Symbicort substitute: quick, practical choices for asthma & COPD

Need a Symbicort substitute? Maybe your copay spiked, your pharmacy is out, or your doctor wants a different device. Symbicort is an inhaled corticosteroid plus a long-acting beta agonist (budesonide + formoterol). If you need a swap, focus on matching the two goals: daily inflammation control (ICS) and long-acting bronchodilation (LABA).

How alternatives differ

Not all substitutes are identical. Some use a different steroid (mometasone, fluticasone) or a different LABA (salmeterol, vilanterol). Common alternatives include:

- Dulera (mometasone/formoterol): similar LABA (formoterol) but a different steroid. Good if you like formoterol’s quick onset.
- Advair / Seretide (fluticasone/salmeterol): widely used ICS+LABA with a long track record; salmeterol acts a bit slower than formoterol.
- Breo Ellipta (fluticasone/vilanterol): once-daily dosing for people who prefer one-a-day therapy, mostly used in COPD and asthma control.
- Generic budesonide/formoterol products: these match Symbicort’s active drugs and are often cheaper when available.

Also think about the inhaler type: metered-dose inhaler (MDI) vs dry powder inhaler (DPI). Technique matters: a cheap alternative is useless if you can’t use the device correctly.

Practical steps to switch safely

First, talk to your clinician. Don’t stop Symbicort suddenly without a plan. Ask about:

- Dose equivalence: steroids and LABAs vary in strength. Your doctor should match doses to keep control.
- Inhaler training: get a demo for the new device and practice at the clinic or pharmacy.
- Monitoring: use a peak flow or symptom diary for 1–2 weeks after switching to catch problems early.
- Rescue inhaler plan: confirm when to use your fast-acting bronchodilator and when to call for help.

Watch for side effects after a switch: increased cough, throat irritation, hoarseness, oral thrush (rinse your mouth), or jitteriness from LABA. If symptoms get worse or you need your rescue inhaler much more often, contact your prescriber.

Cost tips: ask the pharmacist about generics, manufacturer coupons, or patient assistance programs. Sometimes changing the inhaler device or brand lowers your copay significantly. If insurance limits brands, a prior authorization request from your doctor can help.

Bottom line: you have safe options if Symbicort doesn’t work for you. Match the ICS+LABA combination, learn the new device, monitor symptoms, and keep open communication with your healthcare team. That way you stay in control of your asthma or COPD without surprises.