Symbicort is a brand-name prescription medication that’s FDA-approved:
- to treat asthma in adults as well as children ages 6 years and older. Asthma is a condition in which your airways become inflamed or irritated, making it hard to breathe.
- as a maintenance (routine) treatment for chronic obstructive pulmonary disorder (COPD). COPD is a group of lung conditions that include chronic bronchitis and emphysema. In addition to helping keep your airways open, Symbicort reduces the number of COPD flare-ups and how severe they are.
Symbicort isn’t approved to help ease sudden breathing problems. (It’s not a rescue inhaler.)
Symbicort includes two active ingredients: budesonide and formoterol. Budesonide belongs to a class of medications called corticosteroids. (A class of medications is a group of drugs that work in a similar way.) Budesonide helps decrease irritation in the lungs. Formoterol belongs to a class of medications called long-acting beta2-agonists, which help open up the airways.
Symbicort comes as a metered-dose inhaler and is available in the following strengths:
- 80 mcg of budesonide/4.5 mcg of formoterol
- 160 mcg of budesonide/4.5-mcg of formoterol
You’ll take two inhalations (puffs) of Symbicort twice a day.
Effectiveness
Here’s some information about the effectiveness of Symbicort in treating asthma and COPD.
Asthma
Two studies looked at asthma in adults as well as children ages 12 years and older. The people were given Symbicort; either of the individual drugs in Symbicort, budesonide and formoterol; or a placebo (treatment with no active drug).
To track lung function, researchers looked at forced expiratory volume in 1 second (FEV1). This is a standard measure of how much air you can force out of your lungs in 1 second. Asthma and other breathing conditions may make your FEV1 lower due to tightness in your airways.
Compared with people who took a placebo or other drug, people who took Symbicort had a greater improvement in their baseline FEV1. This is FEV1 before taking a dose of medication. In one study, the average FEV1 improvement by the end of treatment for people who took Symbicort was 9%. This was compared with 5% for people who took budesonide, -5% for those who took formoterol, and -7% for those who took a placebo. The -5% and -7% values show that the FEV1 got worse.
COPD
Studies also looked at people with COPD who took Symbicort; one or both of the ingredients in Symbicort, budesonide and formoterol; or a placebo. The group that took 160 mcg/4.5 mcg of Symbicort had a greater improvement in their FEV1 compared with the other groups.
In one study, the average FEV1 improvements from baseline were:
- 11% in the group that took 160 mcg/4.5 mcg of Symbicort
- 8% in the group that took 160 mcg of budesonide plus 4.5 mcg formoterol
- 7% in the group that took 4.5 mcg of formoterol
- 2% in the group that took 160 mcg of budesonide
- 2% in the group that took a placebo
The group that took 80 mcg/4.5 mcg of Symbicort had an FEV1 improvement that was similar to the group that took formoterol.
For more information about the effectiveness of Symbicort, see the “Symbicort Uses” section below.
The Food and Drug Administration (FDA) approves prescription drugs such as Symbicort to treat certain conditions.
Symbicort for asthma
Symbicort is FDA-approved to treat asthma in adults as well as children ages 6 years and older. The medication isn’t approved to help ease sudden breathing problems.
Asthma is a chronic (long-term) condition that affects the airways. Inflammation (swelling) of the airways leads to trouble breathing. Although there isn’t a cure for asthma, you may be able to manage your symptoms to help improve your quality of life and prevent complications.
Effectiveness
Two studies looked at asthma in adults as well as children ages 12 years and older. The people were given Symbicort; either of the individual drugs in Symbicort, budesonide and formoterol; or a placebo (treatment with no active drug). To track lung function, researchers looked at forced expiratory volume in 1 second (FEV1). This is a standard measure of how much air you can force out of your lungs in 1 second. Asthma and other breathing conditions may make your FEV1 lower due to tightness in your airways.
Compared with people who took a placebo or other drug, people who took Symbicort had a greater improvement in their baseline FEV1. This is FEV1 before taking a dose of medication. In one study, the average FEV1 improvement by the end of treatment for people who took Symbicort was 9%. This was compared with 5% for people who took budesonide, -5% for those who took formoterol, and -7% for those who took a placebo. The -5% and -7% values show that the FEV1 got worse.
Symbicort for COPD
Symbicort is FDA-approved as a long-term treatment for people with chronic obstructive pulmonary disorder (COPD). COPD is a group of lung conditions that include chronic bronchitis (irritation of the airways) and emphysema, which is damage to the air sacs of the lungs. In addition to helping keep your airways clear, Symbicort reduces the number of COPD flare-ups and how severe they are.
COPD requires treatment with lifestyle changes and medication. The condition isn’t curable, but you may be able to manage your symptoms to help improve your quality of life and prevent complications.
Effectiveness
Studies also looked at people with COPD who took Symbicort; one or both of the ingredients in Symbicort, budesonide and formoterol; or a placebo. The group that took 160 mcg/4.5 mcg of Symbicort had a greater improvement in their FEV1 compared with the other groups.
In one study, the average FEV1 improvements from baseline were:
- 11% in the group that took 160 mcg/4.5 mcg of Symbicort
- 8% in the group that took 160 mcg of budesonide plus 4.5 mcg formoterol
- 7% in the group that took 4.5 mcg of formoterol
- 2% in the group that took 160 mcg of budesonide
- 2% in the group that took a placebo
The group that took 80 mcg/4.5 mcg of Symbicort had an FEV1 improvement that was similar to the group that took formoterol.
