5 Smart Alternatives to Symbicort: What to Know Before You Switch

If sick of Symbicort’s price or maybe it’s just not clicking with your lungs, you’re not alone. There’s no shame in shopping around—your breathing and your wallet deserve choices like anybody else’s. Sometimes, what works for one person isn’t the sweet spot for the next. I’ve seen friends swap inhalers more often than they change smartphone cases—all searching for that perfect fit.

You’ll find more than a few solid alternatives out there. Each one mixes up different medicines, comes with its own perks, and yes, has some drawbacks, too. Maybe you want something with gentler side-effects, or you need a combo that handles your asthma and COPD at the same time. Or it’s as simple as finding something covered by your plan so you’re not paying more for breathing than you do for rent.

The options lined up below aren’t pulled from thin air—they’re the inhalers real people are leaning on when Symbicort isn’t cutting it. We’ll keep this clear and straight, so it’s easier to decide what might actually work for you, not just in theory, but in the everyday scramble of life.

• Dulera (mometasone/formoterol)
• Breo Ellipta (fluticasone/vilanterol)
• Advair (fluticasone/salmeterol)
• Trelegy Ellipta (fluticasone/umeclidinium/vilanterol)
• Fostair (beclometasone/formoterol)
• Summary Table: Picking the Right Alternative

Dulera (mometasone/formoterol)

Dulera lands on a lot of lists when folks start searching for Symbicort alternatives, and for good reason. It’s a combo inhaler packed with mometasone (an inhaled corticosteroid, or ICS) and formoterol (a long-acting beta agonist, or LABA). You’ll mainly see it prescribed for keeping asthma in check, especially for people who need more than just an ICS alone. It’s not officially for COPD, but some doctors might use it off-label.

One big selling point: Dulera’s generic option can save you a bundle, especially if your insurance isn’t playing nice with brand-name meds. It’s taken twice a day—pretty standard for this class. If routines are your thing, it’s easy to keep on schedule, but missing a dose does happen, so setting a reminder helps.

Pros

• Great for long-term asthma inhaler control, not just symptom relief.
• Strong anti-inflammatory punch from the mometasone part.
• Available as a generic, usually much cheaper out-of-pocket than brand-name Symbicort.
• Generally well-tolerated; most folks don’t get hit with major side effects.

Cons

• Not officially approved for COPD—your doc might be creative, but it isn’t the rule.
• Twice-daily dosing means remembering to use it both morning and night.
• The steroid (mometasone) amount might be higher than you’re used to with Symbicort, depending on the dose your doctor picks.
• If asthma flares up badly, you might still need a separate rescue inhaler or an extra bronchodilator.

If you’re the type who likes researching before every switch, don’t skip asking your doctor about Dulera’s fit for your needs. It’s solid for asthma, but if you’ve got both asthma and more severe COPD, it may not tick every box.

Breo Ellipta (fluticasone/vilanterol)

Breo Ellipta is pretty popular among doctors and patients as a go-to alternative to Symbicort alternatives, especially if you want something once a day. It’s a combo inhaler with fluticasone (a steroid to dial down lung inflammation) and vilanterol (a long-acting bronchodilator that keeps your airways open). The biggest win for Breo is the one-daily dosing—you hit it in the morning and you’re set for 24 hours. No more stressing about missing that second dose if your day gets away from you.

Research published in the New England Journal of Medicine showed that Breo Ellipta can help cut down on asthma attacks and reduce COPD flare-ups compared to some older inhalers. That’s a big deal if you want steady control without a hassle.

Pros

• One puff, once a day—super simple routine.
• Backed by some strong evidence for both asthma and COPD.
• Nice, straightforward inhaler device (Ellipta is easier to use for a lot of folks with shaky hands or arthritis).
• Available in multiple strengths so you can adjust to what you need.

Cons

• Doesn’t work for everyone—some people need an extra controller or a rescue inhaler handy.
• Not everyone’s insurance covers it well, and out-of-pocket costs can sting.
• Only one dose per day, so if you’re really struggling, it might not feel like enough.
• Like all steroid inhalers, there’s a small risk of thrush in your mouth—so rinse and spit after use.

If you’re done juggling multiple doses a day and okay with a device that feels a bit different from a standard inhaler, Breo Ellipta can be a breath of fresh air—especially if you’re dealing with both asthma and COPD. Just check coverage and make sure your doc agrees it fits your needs.

Advair (fluticasone/salmeterol)

Advair packs two meds: fluticasone (which tackles inflammation) and salmeterol (a long-acting bronchodilator to keep your airways open). It’s been a go-to asthma inhaler and COPD option for years, so there’s lots of experience behind this combo. If you’ve ever heard your doc mention "purple disk" or "Diskus," yep, that’s Advair.

People like Advair because it comes in both an inhaler (the Diskus) and a pressurized metered-dose inhaler version, called the HFA. That means there’s probably a format that works for your grip, routine, or even if you fumble with the standard inhalers. Dosing is usually morning and night, so you don’t have to remember a midday puff.

