Symbicort Alternatives: What to Know About Advair, Generics, and More
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 other options can help you play an active role in your treatment plan.
Symbicort overview
Symbicort is a prescription inhaler that contains two medications, 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 lung airways.
Symbicort is FDA approved to treat asthma in adults and kids ages 6 years and older. In fact, Symbicort is considered a first-choice medication for managing asthma. It’s typically used by people who need more than just an ICS to manage asthma symptoms.
Symbicort is also approved to treat COPD. But it’s not a preferred option in this case. You might use Symbicort along with a long-acting muscarinic agonist (LAMA) to help manage your COPD symptoms and prevent flare-ups. Combining an ICS, LABA, and LAMA is known as “triple therapy.”
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.
Symbicort comes in two different doses: budesonide 80 mcg / formoterol 4.5 mcg (80/4.5) and budesonide 160 mcg / formoterol 4.5 mcg (160/4.5). Your recommended Symbicort dosage will depend on your age and whether you’re using Symbicort for asthma or COPD.
Regardless of the dose, most people inhale 2 puffs twice daily.
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 lung function and breathing symptoms. They also lower the risk of experiencing sudden and intense asthma symptoms.
Symbicort is also an effective treatment option for COPD. This is especially true if you have both asthma and COPD. Clinical COPD guidelines don’t always recommend using ICS inhalers, such as Symbicort, long-term, though. Doing so may increase your risk of side effects, such as pneumonia.
First time using Symbicort? We’ve got you covered. Here, GoodRx pharmacists walk through how to use a Symbicort inhaler.
Navigating risks and side effects: Read what experts say about Symbicort side effects and how to manage them.
Symbicort or Advair: Is one of these two popular inhalers more beneficial than the other?
Using Symbicort as a SMART inhaler for asthma
In some cases, your prescriber may tell you to use Symbicort every day and as a rescue inhaler. This strategy is known as “single maintenance and reliever therapy” (SMART). SMART treatment with Symbicort can help delay or prevent asthma attacks. Some data suggests it may even be more effective than combining Symbicort with a short-acting beta agonist, such as albuterol (ProAir RespiClick, Ventolin HFA).
Convenience is another benefit. With SMART, you only have to use one inhaler instead of having separate rescue and maintenance inhalers.
Your prescriber can help you decide if SMART treatment is right for you. Even though taking Symbicort as a rescue inhaler is an off-label use, many studies support this approach for problematic asthma.
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 (if applicable) 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 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.
Trelegy Ellipta (vilanterol / umeclidinium / fluticasone) | Asthma and COPD | Trelegy Ellipta is a once-daily triple therapy 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. Your prescriber can help you identify the best one for you.
What is Airsupra, and is it an alternative to Symbicort?
Airsupra (albuterol / budesonide) is a newer rescue inhaler for adults. You can use Airsupra as needed for asthma symptoms, but you can also use it to prevent asthma attacks. It’s the first rescue inhaler that includes an ICS.
Airsupra is an MDI that contains 90 mcg of albuterol and 80 mcg of budesonide per puff. The recommended Airsupra dosage is 2 puffs as needed, but you shouldn’t use more than 12 puffs in 24 hours.
Symbicort has some similarities to Airsupra when it comes to SMART treatment, but Airsupra isn’t considered a Symbicort alternative. That’s because it’s not a maintenance inhaler. Airsupra 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. Breyna is made by the company Mylan. 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.
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
A-S Medication Solutions. (2024). Symbicort - budesonide and formoterol fumarate dihydrate aerosol [package insert]. DailyMed.
Adrish, M., et al. (2024). POINT: Should triple inhaled therapy be considered in all patients with group E COPD? Yes. Chest.
AstraZeneca Pharmaceuticals. (2019). Budesonide and formoterol fumarate dihydrate aerosol [package insert]. DailyMed.
AstraZeneca Pharmaceuticals. (2024). Airsupra - albuterol sulfate and budesonide aerosol, metered [package insert]. DailyMed.
Beasley, R., et al. (2022). Evaluation of budesonide-formoterol for maintenance and reliever therapy among patients with poorly controlled asthma. JAMA Network.
Global Initiative for Asthma. (2024). Summary guide for asthma management and prevention.
Global Initiative for Chronic Obstructive Lung Disease. (2025). Pocket guide to COPD.
Mylan Pharmaceuticals. (2020). BREYNA- budesonide and formoterol fumarate aerosol, metered [package insert]. DailyMed.
Nephron Pharmaceuticals. (2025). Asthmanefrin - racepinephrine hydrochloride solution [package insert]. DailyMed.
[package insert]. DailyMed.
U.S. Food and Drug Administration. (2023). FDA approves drug combination treatment for adults with asthma.
U.S. Food and Drug Administration. (2025). FDA list of authorized generic drugs.
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