Symbicort for other conditions
You may wonder if Symbicort has any uses in addition to the uses listed above.
Symbicort for allergies (not an appropriate use)
Symbicort isn’t approved for the treatment of allergies and shouldn’t be used for this condition.
If you have breathing issues related to allergies, other treatment options are available. Seasonal or year-round allergies affect many people. So talk with your doctor if you have symptoms that are bothersome or want to learn how to find relief.
Symbicort and children
Symbicort is approved for the treatment of asthma in children ages 6 years and older.
A study of children ages 6 to 11 years with asthma looked at changes in their FEV1 an hour after dosing. The children took either Symbicort or one of its ingredients, budesonide. By 12 weeks, the Symbicort group had almost double the improvement in FEV1 (0.28 L) at 1 hour after dosing compared with the budesonide group (0.17 L) from their baseline reading. This means that the children who took Symbicort had better lung function than those who took budesonide.
Symbicort is a brand-name medication containing the active drugs budesonide and formoterol. It’s also available in generic form.
A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be just as safe and effective as the original drug. Generics also tend to cost less than brand-name drugs.
Budesonide is available as a generic medication called “budesonide” in various dosage forms. The inhaled versions of budesonide are also available as the brand-name drugs Pulmicort and Pulmicort Respules.
Formoterol is available as a brand-name inhaled medication called Perforomist.
The Symbicort dosage your doctor prescribes will depend on several factors. These include:
- the type and severity of the condition you’re using Symbicort to treat
- your age
- other medical conditions you may have
Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Drug forms and strengths
Symbicort comes as a metered-dose inhaler, which dispenses the drug in a spray that you inhale. The inhaler releases the medication in premeasured puffs. Symbicort is available in the following strengths:
- 80 mcg of budesonide/4.5 mcg of formoterol
- 160 mcg of budesonide/4.5 mcg of formoterol
Each inhaler contains either 60 or 120 puffs.
Dosage for asthma
The typical dosage of Symbicort for adults with asthma is two inhalations (puffs) twice a day. The strength that your doctor recommends will depend on your asthma symptoms.
Dosage for COPD
The typical dosage of Symbicort for people with chronic obstructive pulmonary disorder (COPD) is two puffs of the 160-mcg/4.5-mcg strength of Symbicort twice a day.
Pediatric dosage
The typical dosage of Symbicort for children ages 6 to 11 years with asthma is two puffs of the 80-mcg/4.5-mcg strength of Symbicort twice a day.
Children ages 12 years and older with asthma will take Symbicort as two puffs twice a day. The medication strength and dosage your child’s doctor recommends will depend on their asthma symptoms.
What if I miss a dose?
If you miss a dose of Symbicort, take your next dose at the regularly scheduled time.
It’s important to try to take your doses about 12 hours apart. To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.
Will I need to use this drug long term?
Symbicort is meant to be used as a long-term treatment. If you and your doctor determine that Symbicort is safe and effective for you, you’ll likely take it long term.
Symbicort can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Symbicort. These lists don’t include all possible side effects. Side effects might differ slightly between people with asthma and people with chronic obstructive pulmonary disorder (COPD).
For more information on the possible side effects of Symbicort, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.
Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Symbicort, you can do so through MedWatch.
Mild side effects
The mild side effects of Symbicort that are more common* can include:
- upper respiratory tract infection, such as the common cold, flu, bronchitis, or sinusitis
- nasal congestion
- pain when speaking and trouble speaking
- back pain
- stomach discomfort
- nausea or vomiting
- oral thrush (a yeast infection in your mouth)
- headache
Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.
* occurred in more than 3% of people in clinical studies
Serious side effects
Serious side effects from Symbicort aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.
Serious side effects and their symptoms can include:
- Pneumonia (a type of lung infection). Symptoms can include:
- trouble breathing
- low energy
- extreme tiredness
- Decreased growth in children. Symptoms can include:
- slower than expected growth in children
- Decrease in bone density. Symptoms can include:
- bone breaks (if bone density changes are severe)
- Paradoxical bronchospasm (unexpected tightening of your airways because the drug is supposed to treat bronchospasm). Symptoms can include:
- cough
- tightness in chest
- wheezing
- trouble breathing
- Increased level of a hormone called cortisol, which may reduce the activity of your adrenal glands. Symptoms can include:
- weakness
- extreme tiredness
- weight loss
- low blood pressure when standing
- Eosinophilia (high level of certain white blood cells). Symptoms can include:
- rash
- trouble breathing
- peripheral neuropathy (pain, numbness, or weakness that often affects your hands or feet)
- Hypokalemia (low level of potassium). Symptoms can include:
- muscle cramps
- changes in heart rhythm
- dizziness
- Hyperglycemia (high blood sugar). Symptoms can include:
- increased thirst
- increased urination
- dizziness
- trouble concentrating
- Cardiovascular (heart and blood vessel) problems. Symptoms can include:
- chest pain
- changes in blood pressure
- racing heart
- changes in heart rhythm
- Central nervous system problems. Symptoms can include:
- seizures
- headache
- tremor
- dizziness
- Increased risk of infection, such as chickenpox or measles
- Serious asthma-related events that can include:
- hospital stay
- intubation (tube inserted into airway for breathing)
- death
Other serious side effects, explained in more detail below in “Side effect details,” include:
- allergic reactions
- glaucoma and cataracts (types of eye problems)
Side effects in children
Side effects of Symbicort are similar in both adults and children. In one study of children ages 6 to 11 years, the mild side effects of Symbicort that were more common* included common cold symptoms such as cough, sore throat, and stuffy or runny nose, as well as headache.
