9 Alternatives to Symbicort in 2025: Smarter Asthma Choices

posted by: Adrian Harlow | on 19 April 2025

If you’re counting on Symbicort to manage your asthma, you know it’s not the only option out there anymore. Whether side effects, costs, or just personal preference has you on the hunt for something new, 2025 has brought more alternatives than ever before.

Different inhalers and oral meds have their unique strengths—and their headaches—so finding a good fit is less about what’s ‘best’ on paper, and more about what fits your life. Some options are easier to use, some have fewer side effects, and others might be as simple as swallowing a pill. Still, every swap comes with trade-offs, so the details matter.

Let’s break down nine real alternatives you can actually ask your doctor about right now. Whether you’re after better control, less hassle, or just want to know what might work better for your specific situation, you don’t have to stick with just one choice all year. Breathe deep—here are your real options in plain speak.

• Advair Diskus (fluticasone/salmeterol)
• Dulera (mometasone/formoterol)
• Breo Ellipta (fluticasone/vilanterol)
• Pulmicort (budesonide)
• Singulair (montelukast)
• QVAR RediHaler (beclomethasone)
• Alvesco (ciclesonide)
• Asmanex Twisthaler (mometasone)
• ArmonAir Digihaler (fluticasone)
• Summary and Comparison Table

Advair Diskus (fluticasone/salmeterol)

Advair Diskus has been a go-to for people with asthma and COPD for years. It mixes fluticasone, a steroid that dials down lung swelling, with salmeterol, a long-acting bronchodilator that helps keep airways open. This combo is a direct rival to Symbicort alternatives, and you’ll probably hear doctors mention it quickly if you ask about switching up your inhaler.

It's approved for both adults and kids (down to age 4), and dosing is just twice a day. So if you’re on a routine and don’t want to take something every few hours, it’s pretty manageable.

"Advair has been shown to reduce the number of asthma flare-ups and improve overall lung function when used regularly, making it a key component in many maintenance therapies," says the American Lung Association.

One thing to keep in mind: you have to inhale the powder correctly for it to work. No shaking (unlike some metered-dose inhalers), but if you don't get a full, hard breath in, you might miss a dose without realizing. Also, rinse your mouth after each use—steroid inhalers can cause thrush (that weird mouth fungus nobody wants).

Pros

• Helps control both asthma and COPD symptoms
• Reduces risk of flare-ups and ER visits
• Dosed only twice daily—less hassle if you hate remembering medicine all day
• Generic versions available, often cheaper than brand-name Symbicort
• Wide insurance coverage in the US

Cons

• Dry powder form might be tricky for folks with really low lung strength
• Possible side effects: sore throat, hoarseness, oral thrush
• Not meant for instant relief—always keep your rescue inhaler around
• Needs consistent use—missed doses can mean more symptoms

If you’re weighing asthma treatments or you’re comparing inhalers for insurance reasons, here’s a quick table laying out a fact or two you might want to know:

If you want something reliable, widely used, and affordable with solid insurance coverage, Advair Diskus ticks most of the boxes as a Symbicort alternative. Just don’t skip the mouth rinse.

Dulera (mometasone/formoterol)

Dulera combines two medicines: mometasone (an inhaled corticosteroid) and formoterol (a long-acting beta-agonist). It's one of the most direct Symbicort alternatives around. If you’re looking for a familiar inhaler routine, Dulera lands right in that zone—it works in a similar way and even feels pretty close in use. Doctors usually prescribe it for asthma that isn’t managed with a plain steroid inhaler.

One thing that’s nice about Dulera: it gives both daily inflammation control (thanks to mometasone) and quick symptom relief from formoterol’s long-acting, smooth muscle relaxing power. It’s not used as a rescue inhaler in emergencies, but it often means fewer nighttime wake-ups and less wheezing through the day. That’s especially true for people who aren’t happy with just a plain steroid inhaler anymore.

Pros

• Works a lot like Symbicort, so switching isn’t too complicated
• Good for moderate-to-severe asthma
• Usually leads to fewer asthma flare-ups (a few studies show up to a 30% drop in attacks for some patients)
• One inhaler, two meds—simple daily routine
• Device is easy to use and doesn’t require much training

Cons

• Not meant for quick rescue if you’re suddenly short of breath
• May cause similar side effects as Symbicort: headaches, throat irritation, or minor shakes
• Higher doses have a small risk of fungal throat infections (rinse your mouth after each use—it helps a lot)
• Some insurances put Dulera in a pricier category than other asthma meds

Here’s a quick side-by-side of Dulera’s most relevant features for users weighing asthma and inhalers:

If you want a solid everyday alternative to Symbicort without learning a whole new device, Dulera is worth considering with your doctor.

