Symbicort: Advanced Asthma & COPD Control with Dual-Action Therapy
Symbicort
| Product dosage: 100 mcg + 6 mcg | |||
|---|---|---|---|
| Package (num) | Per inhaler | Price | Buy |
| 1 | $46.00 | $46.00 (0%) | 🛒 Add to cart |
| 2 | $36.50 | $92.00 $73.00 (21%) | 🛒 Add to cart |
| 3 | $32.00
Best per inhaler | $138.00 $96.00 (30%) | 🛒 Add to cart |
| Product dosage: 200 mcg + 6 mcg | |||
|---|---|---|---|
| Package (num) | Per inhaler | Price | Buy |
| 1 | $50.00 | $50.00 (0%) | 🛒 Add to cart |
| 2 | $45.50 | $100.00 $91.00 (9%) | 🛒 Add to cart |
| 3 | $41.00
Best per inhaler | $150.00 $123.00 (18%) | 🛒 Add to cart |
| Product dosage: 400 mcg + 6 mcg | |||
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| Package (num) | Per inhaler | Price | Buy |
| 1 | $55.00 | $55.00 (0%) | 🛒 Add to cart |
| 2 | $50.00 | $110.00 $100.00 (9%) | 🛒 Add to cart |
| 3 | $44.00
Best per inhaler | $165.00 $132.00 (20%) | 🛒 Add to cart |
Synonyms | |||
Symbicort (budesonide/formoterol fumarate dihydrate) is a maintenance inhaler indicated for the long-term management of asthma in patients 6 years and older and for the maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It combines an inhaled corticosteroid (ICS) to reduce inflammation and a long-acting beta2-adrenergic agonist (LABA) to relax airway muscles, offering a comprehensive approach to respiratory management. This fixed-dose combination is designed to improve lung function, reduce exacerbation frequency, and enhance overall quality of life in appropriate patient populations. Clinical evidence supports its efficacy in both maintenance and, for asthma, as-needed use in specific formulations, aligning with current GINA and GOLD treatment guidelines.
Features
- Contains budesonide (ICS) and formoterol (LABA) in a single pressurized metered-dose inhaler
- Available in multiple strength combinations: 80/4.5 mcg, 160/4.5 mcg for asthma; 160/4.5 mcg for COPD
- Delivers medication via a hydrofluoroalkane (HFA) propellant
- Features an integrated dose counter to track remaining inhalations
- Designed for twice-daily maintenance dosing in asthma and COPD
- Rapid-onset LABA component (formoterol) may provide quick bronchodilation
- Compatible with standard spacer devices for improved drug delivery
Benefits
- Provides dual anti-inflammatory and bronchodilator effects in a single device, simplifying treatment regimens
- Significantly improves lung function (FEV1) and peak expiratory flow rates in asthma and COPD patients
- Reduces the frequency and severity of asthma exacerbations and COPD flare-ups
- Enhances symptom control, allowing for improved daily activity tolerance and sleep quality
- May decrease reliance on rescue inhalers when used consistently as prescribed
- Supports adherence through convenient twice-daily dosing and integrated dose counter
Common use
Symbicort is primarily prescribed as maintenance therapy for persistent asthma in patients requiring both ICS and LABA treatment. It is also indicated for COPD patients with severe airflow limitation and a history of exacerbations. In asthma, it may be used for both maintenance and reliever therapy in specific populations (SMART regimen) when prescribed as the 160/4.5 mcg strength. Physicians typically initiate Symbicort when medium-dose ICS alone provides inadequate control or when patients require both controller and reliever medications. The medication is not intended for immediate relief of acute bronchospasm, though the formoterol component does provide relatively rapid bronchodilation.