* occurred in more than 3% of children in the study
Side effect details
You may wonder how often certain side effects occur with this drug. Here’s some detail on several of the side effects this drug may cause.
Allergic reaction
As with most drugs, some people can have an allergic reaction after taking Symbicort. However, it’s not known how often allergic reactions occur with the drug.
Symptoms of a mild allergic reaction can include:
- skin rash
- itchiness
- flushing (temporary warmth, discoloration, or deepening of skin color)
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your tongue, mouth, or throat
- trouble breathing or speaking
Call your doctor right away if you have a severe allergic reaction to Symbicort. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.
Weight gain
Weight gain hasn’t been reported as a side effect of Symbicort. However, a class of medications known as corticosteroids can cause weight gain. (A class of medications is a group of drugs that work in a similar way.) And one of the ingredients in Symbicort is a corticosteroid called budesonide.
If you’re concerned about weight gain, talk with your doctor. They can review your diet and exercise routine, as well as your medications.
Eye problems
Eye problems aren’t likely to occur with Symbicort, but it’s possible. Glaucoma, increased eye pressure, and cataracts have been reported after long-term use of inhaled corticosteroids. And Symbicort contains an inhaled corticosteroid called budesonide. However, it’s not known how often problems occur with Symbicort treatment.
During your Symbicort treatment, your doctor will monitor your vision closely, especially if you have a history of certain eye conditions. And if you have blurred vision, changes in your sight, or pain in your eyes, tell your doctor right away.
Sore throat
A sore throat may occur with Symbicort use. The drug can cause laryngitis (inflammation of the voice box), which can cause discomfort or pain. Other possible side effects of Symbicort can also make your throat sore. These include symptoms of the common cold, such as a runny or stuffy nose, or cough.
About 6% to 9% of people who took Symbicort in clinical studies had throat pain compared with 5% of those who took a placebo (treatment with no active drug).
If your throat becomes sore while taking Symbicort, ask your doctor what treatments may help.
High blood pressure
It’s possible that taking Symbicort could cause high blood pressure. This doesn’t usually happen with the usual doses, but the side effect may occur in people who are more likely to have blood pressure problems. Clinical studies have found that people who took Symbicort didn’t have blood pressure changes more often than those who took a placebo.
While taking Symbicort, it’s important to tell your doctor right away if you notice dizziness, headaches, or heart palpitations (feeling of skipped or extra heartbeats). And tell your doctor if you have a history of blood pressure conditions or heart conditions before taking the drug.
Other drugs are available that can treat asthma or chronic obstructive pulmonary disorder (COPD). Some may be a better fit for you than others. If you’re interested in finding an alternative to Symbicort, talk with your doctor. They can tell you about other medications that may work well for you.
Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.
Alternatives for asthma
Asthma treatment usually includes a combination of maintenance medications (used routinely) and rescue medications (used when you’re having symptoms). Symbicort, which includes a corticosteroid and a long-acting beta2-agonist, is considered a maintenance medication.
Examples of other maintenance drugs that may be used to treat asthma include:
- certain inhaled corticosteroids, such as:
- beclomethasone (Qvar)
- budesonide (Pulmicort)
- ciclesonide (Alvesco)
- flunisolide (Aerospan)
- fluticasone (Flovent)
- mometasone (Asmanex)
- certain long-acting beta2-agonists (LABAs), such as:
- salmeterol (Serevent)
- formoterol (Perforomist)
- certain combinations of inhaled corticosteroids and LABAs, such as:
- fluticasone/salmeterol (Advair)
- mometasone/formoterol (Dulera)
- certain leukotriene receptor antagonists, such as:
- montelukast (Singulair)
- zafirlukast (Accolate)
- certain oral corticosteroids, such as:
- methylprednisolone (Medrol)
- prednisolone (Orapred)
- prednisone (Deltasone)
- certain immunomodulators, such as:
- omalizumab (Xolair)
Alternatives for COPD
COPD treatment usually includes a combination of maintenance medications and rescue medications. Symbicort, which includes a corticosteroid and a long-acting beta2-agonist, is considered a maintenance medication.
Examples of other maintenance drugs that may be used to treat COPD include:
- certain LABAs, such as:
- formoterol (Perforomist)
- salmeterol (Serevent)
- indacaterol (Arcapta Neohaler)
- olodaterol (Striverdi Respimat)
- certain anticholinergics, such as:
- tiotropium (Spiriva)
- aclidinium (Tudorza)
- umeclidinium (Incruse Ellipta)
- ipratropium (Atrovent)
- certain combinations of inhaled beta2-agonists and anticholinergics, such as:
- formoterol/aclidinium (Duaklir Pressair)
- formoterol/glycopyrrolate (Bevespi)
- vilanterol/umeclidinium (Anoro Ellipta)
- olodaterol/tiotropium (Stiolto Respimat)
- albuterol/ipratropium (Combivent)
- certain combinations of LABAs and inhaled corticosteroids, such as:
- formoterol/mometasone (Dulera)
- salmeterol/fluticasone (Advair)
- vilanterol/fluticasone (Breo Ellipta)
- certain combinations of LABAs, anticholinergics, and inhaled corticosteroids, such as:
- fluticasone/umeclidinium/vilanterol (Trelegy Ellipta)
You may wonder how Symbicort compares with other medications that are prescribed for similar uses. Here we look at how Symbicort and Breo are alike and different.
