There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
The FDA Drug Labels for budesonide-formoterol (INH), budesonide (INH), glycopyrrolate (INH), formoterol (INH) do not address this question.
From the Research
Concurrent Use of Budesonide-Formoterol and Breztri
There is no direct evidence to recommend the concurrent use of budesonide-formoterol (Symbicort) and Breztri (budesonide-glycopyrrolate-formoterol) in the provided studies.
Available Information on Individual Treatments
- Budesonide/formoterol is a combination inhaled steroid and long-acting bronchodilator approved for use in COPD, which has been shown to be more effective than either component alone in addressing many important aspects of the disease 1.
- Budesonide/glycopyrronium/formoterol (Breztri) is an inhaled fixed-dose combination of the inhaled corticosteroid budesonide, the long-acting muscarinic antagonist glycopyrronium bromide, and the long-acting β2-agonist formoterol fumarate, which has been shown to reduce the rates of moderate/severe COPD exacerbations and improve lung function to a greater extent than budesonide/formoterol and/or glycopyrronium/formoterol 2.
- A network meta-analysis suggested that budesonide/glycopyrronium/formoterol has comparable efficacy to other ICS/LAMA/LABA fixed-dose and open triple combination therapies in reducing exacerbations and improving lung function and symptoms in patients with moderate to very severe COPD 3.
- A review of fixed-dose ICS/LABA combinations, including budesonide/formoterol, found that the effects of budesonide/formoterol on reducing exacerbations and improving quality of life may be similar to, or more marked than, those of other LABA/ICS combinations in COPD 4.
- Budesonide/glycopyrrolate/formoterol fumarate co-suspension metered dose inhaler has been shown to reduce the risk of exacerbations, decrease rescue inhaler use, and improve patient-reported outcomes of symptoms and well-being in patients with COPD 5.
Lack of Direct Comparison
There are no studies that directly compare the concurrent use of budesonide-formoterol and Breztri, and therefore, no recommendation can be made based on the available evidence.