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 generally takes about 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, making Symbicort suitable for patients who need quicker symptom relief. Both medications contain inhaled corticosteroids (budesonide in Symbicort and fluticasone in Advair) for anti-inflammatory effects, but these take longer to work (hours to days) than the bronchodilator components.

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

  • The faster onset of Symbicort may be particularly beneficial for patients who experience more acute symptoms or need more immediate relief
  • Both medications are effective maintenance therapies for asthma and COPD when used regularly as prescribed, as discussed in guidelines for the diagnosis and management of asthma 1 and prevention of acute exacerbations of COPD 1
  • The choice between Symbicort and Advair should be based on individual patient needs and medical history, taking into account factors such as symptom severity, frequency of exacerbations, and response to treatment.

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) is reported to be around 3-5 minutes, as seen in a study comparing the onset of bronchodilation following different inhaled therapies in patients with moderate-to-severe COPD and reversible airway obstruction 2.
  • In contrast, the onset of action of Advair (salmeterol/fluticasone) is not explicitly stated in the provided studies, but it is mentioned that budesonide/formoterol has a faster onset of bronchodilatory effect compared to salmeterol/fluticasone 2.
  • Another study found that budesonide/formoterol had a similar onset of effect to salbutamol, with a median time to onset of 5 minutes 2.
  • However, it is essential to note that the exact average time to onset of Advair is not provided in the given studies, making a direct comparison challenging.

Key Findings

  • Budesonide/formoterol (Symbicort) has a fast onset of effect, which may help patients feel more in control of their condition and improve adherence to their medication 3.
  • The onset of action of budesonide/formoterol is faster than salmeterol/fluticasone (Advair) in patients with COPD and reversible airway obstruction 2.
  • Budesonide/formoterol and salmeterol/fluticasone have similar efficacy and tolerability in patients with persistent asthma, but budesonide/formoterol may have a faster onset of effect 4, 5.

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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