Ingredients
Both Symbicort and Breo contain a combination of two active ingredients, an inhaled corticosteroid and long-acting beta2-agonist. Symbicort contains budesonide and formoterol. Breo contains fluticasone and vilanterol.
Uses
The Food and Drug Administration (FDA) has approved Symbicort:
- to treat asthma in adults as well as children ages 6 years and older. Asthma is a condition in which your airways become irritated, making it hard to breathe.
- as a maintenance (routine) treatment for chronic obstructive pulmonary disorder (COPD). COPD is a group of lung conditions that include chronic bronchitis and emphysema. In addition to helping keep your airways clear, Symbicort reduces the number of COPD flare-ups and how severe they are.
Symbicort isn’t approved to help ease sudden breathing problems.
Breo is FDA-approved:
- to treat asthma in people ages 18 years and older. Breo isn’t approved to help ease sudden breathing problems.
- as a long-term treatment for COPD. In addition to helping keep your airways clear, Breo reduces the number of COPD flare-ups and how severe they are.
Drug forms and administration
Symbicort comes as a metered-dose inhaler, which dispenses the drug in a spray that you inhale. The inhaler releases the medication in premeasured puffs. You’ll take two puffs of Symbicort twice a day for the treatment of asthma or COPD.
Breo comes as a dry powder inhaler, which dispenses the drug as a fine powder that you inhale. You’ll take one puff of Breo once a day for the treatment of asthma or COPD.
Side effects and risks
Symbicort and Breo contain drugs from the same medication classes. (A class of medications is a group of drugs that work in a similar way.) Therefore, these medications can cause some very similar side effects. Below are examples of these side effects.
Mild side effects
These lists contain examples of more mild side effects that can occur with Symbicort, with Breo, or with both drugs (when taken individually).
- Can occur with Symbicort:
- few unique mild side effects
- Can occur with Breo:
- joint aches
- Can occur with both Symbicort and Breo:
- upper respiratory tract infection such as the common cold, flu, bronchitis, or sinusitis
- nasal congestion
- pain when speaking and trouble speaking
- stomach discomfort
- oral thrush (a yeast infection in your mouth)
Serious side effects
This list contains examples of serious side effects that can occur with both Symbicort and Breo (when taken individually):
- pneumonia (a type of lung infection)
- decreased growth in children
- decrease in bone density
- paradoxical bronchospasm (unexpected tightening of your airways because the drug is supposed to treat bronchospasm)
- increased level of a hormone called cortisol, which may reduce the activity of your adrenal glands
- eosinophilia (high level of certain white blood cells)
- hypokalemia (low level of potassium)
- hyperglycemia (high blood sugar)
- cardiovascular (heart and blood vessel) problems
- central nervous system problems
- increased risk of infection, such as chickenpox or measles
- serious asthma-related events, such as a hospital stay
- allergic reactions
- glaucoma and cataracts (types of eye problems)
Effectiveness
Both Symbicort and Breo are used to treat asthma and COPD.
Effectiveness in treating asthma
The use of Symbicort and Breo in treating asthma has been directly compared in clinical studies of people with asthma. In one
The study looked at changes in forced expiratory volume in 1 second (FEV1). FEV1 is the amount of air that you can force out of your lungs in 1 second. Changes in FEV1 were about the same between Symbicort and Breo, which showed that the drugs were similarly effective in easing people’s asthma symptoms.
A
Effectiveness in treating COPD
These drugs haven’t been directly compared in clinical studies of COPD, but studies have found both Symbicort and Breo to be effective for treating the condition.
Costs
Symbicort and Breo are both brand-name drugs. Symbicort also comes a generic, but Breo is only available as a brand-name medication. Brand-name medications usually cost more than generics.
Symbicort generally costs more than Breo when considering the differences in dosages. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.
Like Breo (above), the drug Dulera has uses similar to those of Symbicort. Here’s a comparison of how Symbicort and Dulera are alike and different.
Ingredients
Both Symbicort and Dulera contain a combination of two active ingredients, an inhaled corticosteroid and long-acting beta2-agonist. Symbicort contains budesonide and formoterol. Dulera contains mometasone and formoterol.
Uses
The Food and Drug Administration (FDA) has approved Symbicort:
- to treat asthma in adults as well as children ages 6 years and older. Asthma is a condition in which your airways become irritated, making it hard to breathe.
- as a maintenance (routine) treatment for chronic obstructive pulmonary disorder (COPD). COPD is a group of lung conditions that include chronic bronchitis and emphysema. In addition to helping keep your airways clear, Symbicort reduces the number of COPD flare-ups and how severe they are.
Symbicort isn’t approved to help ease sudden breathing problems.
Dulera is FDA-approved for the treatment of asthma in adults as well as children ages 5 years and older. The drug isn’t approved to help ease sudden breathing problems. Dulera also isn’t approved to treat COPD.
