Symbicort alternatives: What can I take instead of Symbicort?

Compare Symbicort alternatives | Advair | Dulera | Breo | Breztri | Trelegy | Natural alternatives | How to switch meds

Patients with breathing problems may require treatment with the brand-name medication Symbicort. Manufactured by AstraZeneca, Symbicort contains a combination of two active ingredients: budesonide and formoterol. Budesonide belongs to a class of drugs called inhaled corticosteroids (ICS), which reduce inflammation in the lungs. Formoterol belongs to another drug class called long-acting beta-2 agonists (LABA), which relax smooth muscles and open airways. These ingredients work together to make it easier to breathe. Long-acting beta-2 agonists are not used as rescue inhalers for acute symptoms of asthma or COPD. Symbicort is approved by the Food and Drug Administration (FDA) for the maintenance treatment of asthma and chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. 

Symbicort may not be appropriate for everyone, especially people with heart problems, osteoporosis, and glaucoma, among others. It can also cause serious side effects including lung infection and a weakened immune system. In these situations, a healthcare provider may suggest a different medication or natural alternatives to disease management. 

Related: Get Symbicort coupons | What is Symbicort

What can I take in place of Symbicort?

There are many inhaled products available to treat respiratory disorders, and alternative medications may be preferred for some people with pre-existing conditions. Other factors such as side effects, the type of inhaler device, and disease severity may also influence someone to try a Symbicort alternative. Compare examples of other drugs for the long-term treatment of asthma and COPD are listed below.

Other alternatives to Symbicort

• Accolate (zafirlukast)
• Airduo RespiClick (fluticasone/salmeterol)
• Alvesco (ciclesonide)
• Anoro Ellipta (umeclidinium/vilanterol)
• ArmonAir Digihaler (fluticasone) 
• Arnuity Ellipta (fluticasone)
• Asmanex Twisthaler (mometasone)
• Bevespi Aerosphere (glycopyrrolate/formoterol)
• Elixophyllin (theophylline)
• Flovent Diskus (fluticasone) 
• Incruse Ellipta (umeclidinium)
• Pulmicort respules (budesonide)
• Spiriva Handihaler (tiotropium)
• Stiolto Respimat (tiotropium/olodaterol)
• Tudorza Pressair (aclidinium)
• Wixela Inhub (fluticasone/salmeterol)
• Xolair (omalizumab)

Top 5 Symbicort alternatives

While many different inhaler medications are available, the following are the most common alternatives to Symbicort. Note: Short-acting beta agonists like albuterol are not alternatives to long-acting beta agonists such as Symbicort.

1. Advair 

Advair is available as two dosage forms: Advair Diskus and Advair HFA. Advair HFA is an aerosol metered-dose inhaler only approved for asthma, while Advair Diskus is a dry powder inhaler approved for both asthma and COPD. Advair and Symbicort belong to the same drug class, but Advair contains different active ingredients (fluticasone/salmeterol). Because Advair and Symbicort are both ICS/LABA combination medications, they have similar side effects such as upper respiratory infection, headache, sinus pain, and oral thrush. However, some patients may find the Advair Diskus inhaler easier to use because it requires less hand-breath coordination than Symbicort. Advair Diskus is given at a dose of one inhalation twice daily and Advair HFA as two inhalations twice daily.

RELATED: Symbicort vs. Advair

2. Dulera

Dulera is an asthma medication in the same drug class as Symbicort. Dulera contains the steroid mometasone and the LABA formoterol. Dulera and Symbicort share the same bronchodilator ingredient. While Symbicort is FDA-approved to treat asthma and COPD, Dulera is only indicated for the treatment of asthma. In clinical studies, these medications have both been found to be effective for asthma by improving quality of life and reducing asthma attacks. Dulera and Symbicort also have similar side effect profiles and dosing schedules of two inhalations twice daily. 

