Symbicort alternatives: what works instead and why it matters

Symbicort (budesonide + formoterol) is a popular combo inhaler because it gives steroid control plus a fast-acting LABA. But it’s not the only choice—and some people do better on a different drug, device, or treatment approach. Here’s how to pick an alternative that fits your symptoms, lifestyle, and budget.

Quick list: common alternatives and when they help

Pick an option based on what you need: quick relief, once-daily convenience, or stronger control for severe disease.

- Dulera (mometasone + formoterol): Very similar to Symbicort because it uses formoterol (fast onset). Good if you want a comparable rescue-plus-maintenance effect.

- Advair / Seretide (fluticasone + salmeterol): Strong steroid plus a slower LABA (salmeterol). Works well for maintenance but not for immediate relief—so it’s not suitable if you use your combo as needed.

- Breo Ellipta (fluticasone + vilanterol): Once-daily dosing, handy if you forget evening doses. Not for rescue use.

- ICS alone (beclomethasone, fluticasone, budesonide): If your doctor wants to avoid a LABA, inhaled steroid alone may be enough for mild asthma.

- LAMA add-ons (tiotropium/Spiriva): Often added for COPD or severe asthma as a bronchodilator alternative.

- Montelukast (oral): A pill option for mild allergic asthma or as an add-on when inhalers are problematic.

- Biologics (omalizumab, mepolizumab, benralizumab, dupilumab): For severe, eosinophilic or allergic asthma that doesn’t respond to inhalers. These are injections given under specialist care.

How to choose—practical tips

Think about three things: how quickly you need relief, how you take medicines, and your side effects/costs. If you need rescue action from your controller, prefer formoterol-based combos (Symbicort, Dulera). If you want once-daily convenience, look at Breo. If inhaler technique or hand strength is an issue, ask for a dry powder inhaler (DPI) or a spacer with a metered-dose inhaler (MDI).

Check steroid dose equivalence—different combos have different steroid strengths. Switching isn’t always one-to-one; your doctor will adjust the dose. Also, consider insurance coverage and local availability. Some inhalers cost much less with a generic or through certain pharmacies.

If you have frequent attacks despite good inhaler use, ask about biologics or a referral to a specialist. And never stop or switch prescription inhalers without talking to your prescriber—abrupt changes can trigger worsened control.

Final practical step: bring your current inhaler to your next visit, demonstrate your technique, and ask which specific alternative fits your daily routine and medical needs. Small changes—device type, dosing schedule, or adding a spacer—often make the biggest difference.