Symbicort Alternatives: Other Inhalers, Treatments, and When to Switch

Looking for alternatives to Symbicort (budesonide + formoterol)? Whether Symbicort isn’t working, costs too much, or you want a different device, there are solid options. Below I list common alternatives, what to consider when switching, and quick steps you can take with your doctor.

Common inhaler alternatives

If you want the same kind of combo therapy (inhaled corticosteroid + long-acting beta agonist), try one of these:

• Advair / Seretide (fluticasone + salmeterol) — a widely used ICS/LABA with dry powder and inhaler versions.
• Dulera (mometasone + formoterol) — similar to Symbicort because it uses formoterol for fast relief plus steroid control.
• Breo Ellipta (fluticasone furoate + vilanterol) — once-daily option that may be easier for people who forget doses.
• AirDuo / AirDuo Digihaler (fluticasone + salmeterol) — another combination with different device choices.

For COPD specifically, some doctors prefer combining bronchodilators differently (LAMA + LABA), for example:

• Anoro Ellipta (umeclidinium + vilanterol) — LAMA/LABA combo for COPD control.
• Stiolto Respimat (tiotropium + olodaterol) — another LAMA/LABA option that may help breathlessness.

Other treatments and practical tips

If inhaled steroid/LABA combos aren’t ideal, consider these routes:

• Inhaled steroid alone (like Pulmicort/budesonide) plus a short-acting bronchodilator when needed.
• Leukotriene modifiers (montelukast) — oral pills for mild asthma or as add-on therapy.
• Biologic therapies (omalizumab, mepolizumab, dupilumab) — for severe, uncontrolled asthma with allergic or eosinophilic patterns. These need specialist assessment.
• Rescue inhalers (salbutamol/albuterol) — always keep one for sudden symptoms; combo inhalers are not a full substitute for a rescue inhaler in every case.

When choosing, think about: your diagnosis (asthma vs COPD), symptom pattern, inhaler device type (MDI vs DPI), dosing frequency, side effects like thrush or hoarseness, and cost or insurance coverage. Device feel matters — some people manage better with a dry powder than an MDI spacer.

How to switch safely: talk to your prescriber, compare active ingredients, check your insurance/formulary, and ask for a trial prescription. If you switch, monitor symptoms and peak flow for 2–4 weeks and report worsening control immediately. Never stop controller medication suddenly without medical advice.

If you want help comparing two specific inhalers or need a checklist to bring to your doctor, tell me which ones and I’ll make a short comparison you can use during your appointment.