Symbicort alternatives: inhaler options for asthma and COPD

If Symbicort (budesonide/formoterol) isn’t working for you or you want cheaper or simpler options, there are solid alternatives. Below I list common choices, how they differ from Symbicort, and quick tips to switch safely. This is practical info you can use when talking to your doctor.

Main medical alternatives

ICS/LABA combos (same class as Symbicort):

- Dulera (mometasone/formoterol): very similar to Symbicort because it also uses formoterol. Fast relief and good for people who like quick-acting control plus steroid protection.

- Advair/Seretide (fluticasone/salmeterol): widely used. Salmeterol acts slower than formoterol, so you may notice differences in how fast symptoms ease. Often dosed twice daily.

- Breo Ellipta (fluticasone/vilanterol): once-daily dosing for many patients, popular for COPD and asthma control. Convenient if you struggle with twice-daily routines.

LAMA and LAMA/LABA options (more for COPD or as add-ons in asthma):

- Spiriva (tiotropium) can be added for COPD or severe asthma not fully controlled by ICS/LABA.

- Anoro, Stiolto and other LAMA/LABA combos help breathing in COPD and sometimes reduce need for extra meds.

Non-inhaler and advanced options:

- Montelukast (oral) can help milder asthma or as an add-on for allergies-driven symptoms.

- Biologics (Xolair, Nucala, Fasenra, Tezspire) are for severe, uncontrolled asthma with specific markers (like high eosinophils or allergies). These require specialist referral and injections, not inhalers.

How to choose and switch safely

1) Check how fast you need relief. Symbicort’s formoterol gives quick relief. If fast action matters, pick another formoterol product (like Dulera) or keep a rescue inhaler.

2) Match dosing and device. Dry powder vs MDI matters for technique. If you switch to a once-daily inhaler, set a clear habit (morning with coffee, for example).

3) Don’t stop suddenly. Talk to your prescriber about dose changes. Abruptly stopping controller meds can cause flare-ups.

4) Costs and generics. Generic budesonide/formoterol or coupons can cut costs. If price drives the change, ask your pharmacist about equivalent generics and patient assistance.

5) Ask about side effects and suitability. Some options suit COPD better than asthma and vice versa. If you have heart issues, certain long-acting bronchodilators need careful review.

Final practical tip: bring your current inhaler to the appointment, demo your technique, and write down exact brand and dose you switch to. That small step prevents confusion and keeps control steady while you try something new.