Breo Ellipta (fluticasone/vilanterol)

If you’re looking to swap out Symbicort, Breo Ellipta is a big name to know in 2025. This inhaler packs a combo of fluticasone (a corticosteroid) and vilanterol (a long-acting beta agonist), very similar to what Symbicort does, but with its own twist. The standout? It’s once-daily. Instead of reaching for your inhaler twice a day, you use Breo just once, which makes life so much easier for a lot of people who hate keeping track.

Approved for both asthma and COPD, Breo Ellipta fits folks who want something simple, don’t love complicated routines, or who get forgetful with multiple daily doses. It delivers a dry powder, so no pumping and priming—just open, inhale, and you’re done.

Pros

• Only 1 dose per day—super convenient if you hate schedules.
• Strong control for asthma symptoms and COPD, similar to Symbicort.
• Dry powder inhaler—no tricky steps, just inhale.
• Fewer inhaler mistakes compared to metered-dose inhalers.
• Available in different strengths for personalized treatment.

Cons

• Not approved for kids under 18 for asthma—teens and adults only.
• Can cause thrush (oral yeast infection) if you don’t rinse your mouth after using.
• Some insurance plans still have high co-pays on Breo (it’s newer and branded).
• Not meant for sudden asthma attacks—this is a maintenance medicine only.
• May not work as well for people who struggle to inhale deeply (like during flare-ups).

Breo Ellipta’s "set-it-and-forget-it" style is a game changer for folks who routinely miss doses. Using it the right way, every day, actually leads to more stable asthma control compared to ‘remembering’ to use your inhaler half the time. In a 2024 patient survey, over 70% of users said they preferred the once-daily Breo compared to twice-daily alternatives—less hassle meant better sticking to the plan.

If you want your asthma kept in check with as little daily effort as possible, definitely talk to your provider about Breo Ellipta. But don’t skip the rinsing step after each use; that’ll save you annoying mouth problems later on.

Pulmicort (budesonide)

When people talk about alternatives to Symbicort, Pulmicort (budesonide) shows up on the shortlist, especially for those wanting to avoid combo inhalers or LABA-type medications. Pulmicort is a straight-up inhaled corticosteroid (ICS), which means it’s all about calming airway inflammation without mixing in extra bronchodilator action.

Pulmicort is mainly used via a Flexhaler inhaler or as a nebulizer solution, so it actually works for both adults and younger kids. Doctors often go with Pulmicort for folks who don’t need as much power as a combo inhaler, or who have side effects from medications like formoterol or salmeterol.

Pros

• Trusted choice for long-term asthma control—used by millions worldwide.
• Can be used in young children (as young as 1 year when delivered by nebulizer).
• No LABA component, so less risk of certain side effects or drug interactions.
• Available as an easy-to-use dry powder inhaler (Flexhaler) or as a liquid for nebulizer treatment.
• Generic options help keep costs down—sometimes much cheaper than Symbicort.

Cons

• Not as quick or powerful as combination inhalers for people with moderate to severe asthma.
• Doesn’t have a built-in bronchodilator—you’ll need a separate rescue inhaler for sudden symptoms.
• Common inhaler side effects: hoarseness, throat irritation, and oral thrush unless you rinse after use.
• May require two inhalations twice a day for control (could be more frequent than some alternatives).

To get real, Pulmicort is one of those workhorses in the asthma world—it’s rarely flashy, but for basic inflammation control, it gets the job done. A lot of families stick with it because it’s approved for babies and toddlers. Plus, you don’t have to worry about the possible heart jitters or sleep issues seen with combo inhalers. If you’re switching from Symbicort and don’t need both an anti-inflammatory and a long-acting bronchodilator, Pulmicort is definitely worth discussing with your doctor.

If you’re hunting for a Symbicort alternative and want something that’s flexible, affordable, and kid-friendly, Pulmicort is definitely a solid candidate. Just remember: you still need a rescue inhaler handy for sudden symptoms—it’s not a one-size-fits-all fix.

Singulair (montelukast)

If you’re tired of lugging around an inhaler or just can’t get the hang of it, Singulair makes life easier—it’s a once-a-day pill instead of a puff of medicine. That alone is a game-changer for a lot of people, especially kids and folks who already have a drawer full of daily meds. Singulair falls into the class called leukotriene receptor antagonists (LTRAs), designed to block inflammation caused by certain triggers like allergens or even cold air. Instead of treating sudden asthma symptoms, it helps keep things calm in the background.

