When You Can't Get Symbicort, What Are Your Options?

If you've been prescribed Symbicort (budesonide/formoterol) and can't find it at your pharmacy — or the cost is too high — you're probably wondering what alternatives exist. The good news is that several other inhalers work in a similar way and may be a good fit for you.

In this article, we'll explain how Symbicort works, then walk through the most common alternatives your doctor might recommend.

Important: Never switch medications on your own. Always talk to your doctor before changing your inhaler. This article is for informational purposes to help you have an informed conversation with your healthcare provider.

What Is Symbicort and How Does It Work?

Symbicort is a combination inhaler that contains two medications:

• Budesonide — an inhaled corticosteroid (ICS) that reduces swelling and inflammation in your airways
• Formoterol — a long-acting beta2-agonist (LABA) that relaxes the muscles around your airways, making it easier to breathe

This combination of an anti-inflammatory and a bronchodilator is the cornerstone of maintenance therapy for moderate-to-severe asthma and COPD. Symbicort is taken as 2 inhalations twice daily and is available in two strengths: 80/4.5 mcg and 160/4.5 mcg.

For a deeper dive into the science, see our article on how Symbicort works.

Alternative 1: Advair (Fluticasone/Salmeterol)

Advair is probably the most well-known alternative to Symbicort. It's also a combination ICS/LABA inhaler, but uses different active ingredients:

• Fluticasone — the corticosteroid component
• Salmeterol — the long-acting bronchodilator

Advair comes in two forms:

• Advair Diskus — a dry powder inhaler (DPI) available in three strengths (100/50, 250/50, 500/50 mcg)
• Advair HFA — a metered-dose inhaler (MDI) available in three strengths (45/21, 115/21, 230/21 mcg)

Key differences from Symbicort: Advair uses salmeterol instead of formoterol. Salmeterol has a slightly slower onset of action but a similar duration. Advair Diskus is a dry powder inhaler, which some patients find easier to use since it doesn't require the coordination of pressing and breathing at the same time.

Generic available? Yes. Wixela Inhub is an authorized generic of Advair Diskus, and generic fluticasone/salmeterol MDI options are also available. Prices typically range from $150 to $300 depending on the formulation.

Alternative 2: Breo Ellipta (Fluticasone Furoate/Vilanterol)

Breo Ellipta is a newer ICS/LABA combination that offers one major advantage: once-daily dosing. Instead of taking your inhaler twice a day, you take Breo Ellipta just once each morning.

• Fluticasone furoate — the corticosteroid
• Vilanterol — a long-acting bronchodilator

Breo Ellipta is approved for both asthma (in patients 18 and older) and COPD. It comes in two strengths: 100/25 mcg and 200/25 mcg.

Key differences from Symbicort: Once-daily dosing can improve adherence — if you tend to forget your evening dose, Breo Ellipta may be a better fit. It uses a dry powder inhaler device (the Ellipta), which many patients find intuitive.

Generic available? Generic versions are becoming available, which may lower costs. Brand-name Breo Ellipta typically costs $350 to $450 without insurance.

Alternative 3: Dulera (Mometasone/Formoterol)

Dulera is another ICS/LABA combination inhaler that actually shares one ingredient with Symbicort — formoterol. The corticosteroid component is mometasone instead of budesonide.

• Mometasone — the corticosteroid
• Formoterol — the same long-acting bronchodilator found in Symbicort

Dulera is approved for asthma in patients aged 5 and older. It comes in two strengths: 100/5 mcg and 200/5 mcg.

Key differences from Symbicort: Since Dulera contains formoterol (the same LABA as Symbicort), the switch may feel very familiar. The main difference is the corticosteroid component. Dulera is only approved for asthma, not COPD.

Generic available? Generic mometasone/formoterol options are emerging. Cash prices for brand-name Dulera range from $300 to $400.

Alternative 4: Wixela Inhub (Generic Advair Diskus)

If cost is your primary concern, Wixela Inhub deserves special mention. It's an authorized generic of Advair Diskus (fluticasone/salmeterol) and is typically the most affordable ICS/LABA option available.

Wixela Inhub comes in three strengths (100/50, 250/50, 500/50 mcg) and uses a dry powder inhaler device. Cash prices often range from $100 to $250, making it significantly cheaper than brand-name Symbicort or Advair.

How to Talk to Your Doctor About Switching

If you're considering an alternative to Symbicort, here are some questions to bring to your next appointment:

• Which alternative inhaler would work best for my specific condition (asthma vs. COPD)?
• Will switching change how often I need to take my inhaler?
• Are there any differences in side effects I should watch for?
• Is the alternative covered by my insurance, and what will my copay be?
• Should I use a transition period or can I switch directly?

Your doctor knows your medical history and can recommend the best option for your situation.

Final Thoughts

Not being able to fill your Symbicort prescription is stressful, but you have options. Advair, Breo Ellipta, Dulera, and Wixela Inhub all use similar mechanisms to control asthma and COPD symptoms. Generic versions are increasingly available and can save you money.

Start by searching Medfinder to see if Symbicort or its generic is available near you. If it's not, bring this list to your next doctor's appointment and discuss which alternative is the best fit. For more on managing costs, see our guide on saving money on Symbicort.