Drug forms and administration
Both Symbicort and Dulera come as a metered-dose inhaler, which dispenses the drug in a spray that you inhale. The inhaler releases the medication in premeasured puffs.
You’ll take two puffs of Symbicort twice a day for the treatment of asthma or COPD.
You’ll take two puffs of Dulera twice a day for the treatment of asthma.
Side effects and risks
Symbicort and Dulera contain drugs from the same medication classes. (A class of medications is a group of drugs that work in a similar way.) Therefore, these medications can cause some similar side effects. Below are examples of these side effects.
Mild side effects
These lists contain examples of more mild side effects that can occur with Symbicort, with Dulera, or with both drugs (when taken individually).
- Can occur with Symbicort:
- upper respiratory tract infection, such as the flu or bronchitis
- nasal congestion
- back pain
- stomach discomfort
- nausea or vomiting
- oral thrush (a yeast infection in your mouth)
- pain when speaking and trouble speaking
- Can occur with Dulera:
- few unique mild side effects
- Can occur with Symbicort and Dulera:
- sinusitis (swelling of the sinuses)
Serious side effects
These lists contain examples of serious side effects that can occur with Symbicort, with Dulera, or with both drugs (when taken individually).
- Can occur with both Symbicort:
- pneumonia (a type of lung infection)
- Can occur with both Dulera:
- few unique serious side effects
- Can occur with both Symbicort and Dulera:
- decreased growth in children
- decrease in bone density
- paradoxical bronchospasm (unexpected tightening of your airways because the drug is supposed to treat bronchospasm)
- increased level of a hormone called cortisol, which may reduce the activity of your adrenal glands
- eosinophilia (high level of certain white blood cells)
- hypokalemia (low level of potassium)
- hyperglycemia (high blood sugar)
- cardiovascular (heart and blood vessel) problems
- central nervous system problems
- increased risk of infection, such as chickenpox or measles
- serious asthma-related events, such as a hospital stay
- allergic reactions
- glaucoma and cataracts (types of eye problems)
Effectiveness
The only condition both Symbicort and Dulera are used to treat is asthma.
These drugs haven’t been directly compared in clinical studies, but studies have found both Symbicort and Dulera to be effective for treating asthma.
Costs
Symbicort and Dulera are both brand-name drugs. Symbicort is also available as a generic. However, Dulera only comes as a brand-name medication. Brand-name medications usually cost more than generics.
Symbicort and Dulera generally cost about the same. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.
Symbicort can interact with several other medications.
Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.
Symbicort and other medications
Below is a list of medications that can interact with Symbicort. This list doesn’t contain all drugs that may interact with Symbicort.
Before taking Symbicort, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Symbicort and strong CYP3A4 inhibitors
Drugs called CYP3A4 inhibitors slow or block the action of an enzyme called CYP3A4. (An enzyme is a protein that aids chemical changes in your body.) This effect can interfere with how your body breaks down budesonide, which is an active ingredient in Symbicort. So taking a CYP3A4 inhibitor with Symbicort may increase the level of budesonide in your body and lead to side effects. (For more about side effects, see the “Symbicort side effects” section above.)
Examples of CYP3A4 inhibitor medications include:
- ritonavir (Norvir)
- atazanavir (Reyataz)
- indinavir (Crixivan)
- nelfinavir (Viracept)
- saquinavir (Invirase)
- clarithromycin
- telithromycin
- itraconazole (Sporanox)
- ketoconazole
Before using Symbicort, tell your doctor if you’re taking any of the medications listed above. They may choose a different drug to treat your condition.
Symbicort and certain antidepressants
Using certain antidepressants within 2 weeks of taking Symbicort may increase your risk for heart-related side effects. (For more about side effects, see the “Symbicort side effects” section above.)
Examples of antidepressants include:
- nefazodone
- monoamine oxidase inhibitors (MAOIs), such as:
- selegiline (Emsam)
- phenelzine (Nardil)
- tricyclic antidepressants, such as:
- desipramine (Norpramin)
- nortriptyline (Pamelor)
If you’re taking an antidepressant, tell your doctor before you start using Symbicort. They can suggest a different antidepressant for you.
Symbicort and beta-blockers
Taking a beta-blocker with Symbicort may reduce the effectiveness of Symbicort to treat your symptoms. Using beta-blockers may also make it more likely that you’ll have bronchospasms (tightening of your airways that can make it hard for you to breathe).
Examples of beta-blockers include:
- atenolol (Tenormin)
- metoprolol (Toprol)
- bisoprolol (Zebeta)
- labetalol (Trandate)
If you need to take a beta-blocker, your doctor may recommend a drug other than Symbicort for you.
Symbicort and certain diuretics
Taking Symbicort may lower your potassium level or cause changes to your heart rhythm. And taking Symbicort with a diuretic may make these side effects more severe.
Symptoms of a low potassium level include problems with your heart rhythm, muscle cramps, dizziness, and fainting. Symptoms of heart rhythm changes can also include dizziness and fainting, but they may also involve a racing heart or palpitations (feeling of skipped or extra heartbeats).
Typically, changes in your potassium level that are caused by taking Symbicort are temporary. The level usually returns to normal without treatment. But this may not be the case if you’re taking Symbicort with a diuretic.
Examples of diuretics include:
- hydrochlorothiazide (Microzide)
- furosemide (Lasix)
- bumetanide (Bumex)
If you’re taking a diuretic, tell your doctor before you start using Symbicort. They may choose to monitor your potassium levels more often than usual. They may also suggest other diuretics or breathing medications.
