Budesonide/Formoterol Is a Combination Inhaler Used to Treat Asthma and COPD

Budesonide/Formoterol is a prescription combination inhaler that contains an anti-inflammatory corticosteroid and a long-acting bronchodilator, used to prevent and control symptoms of asthma in adults and children ages 6 and older, and to treat chronic obstructive pulmonary disease (COPD) in adults.

If your doctor has prescribed this medication — or you're researching whether it might be right for you — this guide covers everything you need to know in plain language: what it is, how it works, how to take it, what it costs, and important safety information.

What Is Budesonide/Formoterol?

Brand and Generic Names

Budesonide/Formoterol is the generic name for a combination inhaler that's best known by the brand name Symbicort, manufactured by AstraZeneca. It's also available as Breyna and as FDA-approved generic versions (first approved in 2022). The generic versions contain the same active ingredients in the same doses as brand-name Symbicort.

Drug Class

Budesonide/Formoterol belongs to a class of medications called bronchodilator combinations. It combines two types of medication:

• Budesonide — an inhaled corticosteroid (ICS) that reduces inflammation and swelling in the airways
• Formoterol — a long-acting beta2-agonist (LABA) that relaxes the muscles around the airways, opening them up

By combining both an anti-inflammatory and a bronchodilator in one inhaler, Budesonide/Formoterol addresses two key problems at once: airway inflammation and airway constriction. For a detailed explanation of the science, see our article on how Budesonide/Formoterol works.

FDA Approval

The original brand-name product, Symbicort, was approved by the FDA in 2006 for asthma and in 2009 for COPD maintenance. The first generic Budesonide/Formoterol inhalers were approved in 2022, providing patients with more affordable options.

What Is Budesonide/Formoterol Used For?

Asthma

Budesonide/Formoterol is FDA-approved for the maintenance treatment of asthma in patients 6 years and older whose asthma is not adequately controlled on a long-term asthma controller medication (like an inhaled corticosteroid alone), or whose disease severity warrants treatment with both an ICS and a LABA.

It is not a rescue inhaler and should not be used to treat sudden asthma attacks. You still need a short-acting rescue inhaler like Albuterol (ProAir, Ventolin) for acute symptoms.

COPD (Chronic Obstructive Pulmonary Disease)

In adults, Budesonide/Formoterol is approved for the maintenance treatment of airflow obstruction in COPD, including chronic bronchitis and emphysema. It helps reduce flare-ups and improve day-to-day breathing in people with moderate-to-severe COPD.

How Is Budesonide/Formoterol Taken?

Dosage Forms and Strengths

Budesonide/Formoterol comes as a metered-dose inhalation aerosol in two strengths:

• 80/4.5 mcg — 80 mcg of Budesonide and 4.5 mcg of Formoterol per inhalation (lower dose)
• 160/4.5 mcg — 160 mcg of Budesonide and 4.5 mcg of Formoterol per inhalation (higher dose)

Typical Dosing

The standard dose is 2 inhalations (puffs) twice daily — once in the morning and once in the evening, about 12 hours apart. Your doctor will determine which strength is right for you based on your condition and severity.

Important Usage Tips

• Shake the inhaler well before each use
• Prime the inhaler before first use and if it hasn't been used for more than 7 days
• Rinse your mouth with water after each use and spit it out — this prevents oral thrush
• Don't exceed the prescribed dose — using too much can cause life-threatening side effects
• Use it at the same times daily for best results
• Don't stop suddenly — if you need to stop, your doctor will taper the dose gradually

Who Should Not Take Budesonide/Formoterol?

Budesonide/Formoterol is not right for everyone. You should not use this medication if you:

• Are allergic to Budesonide, Formoterol, or any ingredients in the inhaler
• Need treatment for an acute asthma attack or status asthmaticus (use a rescue inhaler instead)
• Have a severe allergy to milk proteins (some formulations may contain trace amounts)

Use with caution if you have:

• Heart disease, high blood pressure, or irregular heartbeat
• Seizure disorders
• Diabetes (Budesonide can raise blood sugar)
• Osteoporosis (long-term corticosteroid use may reduce bone density)
• Liver disease (may increase Budesonide levels in the body)
• Thyroid disorders
• Active or untreated infections, including tuberculosis
• Glaucoma or cataracts

For a full list of potential side effects, see our guide: Budesonide/Formoterol Side Effects: What to Expect.

How Much Does Budesonide/Formoterol Cost?

Cost is a major concern for many patients — and Budesonide/Formoterol isn't cheap. Here's what you can expect:

Without Insurance

• Brand-name Symbicort: $350 to $530 per inhaler (120 inhalations)
• Generic Budesonide/Formoterol: $250 to $530 per inhaler at retail price

With Coupons or Discount Cards

• GoodRx: Generic as low as ~$155 to $200
• SingleCare: Generic as low as ~$156
• RxSaver: Comparable savings available

With Insurance

Generic Budesonide/Formoterol is covered by most Medicare and commercial insurance plans. Your copay will depend on your plan's formulary tier — typically $20 to $75 for a preferred generic. Brand Symbicort may require prior authorization or step therapy.

Manufacturer Savings

AstraZeneca offers a Symbicort Savings Card that can reduce the cost to as little as $35 per month for eligible commercially insured patients. They also offer the AZ&Me Patient Assistance Program for qualifying uninsured or underinsured patients, which provides the medication for free.

For a complete breakdown of all savings options, read our guide: How to Save Money on Budesonide/Formoterol.

Important Drug Interactions

Budesonide/Formoterol can interact with other medications. Key interactions include:

• Strong CYP3A4 inhibitors (Ketoconazole, Ritonavir, Itraconazole, Clarithromycin) — can increase Budesonide levels in your body
• Beta-blockers (Metoprolol, Propranolol) — can reduce the effectiveness of Formoterol
• MAO inhibitors and tricyclic antidepressants — can amplify cardiovascular effects
• Other LABAs — do not use another inhaler containing a long-acting beta-agonist

For a comprehensive list, see our article: Budesonide/Formoterol Drug Interactions: What to Avoid.

Final Thoughts

Budesonide/Formoterol is a well-proven, effective combination inhaler that helps millions of people manage asthma and COPD every day. The availability of generic versions since 2022 has made it more accessible and affordable, though it can still be a significant expense without insurance or coupons.

If you've been prescribed Budesonide/Formoterol, take the time to learn proper inhaler technique, understand the potential side effects, and explore your savings options. And if you're having trouble finding it at your pharmacy, Medfinder can help you locate it in stock near you.