Symbicort vs. Singulair
See how Symbicort and Singulair compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Symbicort is an inhaled steroid-LABA combination taken twice daily, while Singulair is a once-daily pill that blocks leukotrienes instead of using a steroid.
Symbicort carries a boxed warning for LABA-related asthma death risk, while Singulair carries a boxed warning for serious neuropsychiatric side effects.
Singulair also treats seasonal and perennial allergic rhinitis, and Symbicort is FDA-approved for COPD, so the right choice depends on the specific condition being managed.
Symbicort vs. Singulair Drug Summary
Symbicort
Symbicort combines an inhaled corticosteroid (budesonide) with a long-acting bronchodilator (formoterol) in one inhaler. It's FDA-approved for maintenance asthma treatment in patients 6 and older and for COPD. It's taken as two inhalations twice daily and is not meant for sudden asthma attacks.
Singulair
Singulair is a leukotriene receptor antagonist that blocks inflammatory chemicals involved in asthma and allergies. It's taken as a tablet, chewable, or packet of granules once daily for chronic asthma control, exercise-induced bronchoconstriction, and allergic rhinitis. It is not used to stop an asthma attack already in progress.
Symbicort vs. Singulair Side Effects
Symbicort
Singulair
Symbicort vs. Singulair Dosage
Symbicort
Singulair
| STAGE | DOSE | WHEN |
| Starting dose | 2 inh 80/4.5mcg twice/day | At the start |
| Maximum dose | 2 inh 160/4.5mcg twice/day | If needed |
| Dose changes | 1 increase | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 4 mg once daily | At the start |
| Maximum dose | 10 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Symbicort
| STAGE | DOSE | WHEN |
| Starting dose | 2 inh 80/4.5mcg twice/day | At the start |
| Maximum dose | 2 inh 160/4.5mcg twice/day | If needed |
| Dose changes | 1 increase | As tolerated |
Singulair
| STAGE | DOSE | WHEN |
| Starting dose | 4 mg once daily | At the start |
| Maximum dose | 10 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Symbicort vs. Singulair Indications
Symbicort
Symbicort is approved for long-term control of asthma symptoms in people 6 and older, and for maintenance treatment of COPD, including chronic bronchitis and emphysema. It reduces both airway inflammation and airway constriction with regular twice-daily use. It doesn't replace a rescue inhaler for sudden symptoms.
Maintenance asthma treatment, ages 6+
Maintenance COPD treatment (chronic bronchitis/emphysema)
Reduces COPD exacerbations
Not for acute bronchospasm relief
Singulair
Singulair is approved for ongoing asthma control, preventing exercise-induced bronchoconstriction, and relieving seasonal and perennial allergic rhinitis symptoms. It works by blocking leukotrienes, chemicals that trigger airway inflammation and allergy symptoms. It is not intended to treat an asthma attack that has already started.
Chronic asthma prophylaxis and treatment
Prevents exercise-induced bronchoconstriction
Relieves seasonal allergic rhinitis symptoms
Relieves perennial allergic rhinitis symptoms
Symbicort vs. Singulair Pros and Cons
Symbicort
Symbicort pairs a steroid with a long-acting bronchodilator, giving it broader coverage for both asthma and COPD in a single device. It requires correct inhaler technique and carries a boxed warning tied to its LABA component. Coverage and preferred strength vary by plan and severity of disease.
Pros
Treats both asthma and COPD
Combines anti-inflammatory and bronchodilator action in one inhaler
Approved for asthma in children as young as 6
Two strengths allow dose escalation for COPD control
Cons
Boxed warning for LABA-related asthma death risk
Requires proper inhaler technique
Twice-daily dosing
Not usable for sudden asthma symptoms
Singulair
Singulair offers steroid-free daily control as a pill, chewable, or granule packet, which can suit people who prefer not to use an inhaler. It also covers allergic rhinitis, a use Symbicort does not have. Its boxed warning concerns neuropsychiatric effects rather than airway risks.
Pros
No inhaler technique required
Once-daily oral dosing
Also relieves seasonal and perennial allergic rhinitis
Chewable and granule forms available for young children
Cons
Boxed warning for suicidal thoughts and behavior
Not a steroid, so may be less effective for significant airway inflammation
Not approved for COPD
Risk of Churg-Strauss syndrome reported
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