Symbicort vs. Albuterol: What Should I Use to Treat COPD?

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS
Last Updated: August 4, 2022

Chronic Obstructive Pulmonary Disease, referred to as COPD, is a common respiratory condition that impacts millions of Americans per year. COPD causes blockage in the airways, making breathing difficult and uncomfortable.

The long term disease comes in two forms:

  • Chronic bronchitis – The air passages in the lungs become inflamed for a prolonged time, causing intense coughing spells (oftentimes with mucus), wheezing, shortness of breath, and discomfort while breathing.
  • Emphysema – Often caused by smoking or air pollutants, this condition involves damage to the lungs over time, resulting in air sacs in the lungs becoming enlarged. Symptoms include coughing (mucus may be present), tightness in the chest, shortness of breath, and a squeaky or whistling sound when you breathe.

Many people with COPD experience both forms at once. Treating this condition is crucial to delay the disease’s advancement and control its discomforting symptoms.

Symbicort and Albuterol are both options for you or your loved one who is battling COPD. Albuterol is prescribed to everyone with COPD, whereas Symbicort is for people who do not have adequate control on Albuterol. Even if you are using Symbicort, you should always have albuterol as a rescue inhaler.

Each medication is used to offset symptoms, but they differ in their specific purposes in treating breathing difficulties. We recommend speaking with your healthcare provider to determine which is best for you.

 

Symbicort

Symbicort, also used to treat asthma, is a daily inhaler that helps ease COPD symptoms like coughing episodes. Symbicort cannot replace a rescue inhaler for emergency use, but its consistent twice-daily use will help patients improve daily breathing and quality of life.

 

What Medications are Used in Symbicort?

The inhaler works by combining 2 medications, an inhaled corticosteroid (ICS) and a long-acting beta agonist (LABA). ICS is a corticosteroid, used to minimize swelling and enlargement in the lungs. LABA is a bronchodilator formoterol used to relax muscles, making it easier to breathe.

 

What’s the Recommended Dosage?

It is recommended to use Symbicort twice a day, at two puffs each dose. There is no circumstance that a patient should surpass 4 daily pumps unless directed by your doctor.

Symbicort’s inhalers come with numbers on the top to help you count your uses and track how much medication is remaining.

 

What are Symbicort’s Most Common Side Effects?

Using Symbicort comes with potential side effects, some minor and others more severe. It’s important to make your doctor aware of every medication you are on, to avoid negative interactions between Symbicort and another medicine.

 

Potential Mild Side Effects

  • Sinus pain
  • Stuffy nose
  • Back pain
  • Stomach discomfort
  • Nausea and vomiting
  • Throat discomfort
  • Sinus, lung, nose, throat inflammation
  • Blood potassium levels decreasing

Though rare, it’s important to be aware of any possible severe side effects that could be caused by choosing Symbicort. The list of side effects is long because it includes the side effects from both of the individual medications that comprise Symbicort.

 

Possible Severe Side Effects

  • Pneumonia
  • Upper respiratory infections
  • Blood vessel swelling
  • Osteoporosis
  • Hyperglycemia
  • Hypocortisolism (adrenal insufficiency)
  • Oral thrush (fungus in mouth/throat)
  • Glaucoma or other eye problems

Keep in mind, side effects are common with the use of any medication. Discuss Symbicort with your doctor to determine if it’s right for you.

 

Albuterol

Albuterol is a rescue inhaler, designed to bring fast-acting relief when trouble breathing arises. Living with COPD, you face unexpected breathing difficulties that often come without a warning. Albuterol should improve your breathing a few minutes after it is taken, and its relieving effects should last from four to six hours or more.

 

What Type of Medicine is Albuterol?

Albuterol is one of many medicines under an umbrella called ‘adrenergic bronchodilators’. This name was given to medications used to open the bronchial tubes in the lungs to relieve trouble breathing.

Adrenergic bronchodilators also relieve wheezing, coughing, and other discomforts that come with trouble breathing. Just like other adrenergic bronchodilators, Albuterol is breathed in through the mouth.

 

When Should I Use Albuterol?

COPD can cause everyday activities like walking, dusting your home, or petting your animal to trigger an episode. Other triggers to COPD attacks are smoke, different scents, air pollution, and extreme weather (humidity or wind, for example).

We recommend you keep your rescue inhaler near you at all times, just in case of emergency. You are welcome to take Albuterol before you take part in any physical activity as a preventative method. You are encouraged to take Albuterol as soon as you realize you’ve been exposed to a trigger, or when breathing starts to feel difficult.

Tell your doctor if you are needing to use Albuterol daily, as it was not designed to help manage COPD’s daily discomforts and symptoms.

