What is the average time to onset in minutes of Symbicort (budesonide/formoterol) versus Advair (fluticasone/salmeterol)?

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Last updated: April 24, 2025View editorial policy

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From the Guidelines

Symbicort has a faster onset of action compared to Advair, with Symbicort beginning to work within 1-3 minutes while Advair takes approximately 15 to 30 minutes to start working. This difference in onset time is primarily due to the different formulations of the medications. Symbicort contains formoterol as its long-acting beta-agonist (LABA) component, which has a more rapid onset of action than salmeterol, the LABA in Advair, as noted in a study published in the Journal of Allergy and Clinical Immunology 1. Formoterol begins bronchodilation within minutes of inhalation, making Symbicort suitable for both maintenance therapy and quick symptom relief in some patients.

The key factors to consider when choosing between Symbicort and Advair include:

  • Onset of action: Symbicort has a faster onset of action, which can be beneficial for patients who need quick relief of symptoms
  • Patient factors: Individual patient factors, such as symptom patterns and response to therapy, should be taken into account when selecting a medication
  • Disease severity: The choice of medication may also depend on the severity of the patient's asthma or COPD

It is essential to note that both medications are primarily designed for long-term control rather than rescue therapy, and patients should still have a separate rescue inhaler available for acute symptoms, as recommended by guidelines for the diagnosis and management of asthma 1. The choice between these medications should be based on individual patient factors, symptom patterns, and response to therapy. Additionally, other studies have compared the efficacy of combination therapies, including Symbicort and Advair, in preventing acute exacerbations of COPD, but the focus of these studies was not specifically on the onset of action 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Average Time to Onset of Symbicort vs Advair

  • The average time to onset of Symbicort (budesonide/formoterol) and Advair (salmeterol/fluticasone) can be compared based on the available studies.
  • According to the study 2, budesonide/formoterol has a faster onset of bronchodilatory effect compared to salmeterol/fluticasone, with significant differences observed at 3 minutes.
  • The study 2 also reports that the onset of effect was similar with budesonide/formoterol and salbutamol, with a median time to onset of 5 minutes for active treatments.
  • However, the other studies 3, 4, 5, 6 do not provide direct information on the average time to onset of Symbicort vs Advair.

Comparison of Onset Times

  • Based on the available data, it can be concluded that budesonide/formoterol has a faster onset of action compared to salmeterol/fluticasone, with an onset time of around 3-5 minutes 2.
  • However, more research is needed to confirm these findings and provide a more accurate comparison of the onset times of Symbicort and Advair.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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