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
Symbicort
Advair vs. Symbicort Dosage
Advair
Symbicort
| 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 |
| 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
| 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
| 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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