Symbicort vs. Breo
See how Symbicort and Breo compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Symbicort is an inhaled steroid/LABA combination taken twice daily, while Breo delivers a similar combination once a day.
Both drugs are approved for asthma and COPD maintenance, but Symbicort covers asthma down to age 6 and Breo down to age 5.
Neither Symbicort nor Breo is a rescue inhaler, and both carry a boxed warning about LABA-related asthma death risk.
Symbicort vs. Breo Drug Summary
Symbicort
Symbicort combines the inhaled corticosteroid budesonide with the long-acting bronchodilator formoterol in a single metered-dose inhaler. It's approved for maintenance treatment of asthma in patients 6 and older and for COPD, including chronic bronchitis and emphysema. It's inhaled twice a day, every day, and isn't used for sudden symptoms.
Breo
Breo pairs the inhaled corticosteroid fluticasone furoate with the long-acting bronchodilator vilanterol in a dry-powder Ellipta inhaler. It's approved for maintenance treatment of asthma in patients 5 and older and for COPD, including chronic bronchitis and emphysema. It's inhaled just once a day and isn't intended for sudden symptom relief.
Symbicort vs. Breo Side Effects
Symbicort
Breo
Symbicort vs. Breo Dosage
Symbicort
Breo
| STAGE | DOSE | WHEN |
| Starting dose | 2 inh, 80/4.5 mcg | At the start |
| Maximum dose | 2 inh, 160/4.5 mcg | If needed |
| Dose changes | 1 increase | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 50/25 mcg | At the start |
| Maximum dose | 200/25 mcg | If needed |
| Dose changes | 2 increases | As tolerated |
Symbicort
| STAGE | DOSE | WHEN |
| Starting dose | 2 inh, 80/4.5 mcg | At the start |
| Maximum dose | 2 inh, 160/4.5 mcg | If needed |
| Dose changes | 1 increase | As tolerated |
Breo
| STAGE | DOSE | WHEN |
| Starting dose | 50/25 mcg | At the start |
| Maximum dose | 200/25 mcg | If needed |
| Dose changes | 2 increases | As tolerated |
Symbicort vs. Breo Indications
Symbicort
Symbicort is FDA-approved for maintenance treatment of asthma in patients 6 years and older and for COPD, including chronic bronchitis and emphysema. It works by combining an inhaled corticosteroid with a long-acting bronchodilator to control inflammation and keep airways open over time. It is not intended to relieve sudden asthma or COPD symptoms.
Asthma maintenance treatment, age 6 and up
COPD maintenance treatment (chronic bronchitis/emphysema)
Helps reduce COPD exacerbations
Not approved for acute bronchospasm relief
Breo
Breo is FDA-approved for maintenance treatment of asthma in patients 5 years and older and for COPD, including chronic bronchitis and emphysema. Like Symbicort, it pairs an inhaled corticosteroid with a long-acting bronchodilator, but it is taken just once a day. It is not a rescue inhaler and should not be used for sudden symptoms.
Asthma maintenance treatment, age 5 and up
COPD maintenance treatment (chronic bronchitis/emphysema)
Not approved as a rescue inhaler
200/25 mcg strength limited to asthma, age 12+
Symbicort vs. Breo Pros and Cons
Symbicort
Symbicort has been on the market since 2006, giving prescribers a long history of safety data across both asthma and COPD. It's taken twice daily using a metered-dose inhaler, which some patients find easier than a breath-activated dry-powder device. Generic versions have become available, adding a lower-cost path for some patients.
Pros
Over 15 years of real-world safety data since 2006 approval
Metered-dose inhaler doesn't require strong inhalation effort
Generic budesonide/formoterol versions are now available
Simpler two-strength dosing (80/4.5 and 160/4.5 mcg)
Cons
Requires twice-daily dosing, morning and evening
Only approved for asthma starting at age 6
No dry-powder inhaler option
Requires coordinating inhaler actuation with breathing
Breo
Breo offers once-daily dosing through the Ellipta inhaler, a dry-powder device that doesn't require timing a puff with a breath. It's approved for both asthma and COPD, with three strengths to match disease severity, though it carries a specific pneumonia risk warning in COPD patients. It's a newer option, approved in 2013, so it has less long-term real-world data than Symbicort.
Pros
Only needs to be taken once a day
Approved for asthma starting at age 5, one year younger than Symbicort
Ellipta inhaler is breath-activated, no actuation timing needed
Three dose strengths allow finer adjustment for asthma severity
Cons
Newer drug (2013) with less long-term real-world data than Symbicort
Contraindicated in people with severe milk protein allergy due to a lactose ingredient
Carries a specific warning for increased pneumonia risk in COPD patients
200/25 mcg strength is limited to asthma patients age 12 and up
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.