Advair vs. Symbicort

See how Advair and Symbicort compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Advair and Symbicort are both combination inhalers that pair a steroid with a long-acting bronchodilator to control asthma and COPD, not to treat sudden attacks.

  • Advair is a dry powder inhaler taken twice daily, while Symbicort is a metered-dose aerosol inhaler also taken twice daily.

  • Advair has an FDA-approved generic (Wixela Inhub), while Symbicort remains available only as a brand-name inhaler.

Advair vs. Symbicort Drug Summary

Advair

Advair is a combination inhaler that pairs the steroid fluticasone with the long-acting bronchodilator salmeterol. It is used for daily maintenance of asthma in people 4 and older and for COPD, taken as two puffs from a dry powder Diskus device each morning and night.

Symbicort

Symbicort combines the steroid budesonide with the long-acting bronchodilator formoterol. It treats asthma in people 6 and older and COPD, delivered as two puffs from a metered-dose aerosol inhaler twice daily.

Advair vs. Symbicort Side Effects

Advair

Most common
upper respiratory tract infection (up to 3%)
headache (up to 3%)
throat irritation (up to 3%)
dysphonia (up to 3%)

Symbicort

Most common
upper respiratory tract infection (up to 3%)
headache (up to 3%)
nasopharyngitis (up to 3%)
pharyngolaryngeal pain (up to 3%)

Advair vs. Symbicort Dosage

Advair

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 100 mcg/50 mcg twice daily At the start
Maximum dose 500 mcg/50 mcg twice daily If needed
Dose changes 2 increases As tolerated

Symbicort

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 2 inh 80/4.5 mcg twice daily At the start
Maximum dose 2 inh 160/4.5 mcg twice daily If needed
Dose changes 1 increase As tolerated

Advair vs. Symbicort Indications

Advair

Advair is approved for the maintenance treatment of asthma in people 4 years and older and for maintaining airflow in COPD. It also helps reduce the number of COPD flare-ups in people who have had them before. It is not meant to treat a sudden asthma or COPD attack.

  • Maintenance treatment of asthma (age 4+)

  • Maintenance treatment of COPD airflow obstruction

  • Reduces COPD exacerbations in prior sufferers

  • Not for acute bronchospasm or status asthmaticus

Symbicort

Symbicort is approved for the maintenance treatment of asthma in people 6 years and older and for COPD, including chronic bronchitis and emphysema. It is also used to reduce COPD flare-ups. Like Advair, it is not intended for immediate relief of a breathing attack.

  • Maintenance treatment of asthma (age 6+)

  • Maintenance treatment of COPD, including bronchitis/emphysema

  • Reduces COPD exacerbations

  • Not for acute bronchospasm relief

Advair vs. Symbicort Pros and Cons

Advair

Advair has been on the market since 2000 and is available as a lower-cost generic, Wixela Inhub. Its dry powder design means no shaking or priming, but it does require a strong, steady breath to work properly.

Pros

  • FDA-approved generic version (Wixela Inhub) available

  • Approved for asthma starting at age 4

  • No shaking or priming needed before use

  • Long real-world track record since 2000

Cons

  • Requires a forceful inhalation, harder for weak lungs

  • Contraindicated in severe milk protein allergy

  • Must rinse mouth after use to prevent thrush

  • Not usable with a spacer device

Symbicort

Symbicort uses a familiar aerosol inhaler design that some patients find easier to coordinate than a powder device. It carries the same class-wide LABA warning as Advair but is only available as a brand-name product.

Pros

  • Aerosol inhaler works with normal breathing effort

  • Can be used with a spacer for easier delivery

  • 160/4.5 mcg strength specifically built for COPD

  • Formoterol offers a faster onset than salmeterol

Cons

  • No generic version currently available

  • Requires shaking and priming before each use

  • Not approved for asthma below age 6

  • Carries an active boxed warning for LABA risk

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