3. Breo

Breo is another ICS/LABA combination inhaler containing fluticasone and vilanterol. Similar to Symbicort, Breo is indicated for the long-term treatment of asthma and COPD. In a clinical study comparing the effects of Breo versus Symbicort in asthma patients, both drugs showed similar improvements in lung function. However, Breo—which is given at one inhalation once daily—had better convenience and adherence compared to Symbicort, which is dosed at two inhalations twice daily. This once-daily dosing schedule may be preferable for certain patients. 

4. Breztri

Breztri and Symbicort both contain budesonide and formoterol, but Brezti has another added ingredient called glycopyrrolate, making it a triple combination therapy. Glycopyrrolate is an anticholinergic drug that works by relaxing and widening airways in the lungs. Breztri is only indicated for COPD and is not approved for asthma. In a pivotal clinical study, the rate of COPD exacerbations was 13% to 14% lower with Breztri than with Symbicort, and both medications had similar rates of side effects such as pneumonia, upper respiratory infection, and bronchitis. Breztri and Symbicort are both dosed at two inhalations twice daily.

5. Trelegy

Like Breztri, Trelegy is a triple therapy medication with an ICS (fluticasone), anticholinergic (umeclidinium), and LABA (vilanterol). Trelegy is the first FDA-approved triple therapy for the maintenance treatment of asthma and COPD. Common side effects of Trelegy include respiratory infection, sore throat, sinusitis, and oral thrush. Compared to Symbicort, Trelegy was shown to reduce COPD exacerbations by 35% more. Trelegy is given at one inhalation once daily.

Natural alternatives to Symbicort

Natural remedies can help patients with asthma and COPD manage their daily symptoms and improve quality of life. There are multiple non-drug options available, but these therapies usually work best when taken along with prescription drugs like Symbicort. 

Alternative therapies for asthma and COPD include the following treatments, lifestyle modifications, and vitamins: 

• Yoga: Breathing exercises practiced in yoga have been found to improve quality of life, reduce asthma symptoms, and reduce medication use in some patients. However, more studies are needed to understand the full effect of yoga in asthma management. 
• Reducing environmental triggers: Asthma and COPD symptoms can worsen when individuals are exposed to environmental triggers such as cigarette smoke, air pollution, and dust. Patients who smoke are encouraged to quit and avoid secondhand smoke. Limiting time spent outdoors when the air quality is poor and reducing dust exposure are also recommended. 
• Vitamin D: In a meta-analysis examining the role of vitamin D in asthma treatment, vitamin D intake reduced the risk of having an asthma attack requiring hospitalization. Vitamin D deficiency is also common in COPD patients, and supplementation may help ease COPD symptoms. 

There is less scientific evidence about the effectiveness of these natural alternatives compared to prescription medicines. Patients should always consult a healthcare professional for medical advice before modifying their treatment plan.

How to switch to a Symbicort alternative

Asthma or COPD that is not optimally controlled by Symbicort may require different or additional medications. Before switching to a Symbicort alternative, it’s important to take the following steps and discuss them with a healthcare provider:

• Do not stop taking Symbicort. Stopping Symbicort abruptly can lead to worsening of asthma or COPD and withdrawal symptoms such as muscle pain and weakness. The dose should be gradually tapered down in order to stop Symbicort safely.
• Keep a symptom diary. A symptom diary is used to record day-to-day disease symptoms. A healthcare provider can use this diary to evaluate how well Symbicort is working. 
• Keep a record of medication side effects. Record how often you experience Symbicort side effects and if any side effects interfere with daily activities. Call your doctor right away if you have serious side effects such as lung infections, high blood pressure, cataracts, or decreased bone density. 
• Tell the doctor about any dosing preferences. There are many types of inhaler devices with different advantages and disadvantages. Factors to consider when choosing a new inhaler include ease of handling and choice of a once versus twice-daily regimen.
• Ask the doctor about complementary therapies. If you are thinking about adding lifestyle changes or an over-the-counter supplement to your treatment regimen, discuss these options with a healthcare professional first. Don’t change or stop your prescription respiratory medication.
• Check your insurance coverage. Before you switch to a new medication, make sure it’s covered by your insurance plan. If it’s covered but still expensive or if it’s not covered at all, you can always use SingleCare coupons.