Advair vs Symbicort: asthma and COPD inhalers compared
Advair (fluticasone and salmeterol) and Symbicort (budesonide and formoterol) each combine an inhaled steroid with a long-acting reliever for asthma and COPD. The key difference is formoterol’s fast onset, which lets Symbicort serve as both a daily and a reliever inhaler in some asthma plans.
Updated October 4, 2026
At a glance
- Device
- Advair
- Diskus powder inhaler, or an aerosol inhaler
- Symbicort
- Aerosol inhaler
- Usual dose
- Advair
- One inhalation (Diskus) twice a day
- Symbicort
- Two puffs twice a day
- Reliever onset
- Advair
- Salmeterol starts working more slowly
- Symbicort
- Formoterol starts working within minutes
- As-needed reliever use
- Advair
- No
- Symbicort
- Part of some asthma plans (SMART)
- Generic
- Advair
- Yes (Wixela and others)
- Symbicort
- Yes (Breyna and others)
Advair fluticasone and salmeterol; generic Wixela | Symbicort budesonide and formoterol; generic Breyna | |
|---|---|---|
| Device | Diskus powder inhaler, or an aerosol inhaler | Aerosol inhaler |
| Usual dose | One inhalation (Diskus) twice a day | Two puffs twice a day |
| Reliever onset | Salmeterol starts working more slowly | Formoterol starts working within minutes |
| As-needed reliever use | No | Part of some asthma plans (SMART) |
| Generic | Yes (Wixela and others) | Yes (Breyna and others) |
Daily control
Both reduce airway inflammation with an inhaled steroid and keep airways open for about 12 hours with a long-acting bronchodilator. For daily control of asthma or COPD they work comparably well, and the choice often comes down to which device suits you and which your plan covers.
SMART: one inhaler for daily use and relief
Because formoterol acts within minutes, US asthma guidelines endorse budesonide and formoterol as both the daily inhaler and the reliever for many people with moderate to severe asthma, an approach called single maintenance and reliever therapy, or SMART. Advair cannot be used this way, so a separate rescue inhaler such as albuterol is always needed with it.
Using them well
Rinse your mouth with water and spit after each use to prevent thrush. With the Diskus, breathe out away from the device and inhale quickly and deeply; with an aerosol, shake it, breathe out, and inhale slowly as you press. A spacer can help with aerosols. If you need your reliever more often than usual, your plan needs reviewing.
Interactions
Strong CYP3A4 blockers such as ritonavir and ketoconazole raise steroid levels and are avoided with both. Beta blockers can reduce the effect of the bronchodilators.
Cost
Generic versions of both are available, but inhaler prices vary widely between pharmacies and plans, so compare quotes for the exact device and strength prescribed.
Questions for your prescriber
- Would a SMART plan with one inhaler suit my asthma?
- Which device can I use correctly?
- Which version does my plan cover, and what is my copay for each?
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Sources
Written by the Script Unlock editorial team from the sources above. It is general information, not advice for you or your pet; your prescriber decides which medicine is right.
Script Unlock is a marketplace that lets licensed pharmacies quote a cash price on your prescription. It does not prescribe, dispense or sell medication, does not process patient payments, and does not give medical advice. Always follow the instructions of your prescriber and pharmacist and read the medication guide supplied with your medicine.