Symbicort alternatives: what works and what to watch for
Symbicort (budesonide + formoterol) helps a lot of people control asthma and COPD because it combines a steroid with a fast-acting long-acting bronchodilator. But maybe you don’t tolerate it, your insurance won’t cover it, or you prefer a different device. Good news: there are solid alternatives. Here’s a straightforward look at the real options and how to choose between them.
First, know why alternatives matter. Some inhalers act faster, some last longer, and some are cheaper. Device type matters too — metered-dose inhalers (MDIs) need coordination or a spacer, while dry powder inhalers (DPIs) need a good breath in. Also think about whether you need an inhaler that can double as a rescue (reliever) or only as daily maintenance.
Common alternatives to Symbicort
Dulera (mometasone + formoterol) — Very similar to Symbicort. Same fast-acting formoterol, so it can be used in some "maintenance and reliever" strategies. Good for people who need quick relief plus daily control.
Advair (fluticasone + salmeterol) — A widely used combo, but salmeterol acts slower than formoterol. It’s mainly for maintenance, not for using as a quick reliever.
Breo Ellipta (fluticasone + vilanterol) — Once-daily dosing, handy for people who prefer a single daily inhaler. Not a reliever option.
Trelegy Ellipta or Breztri Aerosphere — Triple therapy options that add a LAMA. These are for more severe COPD or asthma not controlled on ICS/LABA alone.
Generic budesonide + formoterol inhalers — If cost is the issue, check for generics. They work like Symbicort but often cost less and may be available through different pharmacies or discount programs.
How to pick the right replacement
Match the inhaler to your needs: if you like the "maintenance and reliever" approach, stick with a formoterol-containing product (Symbicort, Dulera, or a generic budesonide/formoterol). If you want once-daily dosing, Breo or Trelegy might fit better. If cost is the driver, ask about generics, coupons, or patient-assistance programs.
Practical tips: try a sample or ask your pharmacist to demonstrate the device. Always check whether your new inhaler needs a spacer. Rinse your mouth after steroid inhalers to lower thrush risk. Tell your doctor if you take beta-blockers, have heart issues, or are pregnant — these things change the safest choice.
If you’re thinking about switching, bring your current inhaler to the appointment and ask for a written action plan. A short trial under your doctor’s watch can show whether the new inhaler controls symptoms without new side effects. If price or access is the problem, a pharmacist can often point to cheaper equivalents.
Want help comparing options or finding coupons? Ask your clinician or pharmacist — they deal with this every day and can make the switch smoother and safer.
