What is the difference between Synbicort (budesonide/formoterol) and Albuterol (salbutamol) for treating asthma or Chronic Obstructive Pulmonary Disease (COPD)?

From the Guidelines

Symbicort and albuterol serve different roles in treating asthma and COPD, with Symbicort being a preventative maintenance medication and albuterol providing quick relief during symptom flare-ups. The key difference between Symbicort (budesonide/formoterol) and albuterol (salbutamol) lies in their purpose and duration of action. Symbicort is a combination medication that includes an inhaled corticosteroid (budesonide) to reduce airway inflammation and a long-acting beta-agonist (formoterol) that provides bronchodilation for 12 hours 1. It is typically prescribed for daily use to prevent symptoms and control the underlying inflammation in patients with persistent asthma or COPD. On the other hand, albuterol is a short-acting beta-agonist that works quickly to relax airway muscles during acute symptoms but only lasts 4-6 hours 1. It is used as a rescue inhaler for immediate relief during symptom flare-ups.

Some key points to consider when choosing between Symbicort and albuterol include:

• Symbicort is used for long-term control and prevention of symptoms, while albuterol is used for quick relief during acute symptoms.
• Symbicort combines an inhaled corticosteroid and a long-acting beta-agonist, while albuterol is a short-acting beta-agonist only.
• Patients with persistent asthma or COPD often need both medications - Symbicort for daily control and albuterol for breakthrough symptoms.

According to the most recent guidelines, combination therapy with a long-acting beta-agonist and an inhaled corticosteroid, such as Symbicort, is recommended for patients with stable COPD and an FEV1 <60% predicted 1. Additionally, the use of short-acting beta-agonists like albuterol is recommended for quick relief during acute symptoms 1.

Overall, the combination of Symbicort for daily control and albuterol for breakthrough symptoms provides a comprehensive approach to managing asthma and COPD, addressing both the inflammatory component and providing immediate relief when needed 1.

From the FDA Drug Label

BUDESONIDE AND FORMOTEROL FUMARATE DIHYDRATE INHALATION AEROSOL combines an inhaled corticosteroid medicine (ICS), budesonide and a long-acting beta2-adrenergic agonist (LABA) medicine, formoterol.

BUDESONIDE AND FORMOTEROL FUMARATE DIHYDRATE INHALATION AEROSOL is not used to relieve sudden breathing problems and will not replace a rescue inhaler

Albuterol is a rescue inhaler used for sudden breathing problems, whereas Synbicort (budesonide/formoterol) is used for long-term control of asthma and COPD symptoms.

The main difference between Synbicort (budesonide/formoterol) and Albuterol is that:

• Synbicort is a combination of an inhaled corticosteroid and a long-acting beta2-adrenergic agonist used for long-term control of asthma and COPD symptoms.
• Albuterol is a short-acting beta2-adrenergic agonist used for quick relief of sudden breathing problems.

Key points to consider:

• Synbicort is not a rescue inhaler and should not be used to relieve sudden breathing problems.
• Albuterol is a rescue inhaler and should only be used as needed for sudden breathing problems. 2 2

From the Research

Overview of Synbicort and Albuterol

• Synbicort is a combination medication containing budesonide (an inhaled corticosteroid) and formoterol (a long-acting beta2-agonist) used for the treatment of asthma and Chronic Obstructive Pulmonary Disease (COPD) 3, 4, 5.
• Albuterol, also known as salbutamol, is a short-acting beta2-agonist used for the relief of bronchospasm in conditions such as asthma and COPD 4, 6.

Differences in Mechanism of Action

• Synbicort works by reducing inflammation in the lungs through budesonide and relaxing airway muscles through formoterol, providing both anti-inflammatory and bronchodilatory effects 3, 5.
• Albuterol acts solely as a bronchodilator, providing quick relief from bronchospasm but not addressing the underlying inflammation 4, 6.

Efficacy in Asthma and COPD

• Studies have shown that Synbicort is effective in improving lung function, reducing exacerbations, and improving quality of life in patients with asthma and COPD 3, 5, 7.
• Albuterol is effective for acute relief of bronchospasm but may not be sufficient for long-term control of asthma or COPD symptoms 4, 6.
• A study found that as-needed use of albuterol-budesonide resulted in a lower risk of severe asthma exacerbation compared to as-needed use of albuterol alone in patients with mild asthma 4.

Treatment Guidelines

• The National Asthma Education and Prevention Program recommends the use of inhaled corticosteroids, such as budesonide, in combination with long-acting beta2-agonists, such as formoterol, for the treatment of moderate to severe asthma 6.
• For patients with poorly controlled asthma, switching to a single inhaler combination of inhaled corticosteroid-formoterol as both maintenance and reliever therapy (SMART) may be beneficial 5.
• In COPD, triple therapy with an inhaled corticosteroid, a long-acting muscarinic antagonist, and a long-acting beta2-agonist, such as budesonide/glycopyrronium/formoterol, may be recommended for patients who experience further exacerbations or symptoms despite dual therapy 3, 7.