Key takeaways:
Symbicort (budesonide / formoterol) is an inhaler that treats asthma and chronic obstructive pulmonary disease (COPD). It combines an inhaled corticosteroid with a long-acting beta agonist.
Advair Diskus (fluticasone / salmeterol) and Breo Ellipta (fluticasone / vilanterol) are two examples of Symbicort alternatives. They have similar ingredients to Symbicort, and they also manage asthma and COPD symptoms.
Airsupra (albuterol / budesonide) is not a Symbicort alternative, but it shares one active ingredient. It’s the first rescue inhaler that aims to treat asthma symptoms and prevent asthma attacks.
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Many inhalers are available to promote better breathing while living with asthma or chronic obstructive pulmonary disease (COPD). Symbicort (budesonide / formoterol) is one popular example. It aims to improve lung function and breathing symptoms over time, and it’s available at most pharmacies with a prescription.
Symbicort isn’t your only option, though. There are several other breathing treatments available for you to choose from. The best treatment will likely depend on your symptoms, which lung condition you have, and your insurance status.
Knowing more about Symbicort and your other options can help you play an active role in your treatment plan.
Symbicort overview
Symbicort is a prescription inhaler that contains two active ingredients, budesonide and formoterol. They work as a team to help you breathe easier. Budesonide is an inhaled corticosteroid (ICS) that helps lower inflammation in the lungs. Formoterol is a long-acting beta agonist (LABA) that works by relaxing the airways.
Symbicort is FDA approved to treat asthma in adults and kids ages 6 and older. In fact, Symbicort is considered a first-choice medication for managing asthma. It’s also approved to treat COPD, but it’s not a preferred option in this case.
How is Symbicort administered?
Symbicort is a metered-dose inhaler (MDI). This is a device that delivers a measured amount of medication into your lungs.
Most people inhale 2 puffs from their Symbicort MDI twice daily. But your prescribed dosage depends on factors such as your age and whether you’re using it for asthma or COPD.
Keep in mind: Symbicort is a maintenance medication. This means you’ll typically need to use it every day. But your prescriber may also recommend using Symbicort as an off-label “rescue” treatment. We’ll circle back to this in just a bit.
How effective is Symbicort?
Symbicort is an effective inhaler for managing asthma. Combination ICS-LABA inhalers like Symbicort help improve breathing and lower the risk of experiencing sudden and intense asthma symptoms (asthma attacks). It can also manage COPD, especially if you have both asthma and COPD.
Using Symbicort as a SMART inhaler for asthma
Some people use Symbicort as a daily maintenance inhaler and as a rescue inhaler. This convenient strategy is known as “single maintenance and reliever therapy” (SMART). SMART can help delay or prevent asthma attacks.
Even though SMART is considered an off-label treatment, many studies support this approach. Some data suggests it may even be more effective than combining Symbicort with a separate short-acting albuterol (ProAir RespiClick, Ventolin HFA) inhaler.
What are the best Symbicort alternatives?
Symbicort may not be right for everyone. It may not manage your symptoms well enough, or your prescription insurance may not cover it. Thankfully, there are many other effective alternatives.
These are some common Symbicort alternatives that also contain an ICS-LABA.
Medication | Uses | Description |
|---|---|---|
Advair HFA (fluticasone / salmeterol) | Asthma | Like Symbicort, Advair HFA is a MDI that’s used twice daily. |
Advair Diskus (fluticasone / salmeterol) | Asthma and COPD | Advair Diskus is a dry powder inhaler that’s used twice daily. |
Breo Ellipta (fluticasone / vilanterol) | Asthma and COPD | Breo Ellipta is a once-daily inhaler. It may be more convenient than inhalers that are used twice daily. |
Dulera (mometasone / formoterol) | Asthma | Dulera is used twice daily. It can also be used as a SMART inhaler. |
These Symbicort alternatives contain a LABA and a long-acting muscarinic antagonist (LAMA) rather than an ICS and a LABA.
Medication | Uses | Description |
|---|---|---|
Anoro Ellipta (vilanterol / umeclidinium) | COPD | Anoro Ellipta is used once daily. It’s an option if you need more breathing support but want to forego an ICS. |
Bevespi Aerosphere (formoterol / glycopyrrolate) | COPD | Bevespi Aerosphere is a MDI that’s administered twice daily. |
Stiolto Respimat (olodaterol / tiotropium) | COPD | Stiolto Respimat is administered twice daily. It uses a fine mist delivery system. |
These are the available triple-therapy alternatives to Symbicort. They combine an ICS, LABA, and LAMA.
Medication | Uses | Description |
|---|---|---|
Trelegy Ellipta (vilanterol / umeclidinium / fluticasone) | Asthma and COPD | Trelegy Ellipta is a once-daily inhaler. |
Breztri Aerosphere (formoterol / glycopyrrolate / budesonide) | COPD | Breztri Aerosphere has similar ingredients as Symbicort, but it also contains glycopyrrolate, a LAMA. Breztri is used twice daily. |
Other Symbicort alternatives are also available. These include Wixela Inhub, a generic version of Advair, and AirDuo RespliClick. AirDuo has the same active ingredients as Advair, but it’s not technically a generic.
