Breyna- budesonide and formoterol fumarate aerosol, metered [package insert]. DailyMed.
National Institute on Drug Abuse. (2023). Anabolic steroids and other Appearance and Performance Enhancing Drugs (APEDs).
Sobieraj, D. M, et al. (2018). Association of inhaled corticosteroids and long-acting β-agonists as controller and quick relief therapy With exacerbations and symptom control in persistent asthma. JAMA Network.
