Symbicort alternatives: what to try instead of budesonide/formoterol

If Symbicort (budesonide + formoterol) isn’t working for you, or you want a different device, there are sensible alternatives. Which one fits depends on whether you have asthma or COPD, how often you have symptoms, and whether quick relief or long-term control matters most.

Other inhaled combos (ICS + LABA)

Many inhalers work like Symbicort by combining an inhaled steroid (ICS) with a long-acting bronchodilator (LABA). These are the closest alternatives:

• Advair / Seretide (fluticasone + salmeterol) — a common choice. Salmeterol has a slower onset than formoterol but works well for maintenance.
• Dulera (mometasone + formoterol) — similar to Symbicort in quick relief because it uses formoterol.
• Breo Ellipta (fluticasone furoate + vilanterol) — once-daily dosing, often chosen for convenience in COPD and some asthma patients.
• Generic budesonide/formoterol — available in some regions and can lower cost while giving the same active ingredients as Symbicort.

Pick based on how fast you need relief (formoterol acts faster) and whether you prefer once-daily or twice-daily dosing. Device type matters too: DPI vs pMDI may change how well you inhale the medicine.

Other drug classes and strategies

If an ICS/LABA combo isn’t right, consider these alternatives or add-ons:

• ICS alone (e.g., Flovent/fluticasone, Pulmicort/budesonide) — useful for mild persistent asthma where a LABA isn’t needed.
• LAMA or LAMA/LABA (tiotropium, Anoro, Stiolto) — often used for COPD and as an add-on for difficult-to-control asthma.
• Leukotriene modifiers (montelukast) — oral option for allergic asthma or as an add-on for step-up therapy.
• Biologic therapies (omalizumab, mepolizumab, benralizumab) — for severe eosinophilic or allergic asthma when inhalers don’t control symptoms.
• Short-acting bronchodilators (albuterol/salbutamol) — still your rescue inhaler for sudden symptoms.

These choices depend on your pattern of symptoms, test results (like eosinophils or allergy tests), and treatment goals.

Quick tips: always check inhaler technique, ask about a spacer if you use a pMDI, and discuss cost or insurance coverage. Don’t stop or switch inhalers without talking to your doctor — sudden changes can cause flare-ups. If steroid side effects worry you, ask about lowering dose, switching molecules, or using biologics when appropriate.

If you want help narrowing options, note your current symptoms (night wakening, rescue inhaler use, exercise limits), which will guide the right alternative. Your provider can match medicine, device, and dosing to what you actually need.