Now, to set your expectations: Singulair isn’t a magic bullet or “stronger” option compared to classic inhalers like Symbicort (which combines a steroid with a long-acting bronchodilator). It’s more of a backup or add-on, great if you’ve got mild to moderate persistent asthma, especially when allergies are also on the table. Doctors use it for asthma that just won’t fully settle down with inhaled steroids alone, or when someone simply can’t or won’t use an inhaler. The FDA approved it way back in 1998, and many brand new asthma meds are still compared against it in studies today.

Pros

• Just a pill—skip the inhaler, no special technique needed.
• Useful for people with allergic asthma, so it kind of kills two birds with one stone.
• Approved for both children and adults (even down to 1-year-olds for some versions).
• No steroid side effects like voice changes or oral thrush.

Cons

• Not as strong for day-to-day asthma control as inhaler combos like Symbicort.
• Some people report weird side effects—nightmares, mood swings, or even depression (the FDA added a Black Box warning in 2020 for serious mental health issues).
• Doesn’t help much during an asthma flare-up; it’s for prevention only.
• To keep working, you have to remember to take it every single day.

If cost is important, generic montelukast is usually cheap and covered by most insurance plans. A study from 2023 showed about 18% of U.S. asthma patients had tried Singulair at least once. It’s rarely a solo fix, but it’s reliable and easy for folks put off by inhalers or who need help with tough allergy seasons. If you ever notice any mood changes on it, talk it over with your doctor right away.

QVAR RediHaler (beclomethasone)

Looking for a Symbicort alternative that feels less like a hassle? QVAR RediHaler is worth checking out, especially since it's one of the newest "breath-actuated" inhalers. That just means you don't have to press and breathe at exactly the same time—just breathe in and it does the work. It's an inhaled corticosteroid (ICS) without a LABA partner, so it's mainly for folks who just need steroid control and not combo therapy. QVAR delivers beclomethasone, which helps calm airway inflammation and tame everyday asthma symptoms.

The design gets rid of the need for spacers or complex preparation. You don’t need to shake it or even prime before use if you’re switching from Symbicort—just breathe in. This is a big plus for anyone who struggles with timing puffs. It also comes in two dose strengths: 40 and 80 mcg per puff, giving you more options based on your doctor’s plan. Insurance coverage for QVAR RediHaler is decent, but if you have a high-deductible plan, generic beclomethasone might save you a little cash each month.

Pros

• No coordination needed—just breathe in to activate.
• Lightweight, portable, no spacer required.
• Delivers consistent dosing regardless of strength.
• Good for people who can't handle combo inhalers or need a step-down option.
• Lower risk of the jittery side effects that LABA combos can cause.

Cons

• Not a combination inhaler, so not for severe or poorly controlled asthma on its own.
• Needs to be used regularly—won’t help sudden asthma attacks.
• Can cause oral thrush (like all ICS)—rinse your mouth afterward.
• Dose counter can be easy to miss if you don’t keep an eye on it.

Fun fact: In a 2023 asthma patient survey, more than half said they preferred QVAR RediHaler over their old metered-dose inhaler because of the easier technique. That means using your inhaler right—and actually getting the dose—might be a lot less stressful.

Alvesco (ciclesonide)

When looking at Symbicort alternatives, Alvesco (ciclesonide) stands out if you want something straightforward and easy to use. Alvesco is an inhaled corticosteroid just like some other options, but its claim to fame is how gentle it is on your throat and mouth. Unlike some steroid inhalers that might leave you with that annoying cough or a sore throat after each puff, Alvesco releases the medication when it hits your lungs—not while it’s still in your mouth. This smart move keeps side effects like hoarseness and thrush to a minimum for most users.

Ciclesonide is designed for daily use, so you’ll need to use it consistently, not just when symptoms hit. If you stick with it, you might start noticing better asthma control usually after a few days, with the full benefits showing up within a couple of weeks. It’s not for instant relief when you’re already wheezing or breathless—you’ll still need a rescue inhaler for those moments.

Pros

• Lower risk of hoarseness and oral thrush compared to other inhaled steroids
• Delivered directly to lungs for better local action and fewer side effects
• Convenient once-daily dosing is enough for most people

Cons

• Doesn’t work right away if you’re having an asthma attack—no fast relief
• Doesn’t include a bronchodilator, so no combined symptom control like Symbicort
• Not the cheapest inhaler on the market, especially without good insurance

If you’re the kind of person who tends to get mouth problems from other inhalers, or you just want to avoid extra drugs you might not need, Alvesco is worth asking about. Just remember, it won’t replace your rescue inhaler for quick fixes—the idea is to build up control over time.

Asmanex Twisthaler (mometasone)

Asmanex Twisthaler is a dry powder inhaler that packs mometasone, a corticosteroid, to help control asthma symptoms. It’s not a combo like Symbicort alternatives; instead, it’s all about damping down the inflammation that makes you wheeze and cough. The twist-to-load design makes it easy for folks who might be tired of trickier inhalers.