Dosage and direction
Asthma (patients 6 years and older):
- Recommended starting dose: 2 inhalations twice daily (morning and evening, approximately 12 hours apart)
- Maximum daily dose: 4 inhalations twice daily (640/18 mcg total daily dose)
- For SMART regimen: 1-2 inhalations as needed for symptom relief in addition to maintenance dosing
COPD:
- Recommended dose: 2 inhalations twice daily
- Maximum daily dose: 2 inhalations twice daily (640/18 mcg total daily dose)
Administration:
- Shake well before each inhalation
- Exhale fully away from mouthpiece
- Place mouthpiece between lips and inhale deeply and steadily while pressing canister
- Hold breath for 5-10 seconds after inhalation
- Wait 30-60 seconds before second inhalation if prescribed
- Rinse mouth with water after each use to reduce risk of oral candidiasis
Precautions
- Not for primary treatment of status asthmaticus or other acute episodes
- May cause paradoxical bronchospasm; discontinue immediately if occurs
- Increased risk of pneumonia in COPD patients; monitor for symptoms
- Potential systemic corticosteroid effects with high doses (adrenal suppression, reduced bone density)
- May mask signs of infection; evaluate patients with unexplained respiratory symptoms
- Use with caution in patients with cardiovascular disorders, especially coronary insufficiency, arrhythmias, and hypertension
- Monitor growth in pediatric patients receiving prolonged corticosteroid therapy
- Caution in patients with convulsive disorders, thyrotoxicosis, diabetes mellitus, or ketoacidosis
- Assess bone mineral density in patients at risk for osteoporosis with long-term use
Contraindications
- Hypersensitivity to budesonide, formoterol, or any component of the formulation
- Primary treatment of status asthmaticus or acute respiratory episodes
- Significant hypersensitivity to milk proteins (contains lactose)
- Use without concomitant ICS therapy in asthma patients
- As a rescue medication for acute symptoms
Possible side effect
Common (≥1%):
- Headache (12-15%)
- Upper respiratory tract infection (10-14%)
- Pharyngitis (8-12%)
- Sinusitis (5-8%)
- Oral candidiasis (2-5%)
- Hoarseness/dysphonia (2-4%)
- Tremor (2-3%)
- Palpitations (1-2%)
Less common:
- Cough, nausea, gastrointestinal discomfort
- Muscle cramps, nervousness
- ECG changes (including prolonged QTc interval)
- Bronchospasm
- Skin reactions
Serious (rare):
- Pneumonia (particularly in COPD patients)
- Cardiovascular effects (tachycardia, hypertension, arrhythmias)
- Adrenal insufficiency
- Hypersensitivity reactions (urticaria, angioedema, anaphylaxis)
- Osteoporosis with long-term use
- Glaucoma and cataracts
- Hyperglycemia
Drug interaction
- Beta-blockers: may antagonize bronchodilator effects and produce severe bronchospasm
- Diuretics: may potentiate hypokalemia and ECG changes
- MAO inhibitors and tricyclic antidepressants: may potentiate cardiovascular effects
- Ketoconazole and other strong CYP3A4 inhibitors: may increase budesonide exposure
- QT-prolonging drugs: increased risk of arrhythmias
- Other sympathomimetic agents: additive cardiovascular effects
- Xanthine derivatives, steroids, non-potassium sparing diuretics: increased hypokalemia risk
Missed dose
If a dose is missed, take it as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed one. Resume the regular dosing schedule. Patients should not increase frequency or quantity of inhalations without medical consultation. Consistent daily use is essential for optimal therapeutic effect.
Overdose
Symptoms: Exaggeration of known side effects including tachycardia, arrhythmias, hypertension, hypokalemia, hyperglycemia, muscle cramps, headache, tremor, nervousness, and convulsions. Corticosteroid overdose may cause systemic effects including adrenal suppression.
Management: Discontinue Symbicort immediately and institute supportive therapy as indicated. Cardiac monitoring is recommended for arrhythmias. Serum potassium should be monitored and corrected if necessary. Beta-blockers may be considered for severe cardiovascular symptoms but must be used with caution in patients with reversible airway disease due to risk of bronchospasm.
Storage
Store at room temperature (15-30°C/59-86°F). Do not freeze. Keep canister away from direct heat or sunlight. Do not puncture or incinerate, even when empty. Store with mouthpiece down. Keep out of reach of children. Discard inhaler when counter reads “0” or 3 months after removal from foil pouch, whichever comes first. Do not attempt to take the canister apart.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Symbicort is a prescription medication that should be used only under the supervision of a qualified healthcare provider. Individual patient needs may vary, and healthcare professionals should consult full prescribing information before initiating therapy. Patients should not adjust dosage or discontinue medication without medical consultation. The benefits and risks of treatment should be carefully evaluated for each individual patient.
Reviews
“Symbicort has been transformative for my severe asthma management. The combination therapy provides consistent control I hadn’t achieved with separate inhalers. My exacerbation frequency has decreased significantly, and I appreciate the dose counter for tracking usage.” - Asthma patient, 42
“As a pulmonologist, I find Symbicort effective for patients requiring step-up therapy. The dual mechanism addresses both inflammation and bronchoconstriction effectively. The SMART regimen has particularly benefited my moderate-severe asthma patients in reducing exacerbations.” - Respiratory specialist, 15 years experience
“After switching to Symbicort for my COPD, I’ve noticed improved breathing capacity and reduced rescue inhaler use. The twice-daily routine is manageable, though I did experience some initial throat irritation that resolved with proper rinsing.” - COPD patient, 68
“Clinical trial data consistently demonstrates Symbicort’s efficacy in improving lung function parameters and quality of life scores. The safety profile is well-established, though requires monitoring for local and systemic effects, particularly with long-term use.” - Clinical researcher