Symbicort and herbs and supplements
There aren’t any herbs or supplements that have been specifically reported to interact with Symbicort. However, you should still check with your doctor or pharmacist before using any of these products while taking Symbicort.
Symbicort and foods
Eating grapefruit or drinking grapefruit juice may increase the level of Symbicort in your body, which may lead to potentially dangerous side effects. (For more about side effects, see the “Symbicort side effects” section above.)
You should take Symbicort according to your doctor’s or healthcare professional’s instructions.
Symbicort comes as a metered-dose inhaler, which dispenses the drug in a spray that you inhale. The inhaler releases the medication in premeasured puffs.
To avoid a yeast infection in your mouth called oral thrush, rinse your mouth with water and spit the water out after each dose (two puffs). Be sure to do this when you take your dose in the morning and at night.
If your child is taking Symbicort, help them with their doses to be sure they’re using the medication correctly. This should help their symptoms be better controlled.
For more information about how to use Symbicort, visit the manufacturer’s website for instructions and a video.
When to take
You’ll usually take Symbicort as two puffs twice a day, about 12 hours apart. It’s important to take your doses regularly. To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.
Here are answers to some frequently asked questions about Symbicort.
How should I quit taking Symbicort?
Talk with your doctor before changing or stopping the use of any of medications for your asthma or chronic obstructive pulmonary disorder (COPD) symptoms. If you suddenly stop taking your medication, including Symbicort, you may have trouble breathing and your condition may worsen. This can lead to complications such as being less active, having lung infections, having trouble breathing that requires care right away, or needing a hospital stay.
If you have questions about stopping the use of Symbicort, talk with your doctor.
Is Symbicort a rescue inhaler?
No, you shouldn’t use Symbicort as a rescue inhaler. The drug isn’t meant to help you with sudden breathing problems. Instead, you take Symbicort consistently to help control your symptoms. Your doctor will prescribe a different medication for you that’s considered a rescue inhaler. You’ll use it when needed for flare-ups of asthma or COPD. Don’t take extra doses of Symbicort.
Tell your doctor if you don’t feel like your asthma or COPD is well controlled. They can review your treatment plan with you.
Is Symbicort a corticosteroid?
Symbicort contains two active ingredients, budesonide and formoterol. Budesonide is an inhaled corticosteroid. This type of drug helps ease inflammation (irritation) in the airways, making it easier to breathe. Inhaling the medication allows most of it to reach your airways.
Corticosteroids can weaken your immune system’s ability to fight infection. If you’re exposed to certain infections, you may have a greater risk for those infections becoming serious. (To learn more, see the “Symbicort precautions” section below.)
Can I use Flonase and Symbicort together?
Your doctor is unlikely to prescribe both Flonase and Symbicort. This is because both Flonase and Symbicort contain a corticosteroid. And taking two corticosteroids may increase your risk for side effects. (For more about side effects, see the “Symbicort side effects” section above.)
If you have allergies along with asthma or COPD, your doctor may prescribe antihistamine allergy drugs such as fexofenadine (Allegra), cetirizine (Zyrtec), loratadine (Claritin), or allergy shots. These would be in addition to your medications for asthma or COPD.
If you’re taking Flonase for allergies, talk with your doctor about other options before using Symbicort.
Is it OK to take Symbicort with over-the-counter cold, flu, or pain medicines?
Probably, but be sure to first check with your doctor or pharmacist. There aren’t any known interactions between Symbicort and over-the-counter cold, flu, or pain medications. These include Nyquil, acetaminophen (Tylenol), ibuprofen (Motrin, Advil, others), and guaifenesin (Mucinex). It’s generally considered safe to use these medications when taking Symbicort as long as you don’t have any conditions that would cause you to have side effects from taking these medications — for example, problems with your kidneys, liver, heart, or blood pressure.
It’s best to ask your doctor prior to taking any over-the-counter medications while taking Symbicort and other medications for asthma or COPD. They can help make sure you’re taking the best treatment options for you.
Can you take Symbicort and prednisone together?
Yes. In some situations, your doctor may have you take Symbicort with an oral corticosteroid (pill or tablet form) such as prednisone. These situations include having severe symptoms of asthma or COPD, or a sudden flare-up for which you need to immediately see your doctor or visit an emergency room.
Your doctor will usually prescribe the oral corticosteroid for a shorter period of time than your maintenance (routine) medications, including Symbicort. The goal is to use the oral corticosteroid for days to weeks to get your condition under control and back on track. How long you should take it will depend on whether you’re being treated for asthma or COPD.
If you have questions about treatment with Symbicort and prednisone, talk with your doctor.
The treatment of asthma and chronic obstructive pulmonary disorder (COPD) usually requires a combination of medications to control symptoms and prevent complications or flare-ups. Medications are generally grouped into two categories: rescue medications and maintenance medications.
Maintenance medications are taken regularly to help prevent symptoms from worsening and keep them under control. (For more information about maintenance medications, see the “Alternatives to Symbicort” section above.) Rescue medications are used as needed when you have flare-ups (worsening of symptoms) or when symptoms pop up. You shouldn’t use maintenance medications as rescue medications. And you shouldn’t take extra doses of a maintenance medication for this purpose.
