From the Guidelines
Budesonide/formoterol (Symbicort) has several therapeutic equivalents, including fluticasone/salmeterol (Advair, Wixela), fluticasone/vilanterol (Breo Ellipta), mometasone/formoterol (Dulera), and beclomethasone/formoterol (Foster), which are all combination inhalers containing an inhaled corticosteroid and a long-acting beta-agonist (LABA) 1. These medications are similar in function to Symbicort, providing both anti-inflammatory effects from the corticosteroid component and bronchodilation from the LABA component.
- The closest direct equivalent is probably Dulera, as it contains formoterol (the same LABA as Symbicort) paired with a different corticosteroid.
- When switching between these medications, dosing adjustments may be needed as potency varies between different corticosteroids.
- The specific choice among these alternatives should be based on individual response, insurance coverage, and potential side effects, so consultation with a healthcare provider is essential before making any substitution 1. The use of these combination inhalers is supported by guidelines for the diagnosis and management of asthma, which recommend daily anti-inflammatory treatment with inhaled corticosteroids (ICSs) as the cornerstone of therapy for patients with persistent asthma, with the addition of a LABA for patients whose asthma is not adequately controlled with low-dose ICSs 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Equivalent to Symbicort
Symbicort is a combination medication containing budesonide and formoterol. The following are some equivalent medications:
- Budesonide/formoterol combination 2, 3, 4, 5
- Fluticasone/salmeterol combination 2, 4, 6, 5
- Fluticasone furoate/vilanterol combination 3
- Umeclidinium/vilanterol combination 6
Comparison of Medications
The studies compared the effectiveness of these medications in patients with asthma or chronic obstructive pulmonary disease (COPD). The results showed:
- No significant difference in COPD-related exacerbations between budesonide/formoterol and fluticasone/salmeterol 4
- Similar effectiveness between fluticasone furoate/vilanterol and budesonide/formoterol as maintenance and reliever therapy for asthma control 3
- Lower COPD-related medical costs and exacerbation risk with umeclidinium/vilanterol compared to fluticasone propionate/salmeterol, budesonide/formoterol, and tiotropium 6
- Better real-world effectiveness of budesonide/formoterol anti-inflammatory reliever and maintenance therapy compared to fluticasone propionate/salmeterol plus as-needed, short-acting β2 agonists in patients with inadequate asthma control 5
Key Findings
The key findings of the studies are:
- Budesonide/formoterol and fluticasone/salmeterol are commonly used combination medications for asthma and COPD 2, 4, 5
- Fluticasone furoate/vilanterol is an alternative combination medication for asthma control 3
- Umeclidinium/vilanterol may be a cost-effective option for COPD patients with high costs and comorbidities 6
- Budesonide/formoterol anti-inflammatory reliever and maintenance therapy may be more effective than fluticasone propionate/salmeterol plus as-needed, short-acting β2 agonists in patients with inadequate asthma control 5