Symbicort alternatives: what works and when to switch

Symbicort combines an inhaled steroid (budesonide) and a fast-acting LABA (formoterol). People look for alternatives for side effects, cost, insurance coverage, or because their doctor wants a different plan. Before switching, know whether you use Symbicort as a daily controller only or as a maintenance-and-reliever (MART). That matters: not every alternative can be used for quick relief.

Common alternatives and how they differ

Generic budesonide/formoterol – same medicine in Symbicort but usually cheaper. If availability or price is the issue, ask your pharmacist if a generic is an option.

Dulera (mometasone + formoterol) – similar because it contains formoterol. It can control inflammation and act faster than salmeterol combos, but check with your doctor if it’s approved where you live for use as a reliever.

Advair / Seretide (fluticasone + salmeterol) – a well-known combo. Salmeterol is slower to act than formoterol, so Advair isn’t suitable for MART or rescue use. Good if you want a controller you take on a schedule.

Breo Ellipta (fluticasone furoate + vilanterol) – once-daily controller for COPD and asthma in some patients. Not for immediate relief; useful if you prefer once-daily dosing.

Separate inhalers (ICS + SABA) – some people use an inhaled steroid (Flovent/Pulmicort) plus a separate fast-acting rescue inhaler (albuterol). This can work well but requires good adherence and clear routines.

How to pick the right option

Ask these questions when you talk to your clinician: Do I need a reliever that works fast (formoterol)? Is once-daily dosing better for me? Can I switch to a generic to save money? Also discuss inhaler technique, spacers, and side effects like thrush or hoarseness.

Practical tips: check prices for the brand and generics, confirm insurance coverage, and ask if a trial on the new inhaler is possible. If you have frequent flare-ups, don’t swap inhalers without a clear action plan and follow-up.

Watch for side effects after switching: increased cough, voice changes, oral thrush, or feeling shaky. If control gets worse within a few weeks, contact your provider right away. Keep a peak flow or symptom log for the first month so you and your clinician can see how the new treatment is working.

Need help talking to your doctor? Say you want better control, lower cost, or fewer side effects and ask specifically whether the alternative supports maintenance-and-reliever therapy if that’s what you use now. A short, specific request makes the visit more productive.

Switching inhalers can be simple, but it should be done with a plan. If cost or access is the problem, ask about generics and pharmacy savings programs. If control or rescue use matters, prioritize options with formoterol or keep a clear separate rescue inhaler with you at all times.