Examples of rescue medications include short-acting beta2-adrenergic agonists, such as albuterol (Ventolin HFA, ProAir HFA, AccuNeb).
Note: Some of the drugs listed just above are used off-label. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.
In people with asthma, the airways become inflamed and narrowed, making it hard to breathe. Their lungs and airways may also be easily irritated, leading to more trouble breathing.
Chronic obstructive pulmonary disorder (COPD) is a group of lung conditions that include chronic bronchitis and emphysema. So people with COPD may have inflammation of their airways due to bronchitis as well as damage to air sacs in their lungs because of emphysema. The irritation, inflammation, and damage to the air sacs cause the lungs to become less effective at moving air.
Both asthma and COPD are chronic (long-term) conditions affecting the airways. Symbicort works to decrease inflammation and irritation while also opening up the airways, relaxing them. This helps make breathing easier and decreases your asthma or COPD symptoms.
How long does it take to work?
You may notice that Symbicort improves your symptoms within minutes, particularly if you’re taking the drug for asthma. However, the timing varies from person to person. It generally takes at least a couple of weeks for Symbicort to reach maximum effect to control your symptoms.
But if your symptoms don’t ease within a few weeks of taking the drug, talk with your doctor. They may adjust the dose or prescribe a different medication. If you have symptoms between your twice-a-day doses of Symbicort, your doctor will likely want you to use a rescue inhaler for quick relief.
It’s unknown whether it’s safe to use Symbicort during pregnancy.
Symbicort contains two active ingredients: formoterol and budesonide. There are no human studies of formoterol in pregnancy. And studies show that when pregnant people take inhaled budesonide by itself, the drug doesn’t increase the risk of congenital anomalies (commonly known as birth defects).
If you’re currently pregnant or thinking about becoming pregnant, talk with your doctor. They can recommend the best asthma and chronic obstructive pulmonary disorder (COPD) treatment options for you.
It’s not known if Symbicort is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Symbicort.
It’s unknown whether it’s safe to use Symbicort while breastfeeding.
Symbicort contains two active ingredients: formoterol and budesonide. Budesonide passes into breast milk, but there’s no human data on whether formoterol also passes into breast milk.
If you’re breastfeeding, tell your doctor before taking Symbicort. They’ll help you decide on the best way to feed your child and what asthma and chronic obstructive pulmonary disorder (COPD) treatment options are right for you.
When you get Symbicort from the pharmacy, the pharmacist will add an expiration date to the label. This date is typically 1 year from the date they dispensed the medication.
The expiration date helps guarantee that the medication is effective during this time. The
Storage
How long a medication remains good can depend on many factors, including how and where you store the medication.
You should store Symbicort in a dry area and at room temperature (68°F to 77°F/20°C to 25°C) with the mouthpiece down. Avoid storing this medication in areas where it could be exposed to heat or open flame. Don’t expose to temperatures greater than 120°F (49°C) or the canister can burst.
Disposal
If you no longer need to take Symbicort and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.
The
Don’t puncture or incinerate (burn) your Symbicort inhaler. Contact your trash or recycling center to ask about proper disposal of your inhaler. Rules can vary from state to state.
Symbicort isn’t known to interact with alcohol. However, drinking alcohol while taking Symbicort may increase your risk for side effects, especially if you have certain conditions such as problems with your blood pressure or heart. (For more about side effects, see the “Symbicort side effects” section above.)
If you drink alcohol, talk with your doctor before taking Symbicort. Ask them how much alcohol is safe for you to drink during your treatment.
As with all medications, the cost of Symbicort can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.
Your insurance plan may require you to get prior authorization before they approve coverage for Symbicort. This means that your doctor will need to send a request to your insurance company asking them to cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Symbicort.
If you’re not sure if you’ll need to get prior authorization for Symbicort, contact your insurance plan.
Financial assistance
If you need financial support to pay for Symbicort, help is available. AstraZeneca Pharmaceuticals LP, the manufacturer of Symbicort, has a Symbicort Savings Offer and a patient assistance program called AZ&Me. For more information and to find out if you’re eligible for support, call 800-236-9933 or visit the program website.
This drug comes with several precautions. Before taking Symbicort, talk with your doctor about your health history. Symbicort may not be right for you if you have certain medical conditions or other factors affecting your health. These include:
- Allergic reaction. If you’ve had an allergic reaction to Symbicort or any of its ingredients in the past, you shouldn’t use the drug. Ask your doctor about other treatment options.
- Acute severe asthma. If you have a type of asthma called status asthmaticus (acute severe asthma), Symbicort might not be the best medication for you. Ask your doctor what other treatment options are better choices for you.
- Infections or a weakened immune system. Taking Symbicort may put you at risk for new or worsened infections. You shouldn’t use the drug if you have a fungal, bacterial, or viral infection; tuberculosis (TB); or eye herpes. Your doctor can recommend medications other than Symbicort. If you don’t have an infection and your doctor wants you to take Symbicort, make sure you’re up to date with your vaccines, including chickenpox and measles. These conditions can be very severe or lead to death in people who have a weakened immune system or are taking corticosteroids. (An active ingredient in Symbicort called budesonide is a corticosteroid.)
- Use of oral corticosteroids. If you’re taking an oral corticosteroid (pill or tablet form) before using Symbicort, you’ll need to wean off the corticosteroid slowly. Decreasing or stopping the use of an oral corticosteroid too quickly can cause side effects. These include the adrenal glands not making enough hormones, flare-ups of arthritis or eczema, and withdrawal symptoms such as joint or muscle pain and depression. Before taking Symbicort, tell your doctor if you’re taking a corticosteroid or recently stopped using one.
