Symbicort alternatives

If Symbicort (budesonide + formoterol) isn’t right for you — because of side effects, cost, or availability — you’ve got options. Some alternatives work almost the same, others work differently but still help control symptoms. I’ll walk you through the main choices and what to ask your prescriber so you can make a safe switch.

Common medication alternatives

Other combined inhalers (ICS + LABA) are the closest substitutes. These include:

- Advair / Seretide (fluticasone + salmeterol): a long-used option available as a dry powder or inhaler. Salmeterol isn’t fast-acting like formoterol, so it’s not used for immediate relief.

- Breo Ellipta (fluticasone furoate + vilanterol): once-daily dosing for some people with asthma or COPD. Good if you want a simpler schedule.

- Dulera (mometasone + formoterol): similar to Symbicort because it also uses formoterol, so it can act faster than salmeterol combos.

- Generic budesonide/formoterol: many countries offer generics that match Symbicort’s ingredients for a lower cost.

If you need a different approach instead of a combined inhaler, options include:

- Separate inhaled corticosteroid (ICS) plus a reliever or LABA. For example, an ICS like Flovent or Pulmicort plus a quick-relief inhaler such as Ventolin (salbutamol/albuterol).

- LAMA inhalers (long-acting muscarinic antagonists) like Spiriva (tiotropium) are commonly used for COPD and sometimes added for severe asthma. They work differently but improve breathing for many people.

How to choose and switch safely

Pick an alternative based on how you use Symbicort now. Do you use it daily plus as-needed reliever (SMART therapy)? If so, switching to a combo with formoterol is often recommended because formoterol works fast. If you only use a controller daily and a separate rescue inhaler as needed, a different controller plus Ventolin might work fine.

Ask your doctor these specific questions: What will I use for quick relief? Will the new inhaler control nighttime symptoms and attacks? Are there cheaper generics or patient-assistance programs? How do I use the new inhaler correctly?

Side effects can be similar across inhaled steroids and LABAs: throat irritation, oral thrush, hoarseness, and sometimes tremor or a faster heart rate. Rinse your mouth after steroid inhalers to lower the risk of thrush. If you have COPD, talk about pneumonia risk with inhaled steroids — your doctor will weigh benefits and risks.

Finally, don’t stop or swap inhalers without talking to your clinician. A planned switch with dosing instructions and a follow-up plan keeps you breathing easier and avoids gaps in treatment.

If you want, tell me which symptoms you have or what part of Symbicort isn’t working, and I can point to the alternatives that fit your situation best.