Symbicort Inhaler (budesonide/formoterol) is a maintenance inhaler used to minimize attacks in moderate to severe asthma and COPD, including emphysema and chronic bronchitis. It is suitable for patients age 6 and up.

Patients may be prescribed Symbicort Inhaler as a prevention treatment when rescue inhaler use exceeds two or three times per week. Each Symbicort inhaler includes two active ingredients to help alleviate and prevent asthma or COPD:

• Budesonide is a corticosteroid that inhibits the immune system's response to allergens or irritants, reducing airway inflammation and making it easier to breathe.
• Formoterol is a bronchodilator that relaxes muscles around the airways, improving airflow through the lungs.

Some individuals no longer need a rescue inhaler at all once started on Symbicort, but most do need a rescue inhaler now and then. The standard rescue inhaler is albuterol, but there are also other options.

Inhaled corticosteroids like budesonide do provide some benefit for most patients, but there are exceptions. If Symbicort Inhaler fails to produce improvements or makes the condition worse, don't be afraid to speak with a doctor about alternative treatments. There are non-steroidal maintenance inhalers available, such as Tilade Inhaler.

Using Symbicort Inhaler

Symbicort Inhalers are available in a range of dosage strengths; ideally a doctor will determine which is used. If in doubt, patients should buy Symbicort Inhalers in lower dosages, increasing only if needed. A doctor should always advise dosage for children below 12 years of age.

In most cases treatment is consistent regardless of the presence or absence of symptoms:

• Administer 2 inhalations twice per day, morning and evening.
• Wait about 1 minute between inhalations.
• Do not exceed 2 inhalations at a time or 4 inhalations per day.

Patients with very mild symptoms sometimes reduce use considerably:

• Administer 1 inhalation twice per day; or
• Administer 1 inhalation once per day; or
• Administer 2 inhalations once per day.

While some improvement is usually noticeable within the first few days of treatment, it takes about two weeks for maximum benefit to be felt. Attacks should be less frequent and when---or if---an attack does occur, it should be less severe than it would be without Symbicort use.

The mouth should be rinsed out with water after administration to help prevent thrush or other infections in the mouth and throat.

Though much less common, Symbicort Inhaler is sometimes used as a rescue inhaler in very mild cases; the inhaler does include a bronchodilator. In many cases, however, it does not provide quick enough relief or sufficient relief.

Adverse Effects

Common side effects associated with Symbicort Inhaler include:

• Trembling
• Rapid heartbeat or palpitations
• Sore throat
• Hoarseness
• Oral thrush
• Muscle cramps

More rare, and more serious, side effects do sometimes happen. Seek medical attention if experiencing:

• Chest pain
• Pain while breathing
• Fever or chills
• Chronic coughing
• Change in mucus color

Paradoxical bronchospasm is also a concern; in paradoxical bronchospasm breathing will suddenly become worse. If this happens discontinue use of Symbicort Inhaler and seek medical attention. A different rescue inhaler may help if needed. In most cases (but not all) paradoxical bronchospasm will occur early in treatment if it's going to happen.

The active ingredient formoterol in this product is a long-acting beta agonist (LABA). LABAs are associated with an increased risk of hospitalization or death due to severe asthma attacks, though this is very rare. The risk of LABA-associated death is mitigated to some extent when the LABA is taken with a corticosteroid, such as in Symbicort Inhaler, but it is still a risk. In the vast majority of patients the benefits of using corticosteroid/LABA combinations are considered worth the risk. If concerned about this, speaking with a doctor is advisable.