Symbicort vs. Advair: How do they compare?

Symbicort and Advair both contain an inhaled corticosteroid (a “steroid”) and an inhaled bronchodilator in one device to help with breathing. They are used to treat asthma and chronic obstructive pulmonary disease (COPD), are approved for different age groups and come in different types of inhalers.

Symbicort and Advair Diskus are both approved for the maintenance treatment of asthma and chronic obstructive pulmonary disease (COPD), while Advair HFA is used in asthma only and and Symbicort Aerosphere is approved for the maintenance treatment of COPD.

These products are not approved for the relief of acute bronchospasm, such as an asthma attack. A fast-acting inhaler, such as albuterol, should be used for sudden breathing emergencies in either COPD or asthma. If you do have a fast-acting inhaler, contact your healthcare provider.

Symbicort

Symbicort is an inhaled aerosol that contains budesonide, a corticosteroid that lessens inflammation in your lungs and formoterol, a long acting beta-2 agonist (LABA) bronchodilator that helps to relax the muscles around your airways to ease breathing. It comes as an aerosolized metered-dose inhaler.

Symbicort Aerosphere, approved in 2023, is a combination of budesonide, a corticosteroid, and formoterol fumarate, a long-acting beta2-adrenergic agonist (LABA), indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD). It comes as an aerosolized metered dose inhaler.

Advair

Advair HFA (generic name: fluticasone and salmeterol) is an inhaled aerosol in a metered-dose inhaler that contains similar, but different active ingredients from Symbicort: fluticasone propionate, a corticosteroid and salmeterol, a bronchodilator. HFA stands for hydrofluoroalkane or "HFA" inhaler)

Advair Diskus is an inhaled dry-powder formulation but contains the same ingredients as the aerosol inhaler form of Advair HFA. It comes in a disc-shaped inhaler that contains foil packets of the dry powder.

Who can use Symbicort?

Symbicort is approved for use in patients 6 years and older for the treatment of asthma. It is also used for the maintenance treatment of chronic obstructive pulmonary disease (COPD) including chronic bronchitis and/or emphysema.

Symbicort is taken as 2 puffs 2 times each day, morning and evening, about 12 hours apart. After each inhalation, rinse your mouth with water without swallowing.

Symbicort comes in two different strengths: budesonide 80 micrograms (mcg) / formoterol 4.5 mcg and budesonide 160 mcg / formoterol 4.5 mcg. Symbicort 160/4.5 is also indicated to reduce exacerbations of COPD. Symbicort 160/4.5 is the only strength approved for the treatment of COPD.

It's available in a pressurized metered-dose aerosol canister containing 60 or 120 metered inhalations and fitted with a counter. It is made by AstraZeneca and was first FDA-approved in 2006.

Symbicort Aerosphere is used as 2 inhalations twice daily for maintenance treatment of COPD.

Who can use Advair?

Advair HFA is used in adults and children 12 years of age and older for the treatment of asthma. It is not approved for use in COPD. Advair Diskus, a different product, is used for COPD. Both products are manufactured by GlaxoSmithKline.

Advair HFA is taken as 2 puffs 2 times each day, morning and evening, about 12 hours apart. After each inhalation, rinse your mouth with water without swallowing.

Advair HFA comes in three different strengths: 45 micrograms (mcg) fluticasone / 21 mcg salmeterol, 115 mcg fluticasone / 21 mcg salmeterol, and 230 mcg fluticasone / 21 mcg salmeterol. It’s a pressurized aerosol canister containing 60 or 120 metered inhalations and fitted with a counter.

Advair Diskus is used in adults and children 4 years of age and older for the treatment of asthma. It is also used for the maintenance treatment of COPD. Advair Diskus is taken as one puff inhaled twice a day.

Advair Diskus comes in three different strengths: 100 mcg fluticasone / 50 mcg salmeterol, 250 mcg fluticasone / 50 mcg salmeterol, and 500 mcg fluticasone / 50 mcg salmeterol. The lowest strength (100/50) is used in children 4 to 11 years for asthma. Only the 250 mcg / 50 mcg strength is used for COPD.

It comes in a disk inhaler as a dry-powder formulation containing 60 foil blister strips and is fitted with a dose counter.

Which is safer: Symbicort or Advair?

