Symbicort alternatives: real choices for asthma and COPD

If Symbicort (budesonide/formoterol) isn’t working for you or it’s too expensive, you have options. Symbicort is an inhaled steroid plus a long-acting bronchodilator (ICS/LABA). Alternatives fall into similar combo inhalers, single-drug options, add-on devices, and newer biologic treatments for severe asthma. Pick the path that fits your symptoms, budget, and lifestyle.

Other ICS/LABA inhalers

These inhalers combine an inhaled corticosteroid with a long-acting beta agonist, just like Symbicort. Common choices are:

- Advair / Seretide (fluticasone + salmeterol). Good for many patients and available in different strengths.
- Dulera (mometasone + formoterol). Similar profile to Symbicort but a different steroid that may suit some people better.
- Breo Ellipta (fluticasone + vilanterol). Once-daily dosing for people who prefer fewer puffs.
- Generic budesonide/formoterol. In some places generics are available and cost a lot less than brand names.

When switching between ICS/LABA combos your doctor will consider how often you need treatment, inhaler type (metered-dose vs dry powder), and past side effects.

Other drug options and add-ons

If a combo inhaler isn’t right, options include using an inhaled steroid alone (Flovent/fluticasone or Pulmicort/budesonide) plus a short-acting rescue inhaler like albuterol (Ventolin) or levalbuterol (Xopenex). For COPD or some asthma patients, LAMA drugs such as tiotropium (Spiriva) can be helpful alone or combined with an ICS/LABA.

For severe asthma not controlled on inhalers, biologic injections target specific immune pathways. Options include omalizumab, mepolizumab, benralizumab, and dupilumab. These require specialist referral and testing (blood eosinophils, allergy tests).

Think about delivery. Dry powder inhalers (DPI) and metered-dose inhalers (MDI) feel different and need different techniques. If coordination is hard, ask about a spacer or a nebulizer. Proper technique matters as much as the drug.

A few practical tips: check if a generic is available to cut costs; ask your clinician about step-up or step-down plans; review inhaler technique with a pharmacist; watch for steroid side effects like oral thrush—rinse your mouth after use. Don’t stop or switch abruptly without medical advice.

If you’re shopping online for alternatives, be careful—buy only from licensed pharmacies and keep prescriptions in order. Talk to your doctor about what failed with Symbicort and what you need next: better symptom control, fewer side effects, simpler dosing, or lower cost. That makes switching safer and more likely to help.