Your prescriber can help you identify the best alternative for you.
Is Airsupra an alternative to Symbicort?
Airsupra (albuterol / budesonide) is a newer rescue inhaler for adults. You can use Airsupra as needed for asthma symptoms and to prevent asthma attacks. It’s the first rescue inhaler that includes an ICS.
Symbicort has some similarities to Airsupra when it comes to SMART treatment, but it isn’t considered a Symbicort alternative. That’s because Airsupra isn’t a maintenance inhaler. It contains albuterol, which wears off much faster than formoterol (found in Symbicort). Think of Airsupra as an add-on helper to your long-term asthma inhalers. You can lean on it for breathing relief when you need it. But it won’t support better breathing with regular use the way that Symbicort can.
Is a generic version of Symbicort available?
Yes, an authorized generic for Symbicort is available. Authorized generics are exactly the same as their brand-name counterpart — just without the brand name on the label. Symbicort is made by the company AstraZeneca, and so is its authorized generic.
Traditional generic medications are made by a different company. There may also be some other minor differences, such as their inactive ingredients. The FDA approved Breyna (budesonide / formoterol) in March 2022; it’s the first traditional generic for Symbicort. Like Symbicort, Breyna treats asthma and COPD.
Is there an over-the-counter alternative to Symbicort?
Not really. Two over-the-counter (OTC) inhalers are available as rescue inhalers for mild asthma. But they have different active ingredients than Symbicort, and they aren’t preferred treatment options.
Primatene Mist (epinephrine) and Asthmanefrin (racepinephrine) are the two inhalers available OTC. They’re meant for as-needed relief — not for daily or long-term use.
How do I know when it’s time to try a new inhaler?
Before trying a new inhaler, there are a few things your prescriber and pharmacist may check on. They’ll likely ask you a few questions to make sure you’re using your inhaler correctly. They’ll also double-check that you’re using the correct number of puffs every day.
If you have asthma or COPD, your symptoms aren’t well managed, and you’re using your inhaler as prescribed, it may be time for a dose adjustment or a new inhaler. Side effects can also be another factor that comes into play in the decision to switch inhalers. Affordability and health insurance changes can also play key roles.
Based on your situation and symptoms, your healthcare team can help you navigate the best path forward.
Frequently asked questions
Common Symbicort side effects include throat irritation, cough, and upper respiratory tract infections. Rare but serious side effects include worsening breathing problems and a higher risk of pneumonia, especially with long-term use among people living with COPD. Contact a healthcare professional if your symptoms suddenly get worse or don’t improve.
No, albuterol and Symbicort serve different purposes. Albuterol is a rescue inhaler that provides quick relief when you need it. Symbicort is a maintenance inhaler that helps lessen symptoms over time. If you only use albuterol without a maintenance inhaler, you might have a hard time managing your asthma or COPD.
Symbicort does contain a steroid, but it’s different from prednisone. The steroid in Symbicort — budesonide — is inhaled, so it works mainly in the lungs. Because of this, only a small amount reaches the rest of your body. Prednisone, on the other hand, is taken by mouth and works throughout the entire body. As a result, it’s more likely to cause side effects, especially if you take it for a long time.
Common Symbicort side effects include throat irritation, cough, and upper respiratory tract infections. Rare but serious side effects include worsening breathing problems and a higher risk of pneumonia, especially with long-term use among people living with COPD. Contact a healthcare professional if your symptoms suddenly get worse or don’t improve.
No, albuterol and Symbicort serve different purposes. Albuterol is a rescue inhaler that provides quick relief when you need it. Symbicort is a maintenance inhaler that helps lessen symptoms over time. If you only use albuterol without a maintenance inhaler, you might have a hard time managing your asthma or COPD.
Symbicort does contain a steroid, but it’s different from prednisone. The steroid in Symbicort — budesonide — is inhaled, so it works mainly in the lungs. Because of this, only a small amount reaches the rest of your body. Prednisone, on the other hand, is taken by mouth and works throughout the entire body. As a result, it’s more likely to cause side effects, especially if you take it for a long time.
The bottom line
Symbicort (budesonide / formoterol) is a combination maintenance inhaler that manages asthma and chronic obstructive pulmonary disease (COPD). Advair Diskus (fluticasone / salmeterol) and Breo Ellipta (fluticasone / vilanterol) are two examples of Symbicort alternatives, but others are also available. Airsupra (albuterol / budesonide) is the first FDA approved rescue inhaler for asthma that contains an inhaled corticosteroid, but it’s not a true Symbicort alternative. Reach out to your prescriber to see which inhaler is right for you.
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References
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