When my Cocker Spaniel, Bella, hears the sharp click of my inhaler, she always tilts her head, confused but oddly alert. If you’re living with asthma or chronic obstructive pulmonary disease (COPD), that familiar sound probably means relief is near. But for a lot of folks, Symbicort isn’t always an option—maybe because of insurance shenanigans, price spikes, or just not gelling with your style. What do you grab instead? Let’s untangle this noisy jungle of inhalers and see which ones stack up against Symbicort in real life.
Why Switch? Common Reasons Patients and Doctors Seek Symbicort Alternatives
Symbicort gets the spotlight a lot, but costs in the U.S. can skyrocket faster than the latest Portland food trend. Even with insurance, many still fork out hundreds every month. Some people don’t tolerate the formoterol/budesonide combo, or find the inhaler tricky to handle—imagine struggling with those twist-top devices before your morning coffee kicks in.
Another driver? Insurance companies change their formularies every January—just when you think you’ve got your routine down, your plan wants you to use a totally different device. For younger patients, schools prefer easier-to-use inhalers, while older folks often need something with a straightforward design and clear dose counters (have you ever squinted at those tiny numbers?).
Doctors like to keep options handy. If one medicine causes jitteriness, palpitations, or dry mouth, they’ll pivot fast. Plus, new research and generics pop up all the time. Even hospital pharmacies occasionally swap brands due to stock shortages—nobody likes scrambling for backup during wildfire season when air quality tanks.
Medications Similar to Symbicort: The Top 5 Inhaler Alternatives
Here’s the top five picks you’ll see in the wild (or, well, the local pharmacy):
- Dulera (mometasone/formoterol) – Almost a twin to Symbicort chemically, just swaps in a different steroid. The MDI device feels the same in your hand, though it has a slightly different taste and ‘kick’ sensation.
- Advair Diskus (fluticasone/salmeterol) – Old classic, dry powder inhaler, purple round disk. No shaking or priming, which arthritis sufferers appreciate. The device delivers a cool powder puff, making it easy to know you’ve inhaled a dose, but can trigger cough in sensitive throats.
- Breo Ellipta (fluticasone/vilanterol) – Sleek one-a-day inhaler, dry powder style, super low resistance so you don’t have to suck hard. Popular for its once-daily schedule, great for folks who always forget the evening dose.
- AirDuo RespiClick (fluticasone/salmeterol) – Disposable breath-actuated inhaler for folks who can’t perfect the hand-breath coordination of MDIs. Click, breathe in, done. No separate spacers needed.
- Generic Budesonide/Formoterol – You know those ‘store brand’ cereals? This one is the Walgreens/CVS version of Symbicort, typically with a big price cut and almost identical medicine.
If you want a full chart breaking down devices, dosing, and cost brackets, check out this medications similar to Symbicort resource for a real-deal comparison (handy for fast decisions at the doctor’s office).
Device Differences: What It’s Like Using Each Inhaler
Let’s get practical. Imagine you’re stuck in rush hour traffic and suddenly realize you forgot your inhaler at home—what device would you actually want stashed in your glove compartment?
- The Symbicort-style MDI (metered dose inhaler) is compact, and fits easily in jean pockets or small bags. Some folks complain about the coordination: you’ve got to press down and inhale at the same time. If you’re new to inhalers, this learning curve is real—and a lot of folks never mastered it, especially in high-anxiety moments.
- Advair Diskus and Breo Ellipta both use dry powder inhalers (DPIs), which are flat or oval, about palm size, easy to grip. They don’t require fiddling with canisters, just load, click, and inhale. But don’t use them during a really bad attack—if you’re struggling to breathe, you won’t have enough power to get the medicine deep in your lungs.
- Dulera feels like Symbicort in hand and mouth, though some patients swear it tastes chalkier or leaves a weird after-feel. The color is a light blue instead of red, which is surprisingly helpful at separating your medicines if your vision isn’t perfect.
- AirDuo RespiClick needs zero coordination—just open the cap and breathe in. But these inhalers are single-use, so no way to track leftover puffs except the dose counter. No spacers required, making them popular for school-age kids or folks with arthritis.
A trick I picked up: mark your inhaler with a strip of colored tape, so you can tell your maintenance inhaler from your rescue one during those blurry-eyed mornings. Also, avoid storing your inhaler in a hot car—MDIs can burst if the temperature climbs too high (yep, it happened to a friend last summer in Portland, and replacing the device cost more than his monthly dog food bill).
Price Watch: What You’ll Really Pay in 2025 for Each Alternative
The price chalkboard keeps shifting. As of now (July 2025), here’s what I see at Portland pharmacies and from online price trackers:
- Symbicort (brand name): $300–$350 per inhaler, 60–120 doses. Most insurance plans cover it with prior approval—until the next year’s formulary flip.
- Generic Budesonide/Formoterol: $125–$200. A solid choice if you’re price-watching, and sometimes you can find coupons or pharmacy discounts. Works for most insurance plans too.
- Dulera (brand): $240–$320. Still expensive, but coupons from the manufacturer help. Generic versions are not always in stock, depending on supply chains.
- Advair Diskus: $260–$320, but generic waltzes in at $110–$170. The dry powder version’s price depends on whether you’re getting the Diskus (the round purple one) or the MDI version.
- Breo Ellipta: $290–$350 for the brand. No FDA-approved direct generic in the U.S. yet, so prices haven’t dropped.
- AirDuo RespiClick: Brand runs $180–$210, and generics sometimes under $120—though device style changes can be confusing if you’re used to the older models. Coupons and prescription apps make a dent if your insurer plays hardball.
Pro tip: Many patients are shocked at the price when insurance doesn’t cover their script. GoodRx, SingleCare, and local clinics sometimes have better prices than national chains. Never hurts to call around—my buddy at the local pharmacy says prices change weekly based on demand, supply, and those mysterious wholesaler deals. And don’t be afraid to ask your doc to write a refills-crazy script if it helps you get through the year—insurance sometimes honors 90-day supply requests for mail order.
Choosing the Right Inhaler: Doctor and Patient Tips for Best Results
Think about your daily routine before deciding. Do you have mornings that feel like a scramble just getting out the door (kids, pets, spilled coffee)? Pick an easy, one-step inhaler—Breo or AirDuo might rule here. If you’re forgetful or juggling too many meds, look for inhalers with big, clear counters. Also check device noise: some inhalers let out a ‘whoosh’ or click, which might startle sleeping pets or wake a partner.
If your hands don’t work as well these days—hello, arthritis—steer clear of finicky devices that need twisting or locking. Dry powder inhalers are easier for lots of folks, but avoid them if your lung strength is weak or you’ve just had a bad exacerbation. And remember: inhaler technique matters as much as the medicine itself. Half of all patients use their device wrong at least once a week, according to a 2024 review published by the American Thoracic Society. Most pharmacies offer free in-person or video coaching—seriously, take them up on it.
Don’t forget side effects. Symbicort and Dulera can rev you up a little (shakiness, racing heart), while Advair and Breo have a smoother profile—at least according to most users. Always rinse your mouth after steroid inhalers to head off thrush—that weird white yeast infection that sometimes pops up (my neighbor, who cycles, learned that the hard way during marathon training last fall).
If you’re still lost, bring your questions to a real doctor or respiratory therapist—they can match the best inhaler to YOUR needs, not just what the commercial said. Sometimes, the best option isn’t the one with the flashiest box but the one you’ll actually use every single day—without fail, without hassle, without breaking the bank.
