What Is The Difference Between Breo And Symbicort?

In our latest question and answer, the pharmacist discusses the difference between Breo and Symbicort.


I am considering taking Breo to help control my asthma. What side effects does Breo cause compared to Symbicort?

Asked by cyndi On Jun 11, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Jun 13, 2018

COPDBreo and Symbicort are both combination ingredient inhalers used for the treatment of patients with chronic obstructive pulmonary disease (COPD), and to reduce COPD exacerbations. Although similar and both considered first-line therapy for COPD patients with a high risk of exacerbation according to the Global Initiative For Chronic Obstructive Lung Disease, they do have some key differences, discussed below.

Breo Vs. Symbicort: Active Ingredients

  • Breo contains the following two active ingredients:
    • Fluticasone
    • Vilanterol
  • Symbicort contains the following two active ingredients
    • Budesonide
    • Formoterol

Both Symbicort and Breo are a combination of a steroid (fluticasone and budesonide) and a long-acting beta-agonist (vilanterol and formoterol). The steroids help to reduce inflammation and secretions while the long acting beta agonists reduce smooth muscle contractions.

Breo Vs. Symbicort: Dosing

One of the main differences between Breo and Symbicort is the dosing schedule:

  • Breo is dosed once-daily
  • Symbicort is dosed twice-daily

Breo Vs. Symbicort: Devices

  • Breo is a DPI (dry powder inhaler). Upon use, a blister containing the powdered medicine is opened and inhaled. Dry powder inhalers require the user the inhale rather forcefully and over a period of a few seconds to consume the entire dose.
  • Symbicort is a HFA inhaler and works in a similar way to albuterol inhalers. The user simply needs to push down on the actuator and a dose of medication is delivered.

Breo Vs. Symbicort: Indications

  • Breo is FDA-approved only for adults age 18 and older.
  • Symbicort is FDA-approved for children 6 years and older as well as for adults.

Breo Vs. Symbicort: Adverse Effects

Side effect profiles for Breo and Symbicort are similar and no one agent is recommended over the other when it comes to side effects. Side effects can include:

  • Headache
  • Decreased ability to fight infection
  • Oral thrush
  • Nasopharyngitis
  • Upper respiratory tract infection
  • Sinusitis
  • Bronchitis
  • Cough
  • Back pain

As Breo and Symbicort contain steroids, it is important to rinse your mouth out after every dose to prevent oral thrush (fungal) infections.

Breo Vs. Symbicort: Efficacy

There have been no head to head studies comparing Breo to Symbicort. However, both Breo and Symbicort have show superior effiacy in reducing COPD exacerbations when comapred to steroids alone.


Breo and Symbicort are similar medications and both contain a combination of a steroid and long-acting beta agonist. The main differences are:

  • Breo is a dry powder inhaler while Symbicort is a HFA inhaler.
  • Breo is dosed once daily while Symbicort is dosed twice daily.

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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