Symbicort vs. Advair

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS

Last Updated: September 10, 2021

Asthma and COPD are dangerous chronic diseases that require medication for people to continue to breathe properly. There are many medication options to choose from. Health care providers need to look at many details to help patients get the best treatment option.

Asthma is a lung condition where the bronchi (airways) become inflamed. They narrow and swell, making it hard to breathe. This condition can start in childhood or as an adult. The cause of an asthma attack is usually an allergic reaction. It is a very common condition.

Chronic obstructive pulmonary disease (COPD) is a group of lung diseases that cause breathing problems. The two most common are emphysema and chronic bronchitis. COPD most often affects adults over the age of 45. The biggest contributing factor is tobacco smoke. Other environmental factors can cause it.

What is Symbicort?

Symbicort is a combination medication made by AstraZeneca. It was FDA approved in 2006 for the treatment of asthma in patients ages six and older. It can also be used to treat COPD.

Symbicort is a combination of budesonide and formoterol. Budesonide is a corticosteroid used to reduce inflammation. Formoterol is a long-acting beta-agonist (LABA).

It is used to control wheezing, shortness of breath, and chest tightness, by relaxing and opening the airways.

Symbicort comes in two different strengths, budesonide 80 mcg / formoterol 4.5 mcg and budesonide 160 mcg / formoterol 4.5 mcg. The higher dose is the only one approved for the treatment of COPD.

Symbicort is taken twice a day, about twelve hours apart. Two puffs of the inhaler at each time.

Side Effects of Symbicort

Most medications have side effects. A side effect is a secondary effect, different from the intended effect, and is often unpleasant. Some side effects are more dangerous than others.

Some common side effects of Symbicort are:

Nausea
Vomiting
Diarrhea
Headache
Throat irritation
Back pain
Stuffy nose
Muscle or joint pain
Temporary changes in voice

There are some less common side effects, and a patient should contact their doctor right away if they happen:

Blurred vision
Increased thirst or urination
Muscle cramps
Tremors
Signs of infection like a fever
Mental health or mood changes like nervousness
Trouble sleeping

What is Advair?

GlaxoSmithKline produces Advair as a combination medication. It contains fluticasone and salmeterol. Fluticasone is a corticosteroid that decreases swelling and irritation in the airways. This allows for easier breathing. Salmeterol is a long-acting beta-agonist (LABA).

There are two different formats, Advair HFA and Advair Diskus.

Advair HFA

Advair HFA was approved for use in 2000 for adults and children aged twelve and older for asthma. It is not approved for the treatment of COPD. It comes in three different strengths:

45 mcg fluticasone / 21 mcg salmeterol
115 mcg fluticasone / 21 mcg salmeterol
230 mcg fluticasone / 21 mcg salmeterol

It comes as a pressurized canister with 60 or 120 metered inhalations. It has a built-in dose counter.

Advair HFA is taken twice a day, twelve hours apart, two puffs each time.

Advair Diskus

Advair Diskus was approved in 2000 for the treatment of asthma in patients aged four and older. It is also approved for the treatment of COPD. It comes in three different strengths:

100 mcg fluticasone / 50 mcg salmeterol
250 mcg fluticasone / 50 mcg salmeterol
500 mcg fluticasone / 50 mcg salmeterol

The lowest dose is used once daily in children ages 4-11 for asthma.

The highest strength is used for COPD in adults over 12 and the dosage is one inhalation twice daily, twelve hours apart.

Advair is a dry powder formula containing 60 foil blister strips. It comes in a disk inhaler with a built-in dosage counter.

Side Effects of Advair

The side effects of Advair HFA are:

Upper respiratory tract infections or inflammation
Sore throat
Hoarseness
Thrush
Bronchitis
Cough
Headache
Nausea and vomiting
Sinus pain
Diarrhea

The side effects of Advair Diskus for asthma are:

Cough
Headache
Nausea and vomiting
Bronchitis
Hoarseness
Upper respiratory tract infections or inflammation
Sore throat
Thrush

The side effects of Advair Diskus for COPD are:

Pneumonia
Thrush
Sore throat
Hoarseness
Viral respiratory infections
Headaches
Muscle and bone pain
Diarrhea
Stuffy nose
Sinus pain
Dizziness
Dry mouth, nose, throat
Nausea, vomiting, upset stomach

Symbicort Vs. Advair: Which Works Best for Asthma and COPD?

These two medications perform the same functions. They each contain a corticosteroid and a long-acting beta-agonist. Doctors and patients have to consider the effects of each medication to see which formula will work best for them. A drug that works for one person can have a different result for the next person.

What are the Pros and Cons of Symbicort?

The pros of using Symbicort to control asthma and COPD are:

Using Symbicort every day works well to treat asthma and COPD.
It is a combination of two medications in one inhaler.
It helps reduce the number and severity of asthma attacks.
It helps reduce the number of flare-ups for a patient with COPD.

The cons of using Symbicort:

It can cause side effects like headaches and infections.
It can cause fungal infections called thrush in the mouth, and throat, so patients need to rinse their mouth out after each use.
It can not be used as a rescue inhaler.
Patients with COPD have to use the higher dosage.
It could take weeks before someone feels better using it.

What are the Pros and Cons of Advair HFA and Advair Diskus?

The pros and cons for Advair HFA and Advair Diskus are mostly the same. The pros of using Advair are:

The combination of two medications makes it more effective.
It is a first-choice medication for the treatment of asthma.
Advair Diskus can be used to treat asthma and COPD.

The cons of using Advair HFA or Advair Diskus are:

Dry powder inhalers can contain lactose, so they are not safe for people with severe milk allergies.
It cannot be used as a rescue inhaler.
It can cause fungal infections (thrush) in the mouth and throat. It could take weeks before someone starts to notice a benefit.

Save Money on Prescriptions Every Month With The Rx Advocates

COPD and asthma do not go away. They are chronic diseases with no cure. People suffering from these lung conditions will need to use medications for the rest of their lives.

Prescription medications are expensive—especially name-brand prescriptions like Symbicort and Advair. One of the cons of both medications is that they can not be used as rescue inhalers for sudden breathing problems.

That means each person with asthma or COPD needs a second medication to stop sudden symptoms.

At The Rx Advocates, we understand how expensive prescriptions can be. We connect people with patient assistance programs that pharmaceutical companies offer. Many people may not even know these programs exist.

We take care of all the paperwork to get prescriptions to people from the pharmaceutical companies. Patients do not have to try to figure out the process for themselves. The only cost is our low monthly fee of $70-$100, depending on the number of medications someone needs.

Sources:

American Lung Association. What is Asthma?. https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/learn-about-asthma/what-is-asthma. October 23, 2020.
American Lung Association. Chronic Obstructive Pulmonary Disease (COPD). https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd.
Symbicort. Symbicort. https://www.mysymbicort.com/. October 2020.
Medline Plus. Formoterol Oral Inhalation. https://medlineplus.gov/druginfo/meds/a602023.html. October 15, 2019.
Medline Plus. Fluticasone Oral Inhalation. https://medlineplus.gov/druginfo/meds/a601056.html. April 15, 2019.