From the Guidelines
Dulera (mometasone/formoterol) is a good alternative to Symbicort inhaler, as it contains a similar combination of an inhaled corticosteroid and a long-acting beta-agonist (LABA) with a rapid onset of action, as recommended by the working group 1. When considering alternatives to Symbicort, it's essential to look at combination inhalers that contain both an inhaled corticosteroid and a LABA.
- Advair (fluticasone/salmeterol) is another option, but it contains salmeterol, which has a more delayed onset of action compared to formoterol 1.
- Breo Ellipta (fluticasone/vilanterol) and Wixela Inhub (fluticasone/salmeterol) are also alternatives, but the choice between these medications depends on factors like insurance coverage, personal response, and side effect profile. The most recent guidelines recommend using ICS/LABA combinations, such as budesonide/formoterol, as the preferred treatment for steps 3 and 4 in children and adults 1. However, the working group also suggests that other ICSs, like mometasone, can be used in combination with formoterol, making Dulera a viable alternative 1. It's crucial to maintain consistent use as prescribed and not stop suddenly when switching from Symbicort to any alternative medication, as this could worsen respiratory symptoms 1. Any switch between these medications should be supervised by a healthcare provider who can determine appropriate dosing and monitor your response to the new medication 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Alternatives to Symbicort Inhaler
There are several alternatives to the Symbicort inhaler, including:
- Salmeterol/fluticasone propionate (Seretide/Advair/Adoair) 2
- Beclometasone/formoterol (Foster) 2
- Formoterol and budesonide in separate inhalers 3
- Formoterol and fluticasone in separate inhalers 3
- Salmeterol and fluticasone in separate inhalers 3
Comparison of Alternatives
Studies have compared the efficacy of these alternatives, including:
- A study comparing budesonide/formoterol with salmeterol/fluticasone propionate, which found that budesonide/formoterol reduced the risk of hospitalizations/emergency-room visits by 28% compared to salmeterol/fluticasone propionate 2
- A study comparing formoterol and budesonide with salmeterol and fluticasone, which found that formoterol and budesonide improved asthma control and reduced exacerbations compared to salmeterol and fluticasone 4
- A systematic review comparing fluticasone and formoterol with budesonide and salmeterol, which found that fluticasone and formoterol provided improved therapeutic benefits compared to budesonide and salmeterol 3
Safety Profile
The safety profile of these alternatives has also been studied, including:
- A study comparing the safety of formoterol and budesonide with salmeterol and fluticasone, which found that there was probably little to no difference in non-fatal serious adverse events between the two treatments 5
- A study comparing the safety of budesonide/formoterol with salmeterol/fluticasone propionate, which found that budesonide/formoterol had a similar safety profile to salmeterol/fluticasone propionate 2
Efficacy in Uncontrolled Asthma
The efficacy of these alternatives in uncontrolled asthma has also been studied, including:
- A study comparing budesonide/formoterol maintenance and reliever therapy with high-dose salmeterol/fluticasone, which found that budesonide/formoterol reduced the incidence of severe asthma exacerbations and hospitalization/emergency room treatment compared to salmeterol/fluticasone 6