This one’s only for maintenance—don’t count on it for a quick rescue. Because it’s a steroid, the idea is to stick with it every day, even when you feel fine. The payoff? For many, fewer trips to the ER and a real boost in quality of life. Mometasone's been shown to slash asthma flare-ups and improve breathing test scores over a few months of regular use.

"Mometasone furoate inhalers, like Asmanex Twisthaler, are well-tolerated in both adults and children, with fewer reported throat infections than some older corticosteroids." — Journal of Asthma Management, 2024

Pros

• Simple to use—twist, inhale, done.
• No need to coordinate puff timing like pressurized inhalers.
• Less risk of oral thrush compared to some other inhaled steroids.
• Once-daily dosing for many patients.

Cons

• No fast relief—only prevents symptoms, doesn’t stop an attack.
• Some folks still need a separate rescue inhaler.
• Like any steroid inhaler, rinsing your mouth after each use is key to avoid hoarseness or oral thrush.
• Not always the best fit for people who struggle with dry powder inhalers (young kids or severe asthma).

If you hate juggling two inhalers, remember that Asmanex isn’t a bronchodilator. You will still need a separate rescue med. That said, for the right person—especially if you’re trying to drop your steroid dose or want a no-nonsense device—it’s a powerhouse in the maintenance game.

ArmonAir Digihaler (fluticasone)

Here’s a newer inhaler option—ArmonAir Digihaler. It delivers pure fluticasone, which is a well-known inhaled corticosteroid (ICS) for controlling asthma. What makes ArmonAir Digihaler stand out is its digital tech. This inhaler actually records when you use it and how well you’re using it, then syncs this info to a smartphone app. That kind of feedback can help keep your asthma on track, especially if you sometimes forget doses or want to spot attack triggers.

Unlike combo inhalers like Symbicort, ArmonAir Digihaler only contains fluticasone. This means it’s mostly for folks who need maintenance therapy and don’t need a fast-acting bronchodilator as part of their daily routine. It’s a dry powder inhaler, so you just open the cap, inhale, and you’re set—no spacers required, no shaking, and no counting sprays left in a canister.

Pros

• Digital sensor logs actual use—lists doses and can remind you via an app
• No need to shake or prime the device
• No propellants or taste—just inhale gently for a controlled dose
• Highly accurate fluticasone delivery, matches guidelines for moderate to severe asthma
• Compatible with most insurance plans as of 2025, and more affordable if you’re already using certain digital health platforms

Cons

• No rapid relief for asthma attacks—maintenance only
• Some users find the dry powder format a little awkward, especially at first
• If you don’t keep your phone updated or use the app, the digital data doesn’t do much good
• Potential for mild throat irritation or hoarseness—rinse your mouth after use to avoid this
• Doesn’t cover people who need a combo ICS/LABA like Symbicort; you may need another rescue inhaler

If forgetfulness or keeping up with your medications is a big deal for you, ArmonAir Digihaler’s digital reminders are a game-changer. Plus, it keeps things simple—one twist, one inhale, and you’re done. Just remember, it’s not for emergencies, so you’ll always need a back-up rescue inhaler for quick relief.

Summary and Comparison Table

If you’re trying to figure out which Symbicort alternatives actually stack up, it’s not as simple as picking the one your friend likes most. Here’s what really matters: how they work, how you use them, and what makes daily life easier or harder. For example, some people hate hauling around an inhaler all day, while others care more about quick relief or a simple dosing schedule. Not all meds are created equal.

Here’s a quick cheat sheet that compares the big players for asthma control in 2025. Take a look at this table before talking meds with your doc—it’s a snapshot, not a deep dive, but it’ll help you ask smarter questions.

Every single one here can help control asthma, but there’s no one-size-fits-all fix. Picking an alternative to Symbicort really comes down to your habits, triggers, and what you’ll actually use day in, day out. For some, swallowing a pill like Singulair seems easier than messing with a device. For others, a gadget like the ArmonAir Digihaler is worth it for peace of mind (and better tracking if your memory is spotty).

• If you want once-daily, low-fuss treatment, Breo Ellipta or Asmanex Twisthaler top the list.
• If you care about avoiding inhalers, Singulair is your only real pill option.
• If cost is tight, old favorites like Pulmicort and Advair Diskus often have generic versions and big discounts in 2025.

The right fit depends on your lifestyle and what side effects you’re willing to tolerate. Chat with your healthcare provider using these facts in hand. That’s how you’ll land the best option to keep your lungs—and your daily routine—running strong this year.