Symbicort and Advair products are well-tolerated by most patients. The medicine is delivered directly to the lungs which helps to limit side effects. Some commonly reported side effects, occurring in at least 2% to 3% of patients include:

Symbicort:

• Asthma: common cold, headache, upper respiratory tract infection, throat pain, oral thrush, sinusitis (inflammation of the sinus membranes), the flu, back pain, nasal congestion, stomach pain, vomiting.
• COPD: common cold, oral thrush, bronchitis, sinusitis, upper respiratory tract infection.

Related Questions

• How long can you be on Symbicort?
• What does Symbicort do to the lungs?
• Is Symbicort a steroid inhaler?

Symbicort Aerosphere:

• COPD: upper respiratory tract infection, COPD, back pain, headache, bronchitis, oral thrush, hoarseness, muscle spasm.

Advair HFA:

• Asthma: upper respiratory tract infection or inflammation, throat irritation, hoarseness, headache, dizziness, nausea and vomiting.

Advair Diskus:

• Asthma: upper respiratory tract infection or inflammation, sore throat, hoarseness, oral thrush, bronchitis, cough, headache, nausea and vomiting.
• COPD: pneumonia, oral thrush, sore throat, hoarseness, viral respiratory infections, headaches, muscle and bone pain.

To help prevent the development of oral thrush or candidiasis (white patches in the mouth or throat), rinse your mouth with water, and spit it out, after each inhalation.

Other side effects, drug interactions, and warnings exist with these medications. Tell your healthcare provider about all the medicines you use, including prescription and over-the-counter (OTC) drugs, herbal products and vitamins or other dietary supplements.

Which is more effective: Symbicort or Advair?

These products are very effective when you use them daily as prescribed by your doctor. In asthma and COPD, Symbicort and Advair should work similarly. However, the active ingredients and devices are different and some people may find that one works better for them than the other.

Inhaling an aerosol, such as Symbicort or Advair HFA is a different technique than inhaling the dry-powder formulation with the Advair Diskus. If you have trouble inhaling from any device, be sure to let your doctor or pharmacist know. They can provide a spacer for your aerosol inhaler or help you with your technique.

Which is more expensive: Symbicort and Advair?

Symbicort, Advair HFA and Advair Diskus are available in the original brand name products as well as generic / brand alternatives, which can help you save you money. Listed cash prices are based on using the Drugs.com Discount Card. Symbicort Aerosphere is not yet available as a generic option.

Follow these links to view the latest brand and generic prices, discount coupons and patient financial assistance programs.

• Price Guide for Advair Diskus
• Price Guide for Advair HFA
• Price Guide for Symbicort

Cash price per inhaler:

• Symbicort: $155-$177
• Advair HFA: $174-$278
• Advair Diskus: $57-$87

Prices can vary based on strengths, pharmacy, use of online coupons and even which part of the country you are in. If you have insurance, you may have a lower copay with a generic, so be sure to check with your insurance company to see if one product is preferred over another. These prices are always subject to change over time, too.

Generic options are also available and can be seen here: Drugs.com Pricing and Coupon Guide

The manufacturers of both Symbicort (AstraZeneca) and Advair (GlaxoSmithKline) may have patient assistance programs that can help with cost and copays, too. Contact them directly.

Bottom Line

• Symbicort, Advair HFA , Advair Diskus Symbicort Aerosphere and are all inhaled medications that treat lung diseases like asthma or COPD. They all contain a combination of an inhaled corticosteroid, to help lower lung inflammation, and an inhaler bronchodilator, to help relax the muscles around your airways and ease your breathing.
• Symbicort and Advair HFA come as an aerosolized metered-dose inhaler and Advair Diskus comes as a disk-shaped inhaler that delivers a dry-powder formulation. You may find one product easier to use than the other.
• These medicines are usually very well-tolerated with minimal side effects, as their primary action is delivered directly to the lungs. Common side effects include throat irritation, oral thrush, and respiratory tract infections.
• Brand names products may be expensive when paying cash, but lower-cost options are available these products. If paying cash without insuracne, consider using an online coupon to help lower your prices.

This is not all the information you need to know about Symbicort, Symbicort Aerosphere, Advair HFA or Advair Diskus for safe and effective use and does not replace your healthcare provider's instructions. Review the full information for each product here, and discuss this information with your doctor or other health care provider.