Can't Find Breyna? Here Are Your Options

If your pharmacy keeps telling you Breyna is out of stock, you're probably wondering: what else can I take? The good news is that Breyna is not the only ICS/LABA combination inhaler available. Several alternatives treat asthma and COPD with similar effectiveness.

In this guide, we'll cover what Breyna is, how it works, and walk through 4 real alternatives your doctor may recommend. Important: Never switch or stop your inhaler without talking to your prescriber first.

What Is Breyna?

Breyna is a prescription metered-dose inhaler (MDI) containing Budesonide (an inhaled corticosteroid) and Formoterol (a long-acting beta-2 agonist). It was launched in 2023 by Viatris as the first FDA-approved generic version of Symbicort.

Breyna is prescribed for:

• Asthma in patients 6 years and older who need both an anti-inflammatory and a bronchodilator
• COPD maintenance treatment, including chronic bronchitis and emphysema

It comes in two strengths — 80/4.5 mcg and 160/4.5 mcg — and is taken as 2 inhalations twice daily. For a complete overview, see our guide on what Breyna is and how to use it.

How Does Breyna Work?

Breyna works through its two active ingredients targeting different aspects of airway disease:

• Budesonide reduces inflammation in the airways. Chronic inflammation is a core feature of both asthma and COPD, causing swelling, excess mucus, and narrowing of the air passages. By calming this inflammation, Budesonide helps prevent symptoms before they start.
• Formoterol relaxes the smooth muscles surrounding the airways. This bronchodilator effect opens up the air passages and makes it easier to breathe. Because it's a long-acting beta-agonist, its effects last approximately 12 hours.

Together, these two medications provide both anti-inflammatory and bronchodilator benefits in a single inhaler. For a deeper dive, read our article on how Breyna works.

4 Alternatives to Breyna

All of the alternatives below are ICS/LABA combination inhalers. They work on the same principle as Breyna — combining a corticosteroid with a long-acting bronchodilator — but use different active ingredients or delivery systems.

1. Symbicort (Budesonide/Formoterol)

Why it's relevant: Symbicort is the brand-name version of Breyna. They contain the exact same active ingredients in the same strengths and are considered therapeutically equivalent by the FDA.

• Strengths: 80/4.5 mcg and 160/4.5 mcg per actuation
• Dosing: 2 inhalations twice daily
• Approved for: Asthma (6+ years) and COPD
• Cost: Brand-name Symbicort typically costs $300 to $400 per inhaler without insurance, though discount cards can bring it down

If your pharmacy is out of Breyna, they may have Symbicort in stock since it comes from a different manufacturer (AstraZeneca).

2. Advair Diskus/HFA (Fluticasone/Salmeterol)

Why it's relevant: Advair is one of the most well-established ICS/LABA inhalers on the market. It's been around since 2000 and has an extensive track record for treating asthma and COPD.

• Strengths: Multiple options — 100/50 mcg, 250/50 mcg, 500/50 mcg (Diskus); 45/21 mcg, 115/21 mcg, 230/21 mcg (HFA)
• Dosing: 1 inhalation twice daily (Diskus) or 2 inhalations twice daily (HFA)
• Approved for: Asthma (4+ years) and COPD
• Cost: Generic Fluticasone/Salmeterol is available and may cost $50 to $150 with a discount coupon
• Key difference: Available as both a dry powder inhaler (Diskus) and a metered-dose inhaler (HFA). The Diskus doesn't require coordination between pressing and inhaling.

3. Dulera (Mometasone/Formoterol)

Why it's relevant: Dulera uses a different corticosteroid (Mometasone) paired with the same bronchodilator found in Breyna (Formoterol).

• Strengths: 100/5 mcg and 200/5 mcg per actuation
• Dosing: 2 inhalations twice daily
• Approved for: Asthma (5+ years); not currently FDA-approved for COPD
• Cost: Around $350 to $500 per inhaler without insurance
• Key difference: A good option for asthma patients, but not approved for COPD. If you use Breyna specifically for COPD, Dulera may not be appropriate.

4. Breo Ellipta (Fluticasone/Vilanterol)

Why it's relevant: Breo Ellipta is a once-daily ICS/LABA inhaler, which some patients prefer for convenience.

• Strengths: 100/25 mcg and 200/25 mcg
• Dosing: 1 inhalation once daily
• Approved for: Asthma (18+ years) and COPD
• Cost: Around $350 to $500 per inhaler without insurance; may be covered at a preferred tier on some plans
• Key difference: Only needs to be taken once a day instead of twice, which can improve adherence. However, it's a dry powder inhaler, not an MDI — so the inhalation technique is different from Breyna.

How to Decide Which Alternative Is Right for You

The best alternative depends on your specific situation. Here are some questions to discuss with your doctor:

• What condition are you treating? If it's COPD, make sure the alternative is FDA-approved for COPD (Dulera is not).
• Do you prefer an MDI or a dry powder inhaler? If you have trouble coordinating the press-and-breathe technique of an MDI, a dry powder inhaler like Advair Diskus or Breo Ellipta might be easier.
• How many times a day do you want to use your inhaler? Breo Ellipta is once daily; the others are twice daily.
• What does your insurance cover? Check your plan's formulary. The most affordable option may be a generic version of Advair (Fluticasone/Salmeterol) or Symbicort.
• Have you had side effects with Breyna? If you've experienced issues like oral thrush or voice changes, switching corticosteroid components (e.g., from Budesonide to Fluticasone) may help.

Final Thoughts

Running out of Breyna is stressful, but you have real options. Symbicort, Advair, Dulera, and Breo Ellipta all belong to the same drug class and can provide similar symptom control for asthma and COPD. Talk to your doctor about which alternative makes the most sense for your condition, your insurance, and your lifestyle.

In the meantime, use Medfinder to search for pharmacies that may have Breyna in stock. And for tips on affording your medication, check out our guide on how to save money on Breyna.