Breztri alternatives: what to try if Breztri isn’t right for you

Not happy with Breztri or can’t afford it? You’re not stuck. Breztri is a triple combo inhaler (an inhaled steroid + a LAMA + a LABA), and there are clear alternatives — some are single-inhaler triples, others are smart combinations of two devices. Below I’ll explain the real choices, how they differ, and what to ask your doctor.

Single-inhaler triple options

These give steroid + LAMA + LABA in one device, like Breztri does. The most common rivals are Trelegy (fluticasone furoate/umeclidinium/vilanterol) and Trimbow (beclometasone/formoterol/glycopyrronium in markets where it’s available). The big differences are device type (DPI vs MDI), dosing schedule (some are once-daily, some twice-daily) and cost. If you want simplicity — one inhaler, one routine — these are the closest matches.

Mix-and-match alternatives

Not into a triple inhaler? You can pair an ICS/LABA with a separate LAMA. Popular pairs include:

• ICS/LABA (like Breo Ellipta or Symbicort) + a LAMA inhaler (Spiriva/tiotropium or Incruse/umeclidinium)
• LAMA/LABA (Anoro or others) plus an inhaled steroid when needed

This approach gives flexibility: you can try different device types or adjust doses without swapping the whole triple product. It can be cheaper if generics are available.

For asthma that won’t respond to inhalers, biologic drugs (dupilumab, benralizumab, mepolizumab) are options — but those are for specific severe cases and need specialist care.

There are also oral drugs like roflumilast for certain COPD patients, but these aren’t substitutes for inhaled triple therapy — they’re an add-on in specific situations.

When picking an alternative, focus on three practical things: device type (can you use a DPI or need an MDI?), dosing frequency (once daily vs twice), and cost/coverage. A cheaper inhaler is useless if you can’t use it correctly.

What to ask your doctor or pharmacist:

• Why switch — is it side effects, cost, or symptom control?
• Which inhaler device will I actually use correctly?
• How will we measure whether the new option works (symptoms, rescue inhaler use, peak flow)?
• Any changes to side effects to watch for (thrush, dry mouth, tremor)?

Final practical tip: if you switch, get a quick inhaler technique check and plan a follow-up within 4–8 weeks to see if symptoms improved or side effects appeared. Your doctor can help match a safety, cost, and convenience balance that fits your life.