 

What Side Effects are Possible While Using Albuterol?

Just like Symbicort and any other medication, there are possible side effects to Albuterol as well. You need a doctor’s prescription to take Albuterol, but remember to speak with your doctor about all the medications you are currently taking to ensure they can be mixed with Albuterol.

 

Potential Mild Side Effects 

  • Sore throat
  • Nasal irritation
  • Headache
  • Dizziness
  • Muscle aches
  • Trouble sleeping
  • Change in taste
  • Dry mouth

Possible Severe Side Effects

  • Rapid heart rate known as tachycardia
  • Sense of fluttering or pounding heart
  • Tremors and shaking

Keep in mind, severe side effects from Albuterol are extremely rare. Your doctor will help you determine if Albuterol is worth potential side effects and cohesive with your other medications.

 

Pros and Cons of Each Medication

Symbicort Pros

  • Simple instructions
  • Easy to transport
  • Number system on top of the inhaler to track uses
  • Improves quality of life by managing ongoing symptoms
  • Combines perfect dosage of 2 necessary medications into one inhaler

Symbicort Cons

  • Requires 2 uses a day, every day
  • Side effects from both individual medications (ICS/LABA) present, making the overall side effect list longer
  • An inhaler is currently the only option to administer medication
  • People with COPD need a higher dosage than patients with asthma
  • Can take a few weeks of regular doses before you notice a difference

Albuterol Pros

  • Many inhaler options in case one isn’t right for you
  • Easy to transport
  • Only needed in case of an emergency or for preventative use
  • Provides peace of mind that you are safe in case of unexpected trigger
  • The side effect list is short and cases are rare

Albuterol Cons

  • Cannot help improve daily quality of life
  • Short lasting relief, so may have to be used multiple times a day
  • Not the best options for patients with heart problems
  • Children may find the inhaler difficult to use

 

Symbicort or Albuterol – Which is Right for Me?

Examining Your Medical Needs

In recap, Symbicort may be the better option for you if you suffer consistently from ongoing symptoms. Instead of only having an inhaler that can help you in case of an emergency, you’d have the benefit of ongoing relief from consistent daily treatments.

Perhaps if you struggle with breathing difficulties that come inconsistently, Albuterol may be better for you. If daily symptoms do not impact your quality of life, but certain triggers cause flare-ups that make breathing difficult, an emergency inhaler would probably best fit your needs.

 

Can You Combine Both Medications?

Yes. Symbicort should never be used by itself and requires a concurrent prescription for a rescue inhaler like albuterol. Symbicort is only used for maintenance treatment and cannot treat bronchospasms.

If you do not have an emergency inhaler along with your Symbicort, talk with your doctor. Symbicort is not FDA-approved to be an emergency inhaler, though in some cases doctors will prescribe it as a maintenance and emergency inhaler.

 

Choosing the Best Medicine to Treat COPD

Hopefully, you’ve gained some insight into each medication and learned about the many factors in determining the best one for you.

It goes without saying that your doctor is the best person to help you determine the right course of action to fight your COPD. It is vitally important to find a treatment that works best for you, especially because COPD is a chronic disease that doesn’t have a cure yet.

Your quality of life matters and your doctor will help you weigh your options and create the best course of action to fight against the discomfort COPD can cause. You are not fighting alone!

 

The Rx Advocates – How We Can Help

Regardless of which treatment plan you choose, The Rx Advocates would be honored to help. We understand the financial burden that necessary medications can bring. Our specialty is helping patients reduce the monthly cost of their medications through patient discount programs. Patients pay for our services $70-$100 per month, and their medications are delivered to them at no extra cost.

We are proud to have assisted many patients in saving money on their journeys towards health. If paying for your medications is a struggle, we would be happy to see what ways we could help. We look forward to hearing from you! Please contact us today to determine your eligibility.

 

Sources:

CDC. Chronic Obstructive Pulmonary Disease. https://www.cdc.gov/copd/index.html#:~:text=Chronic%20obstructive%20pulmonary%20disease%2C%20or,Americans%20who%20have%20this%20disease. February 22, 2021.

John Hopkins Medicine. Chronic Bronchitis.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-bronchitis#:~:text=Chronic%20bronchitis%20is%20long%2Dterm,bronchitis%2C%20when%20symptoms%20are%20worse. 2022.

American Lung Association. Emphysema.
https://www.lung.org/lung-health-diseases/lung-disease-lookup/emphysema. 2022.

Mayo Clinic. Albuterol.
https://www.mayoclinic.org/drugs-supplements/albuterol-inhalation-route/description/drg-20073536. January 1, 2022.

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