Pros

• Proven track record for both asthma and COPD
• Available as a generic, so it usually costs way less than brand-only inhalers like Symbicort
• Comes in two styles: Diskus (dry powder) and HFA (spray), which is great for personal preference
• Widely covered by insurance, especially the generic
• Well-studied in adults and kids (Diskus approved down to age 4 for asthma)

Cons

• Has to be used twice daily—forgetting makes it much less effective
• Dry powder Diskus device can be tricky for people with weak breaths or coordination problems
• Higher long-term steroid dose might mean more risk of side effects like hoarse voice or throat infections
• Doesn’t cover every possible asthma trigger—you might still need a rescue inhaler

If you’re curious, here’s how Advair compares to Symbicort and Dulera in some key areas:

If cost, long-term safety, or a certain inhaler style has kept Symbicort off your must-have list, Advair gives a lot to think about. Remember, whether you’re switching because of budget, side effects, or doctor’s orders, there’s nothing wrong with finding what actually works for you day-to-day.

Trelegy Ellipta (fluticasone/umeclidinium/vilanterol)

If your doctor ever brings up Trelegy Ellipta, pay attention—it’s a triple-threat inhaler. Trelegy packs three meds in just one device: an inhaled corticosteroid (fluticasone), a long-acting beta agonist (vilanterol), and a long-acting muscarinic antagonist (umeclidinium). It’s mostly known for asthma and especially maintenance treatment for moderate-to-severe COPD. That extra medicine (umeclidinium) tackles the muscle tightening in your airways and can really help if other combos aren’t cutting it.

What sets Trelegy apart from something like Symbicort? Honestly: it’s the triple action. While Symbicort only mixes two medications, Trelegy’s third ingredient is a game-changer for folks who still feel tight or wheezy on a regular combo inhaler. In one real-world study of over 6,000 COPD patients, Trelegy cut the risk of flare-ups by nearly a fourth compared to dual-inhaler types. Not too shabby, right?

And get this—it’s just one puff, once a day. That’s a big relief if you get tired of remembering inhalers in the morning and at night. The device itself is pretty user-friendly, too. The Ellipta inhaler doesn't require coordinated timing with your breath, making it much less fussy during a flare or when you’re half-awake.

Pros

• Three meds in one inhaler: more complete airway control for tough cases
• Once-daily dosing—easy for forgetful folks or busy mornings
• Proven to lower COPD flare-ups and hospital visits in studies
• User-friendly device—no need to sync up pressing and inhaling

Cons

• Usually pricier than many two-drug inhalers like Symbicort alternatives
• Triple therapy may be more than you need if your symptoms are mild
• Not everyone can tolerate all three ingredients; dry mouth and hoarseness are possible
• Insurance might be tricky—always check your coverage first

The takeaway: If you feel like you’re maxed out on dual inhalers but still short of breath, Trelegy could be worth asking your doc about. It’s made for people with trouble getting stable, especially if flares keep sneaking up.

Fostair (beclometasone/formoterol)

Looking for something outside the regular American asthma inhalers menu? Enter Fostair. This one’s a popular combo inhaler in Europe and other spots around the world, though you won’t find it in the U.S. pharmacies just yet. That's kind of a bummer, since a lot of folks switching from Symbicort alternatives like the smooth feel of Fostair’s dose. It mixes beclometasone (an inhaled steroid) and formoterol (a fast-acting long-acting beta-agonist). The result: quick relief from tightness, while also chilling out the swelling in your airways.

One cool detail—Fostair tends to use "extra-fine" particles. This sneaky science means the medicine gets deeper into your lungs than some other options, giving you a bit more bang for your dose. In studies from UK clinics, patients switching to Fostair reported less coughing and were more likely to stay on their plan. It's available in both a regular pressurized aerosol inhaler (pMDI) and a dry powder version, which some people find easier to use if the typical push-and-breathe routine is tough for them.

Pros

• Uses extra-fine particles for better reach in the lungs
• Fast onset—formoterol starts working in minutes
• Popular in Europe for both asthma and some COPD patients
• Comes in multiple inhaler formats
• Many patients feel fewer throat or voice side-effects (compared to some other steroids)

Cons

• Not officially available in the U.S.—insurance may not cover if imported
• Needs twice-daily use
• Beclometasone dose may be lower than what U.S. users expect
• May not be right for severe COPD cases

If you’ve ever traveled abroad and noticed the inhalers look a bit different, that’s not just the change in packaging. Sometimes the formulas and the feel change too. Worth talking over with your doctor if you’re considering an imported med or thinking about a move overseas—you don’t want any surprises during pollen season.

Summary Table: Picking the Right Alternative

After breaking down each inhaler, let’s lay out all the key info side by side. Picking between these Symbicort alternatives isn’t about going with what sounds fancy—it’s about fit. For some, it’s control over asthma. For others, insurance coverage is the deciding factor. Often, it’s about fewer side-effects, or even just using the inhaler once instead of twice a day. Here’s what you should actually consider:

Here’s a quote that sums it up well:

"Switching from one inhaler to another isn’t just about swapping out names—the delivery device, dosing, and costs all play a huge role in finding the right match for each patient." — Dr. Michael Wechsler, National Jewish Health

Asthma inhalers are not one-size-fits-all. You might need to chat with your doctor and even your pharmacist (they know the insurance tricks!). If your insurance plan drops Symbicort or suddenly covers a new one, ask about a trial. Keep an eye on your symptoms during any switch. Write them down if it helps—you’ll have a clearer story to tell your provider if you don’t feel right.

If you ever feel stuck, patient assistance programs sometimes help with the cost, especially for brand-name options. And don’t rule out generics—they’re often the big budget savers and still do the job for most people. Breathing easy shouldn’t mean draining your bank account.