Symbicort vs. ProAir

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

Key Takeaways

  • Symbicort is a daily controller inhaler that combines a steroid and a long-acting bronchodilator to prevent asthma and COPD symptoms over time.

  • ProAir is a fast-acting rescue inhaler used to relieve sudden bronchospasm or prevent it before exercise, not for daily control.

  • The two are often used together: Symbicort for everyday maintenance and ProAir for quick relief when symptoms break through.

Symbicort vs. ProAir Drug Summary

Symbicort

Symbicort combines an inhaled corticosteroid and a long-acting bronchodilator to control asthma and COPD symptoms over time. It is used as a twice-daily maintenance therapy delivered through a metered-dose inhaler, not for immediate relief of a flare-up.

ProAir

ProAir is a short-acting bronchodilator inhaler used to quickly relieve sudden bronchospasm or prevent it before exercise. It is taken as needed rather than on a daily schedule, using a metered-dose inhaler with fast onset.

Symbicort vs. ProAir Side Effects

Symbicort

Most common
headache (3% or greater)
nasopharyngitis (3% or greater)
pharyngolaryngeal pain (3% or greater)
sinusitis (3% or greater)

ProAir

Most common
headache (3% or greater)
tachycardia (3% or greater)
pain (3% or greater)
dizziness (3% or greater)

Symbicort vs. ProAir Dosage

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

ProAir

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 2 inhalations pre-exercise At the start
Maximum dose 2 inhalations pre-exercise Same as starting
Dose changes None Fixed dose

Symbicort vs. ProAir Indications

Symbicort

Symbicort is FDA-approved as a daily maintenance treatment for asthma in people 6 and older and for COPD, including chronic bronchitis and emphysema. It works by reducing airway inflammation and keeping airways open around the clock, not by treating a sudden flare.

  • Maintenance asthma treatment for ages 6 and up

  • Maintenance treatment for COPD (chronic bronchitis and/or emphysema)

  • Reduces exacerbations in COPD

  • Not approved for acute bronchospasm relief

ProAir

ProAir is FDA-approved to treat or prevent bronchospasm in reversible airway diseases like asthma in people 4 and older. It is also approved to prevent bronchospasm triggered by exercise when taken shortly beforehand.

  • Treats sudden bronchospasm in asthma and COPD

  • Prevents bronchospasm for ages 4 and up

  • Prevents exercise-induced bronchospasm when used pre-exercise

  • Not approved for tocolysis (pre-term labor)

Symbicort vs. ProAir Pros and Cons

Symbicort

Symbicort is a controller medication that pairs a steroid with a long-acting bronchodilator, taken every day regardless of symptoms. It carries a boxed warning about LABA-related risk and is not a substitute for a rescue inhaler.

Pros

  • Combines an ICS and LABA for daily control in one inhaler

  • Approved for both asthma (age 6+) and COPD maintenance

  • Reduces exacerbations with regular twice-daily use

  • Two strengths allow dose escalation without switching inhalers

Cons

  • Not for rescue use during an acute asthma attack

  • Carries a boxed warning for LABA-related asthma death risk

  • Requires twice-daily adherence even when symptom-free

  • Costs roughly $300 to $500 per month without insurance

ProAir

ProAir is a rescue medication that opens airways within minutes and is meant for as-needed use during symptoms or before exercise. It does not address the underlying inflammation that drives asthma, so it is often paired with a daily controller like Symbicort.

Pros

  • Works within minutes to relieve sudden asthma symptoms

  • Also approved to prevent exercise-induced bronchospasm

  • Approved for children as young as 4 years old

  • Costs roughly $85 to $95 per month without insurance

Cons

  • Does not treat the underlying airway inflammation

  • Frequent use can signal worsening asthma needing other treatment

  • Not intended for daily maintenance dosing

  • Short duration of action requires redosing every 4-6 hours

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