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Symbicort

What You Need To Know About Symbicort

By

Updated June 30, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Woman holding Inhaler, close-up
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Symbicort is an asthma controller medication combining two drugs into one inhaler -- an inhaled steroid and a long-acting beta agonist with each inhalation.

More specifically, Symbicort contains:

  • Pulmicort (budesonide) -- a steroid that improves asthma symptoms by decreasing irritation and inflammation.

  • Foradil (formoterol) -- a long-acting bronchodilator, or LABA, that relieves bronchoconstriction. Symbicort provides bronchodilation by relaxing smooth muscle in the lungs and making the airways wider, thereby decreasing symptoms.

Symbicort is designed to relieve asthma symptoms such as:

Advantages of Symbicort

  • Easier than taking each component medicine separately
  • Increases your compliance
  • Allows for lower doses of total inhaled corticosteroid, which may minimize potential side effects

Disadvantages of Symbicort

  • Less flexibility in dosing
  • If Symbicort is used for relief of acute symptoms, you will receive a much higher dose of the steroid than is currently recommended

Form and Dosage of Symbicort

Symbicort is a metered dose inhaler. Each time you press the inhaler, a specific amount of medicine is aerosolized for inhalation.

Symbicort comes in 2 strengths: Symbicort 80/4.5 and Symbicort 160/4.5. The 80 and 160 refers to the amount (micrograms) of budesonide in each inhalation, while the amount of formoterol always stays the same at 4.5 micrograms.

Generally, Symbicort is taken 2 puffs twice per day, approximately 12 hours apart. If your asthma symptoms worsen or do not improve, your doctor will likely step you up to the formulation with more budesonide. Symbicort needs to be taken every day to improve your asthma symptoms.

Additionally, a few studies have suggested the possibility of using a combination product as your only inhaler for both control and acute symptoms, but you should discuss this with your doctor before trying it.

Potential Side Effects of Symbicort

As with most other drugs, only a small percentage of patients experience side effects. Potential side effects of Symbicort are similar to those of both inhaled steroids and LABAs.

Symbicort carries a "black box" warning like other medicines that contain a LABA. There has been some concern regarding whether LABA treatment increases the severity of asthma exacerbations and possibly increases the risk of fatal asthma. Even though a LABA may decrease the frequency of asthma episodes and severity of symptoms, a LABA may make asthma episodes more severe when they do occur.

Summary

Symbicort can be a useful tool for patients who are not able to achieve control of their asthma with an inhaled steroid alone. You and your physician need to to discuss the possible risks and benefits of combination therapy, and make sure you notify your physician of any worsening of your asthma symptoms.

Sources:

Nelson HS. Combination Therapy of Long-acting β agonists and Inhaled Corticosteroids in the Management of Chronic Asthma. Current Allergy and Asthma Reports 2005, 5:123–129.

National Heart, Lung, and Blood Institute. Accessed: April 3, 2011. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma

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