- Use of just a long-acting beta2-agonist. Symbicort contains two drugs: budesonide and formoterol. Budesonide is an inhaled corticosteroid (ICS), and formoterol is a long-acting beta2-agonist (LABA). Taking a LABA without an ICS may increase your risk for serious asthma-related events such as a hospital stay, intubation (tube inserted into an airway for breathing), or death. The risk isn’t increased when a LABA is taken with an ICS. Don’t take a LABA without an ICS unless your doctor tells you to.
- Heart or central nervous system conditions. If you have certain heart or central nervous system (brain and spinal cord) conditions, taking Symbicort may increase your risk for side effects. (For more about side effects, see the “Symbicort side effects” section above.) Some of these conditions include abnormal heart rhythms, high or low blood pressure, seizures, and other convulsive disorders. Talk with your doctor before taking Symbicort if you have any of these conditions. They can help choose the best treatment options for you.
- Osteoporosis. If you have a condition such as osteoporosis or osteopenia in which you have low bone density, tell your doctor before taking Symbicort. An active drug in Symbicort is called budesonide, and it’s a corticosteroid. Using corticosteroids for a long time can decrease bone density. Your doctor may monitor you more closely, especially if you have other risk factors for decreased bone density. These include having gone through menopause, being an older adult, using certain medications, or using tobacco. Your doctor may also prescribe a different medication to treat your condition.
- Glaucoma and cataracts. Eye problems such as glaucoma and cataracts have been reported in people taking inhaled corticosteroids such as budesonide. (Budesonide is an active ingredient in Symbicort.) Before taking Symbicort, it’s important to tell your doctor if you have a history of glaucoma or cataracts. They’ll likely monitor you more closely during your treatment to make sure your eye condition doesn’t worsen.
- Thyrotoxicosis. If you have thyrotoxicosis (too much thyroid hormone in your body), you may be more likely to have side effects from taking Symbicort. (For more about side effects, see the “Symbicort side effects” section above.) This is because thyrotoxicosis can cause some of the same symptoms. Talk with your doctor before taking Symbicort if you have thyroid problems. They may choose a different medication or treat your thyroid condition first.
- Ketoacidosis or diabetes. If you have ketoacidosis or diabetes, taking Symbicort may make your condition worse. Ketoacidosis is a complication of diabetes that occurs when the body breaks down fat too quickly. If you’ve had ketoacidosis in the past or currently have diabetes, talk with your doctor before taking Symbicort. The drug may increase your blood sugar, and you may need to be monitored more closely.
- Pregnancy and breastfeeding. It’s unknown whether it’s safe to take Symbicort while pregnant or breastfeeding. For more information, please see the “Symbicort and pregnancy” and “Symbicort and breastfeeding” sections above.
Note: For more information about the potential negative effects of Symbicort, see the “Symbicort side effects” section above.
Using more than the recommended dosage of Symbicort can lead to serious side effects. Symbicort contains two active ingredients: budesonide and formoterol. An overdose of budesonide isn’t as severe or life threatening as an overdose of formoterol. Taking too much budesonide for a long time can lead to overdose symptoms, but an overdose of formoterol can cause symptoms almost right away. For more information, see below.
Overdose symptoms
Symptoms of an overdose can include:
- seizures
- nausea
- chest pain
- changes in blood pressure
- racing heart
- palpitations (feeling of skipped or extra heartbeats )
- headache
- muscle cramps
- dizziness
- hyperglycemia (high blood sugar)
- hypokalemia (low level of potassium)
- shaking hands (tremor)
- anxiety (nervousness)
- trouble sleeping
What to do in case of overdose
If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.
The following information is provided for clinicians and other healthcare professionals.
Indications
The Food and Drug Administration (FDA) has approved Symbicort for:
- treatment of asthma in people ages 6 years and older
- maintenance treatment of chronic obstructive pulmonary disorder (COPD) (including chronic bronchitis and emphysema) to help reduce exacerbations
It should not be used as a rescue medication and is not indicated for the relief of acute bronchospasm. Safety and efficacy have not been validated in people younger than age 6 years.
Mechanism of action
Symbicort contains two active ingredients: budesonide and formoterol. Budesonide is an inhaled corticosteroid that works to mitigate inflammation through its strong glucocorticoid activity. It is a weak inhibitor of mineralocorticoids. Corticosteroids such as budesonide inhibit inflammatory cells like lymphocytes, neutrophils, eosinophils, mast cells, and macrophages. They also inhibit mediators of inflammatory cells, such as histamine and cytokines.
Formoterol is a long-acting selective beta2-agonist. It exhibits activity directly in the lungs to cause bronchodilation. Formoterol also increases cyclic AMP levels to relax smooth muscles in the bronchial system and inhibits the release of inflammatory mediators.
Pharmacokinetics and metabolism
The peak concentration of budesonide is typically reached at about 20 to 30 minutes after dosing. Most of the drug is absorbed systemically when taking via inhalation. Formoterol is absorbed even more quickly, reaching peak levels within about 15 minutes.
Budesonide is metabolized via the cytochrome P450 system, and CYP3A4 specifically. It is broken down into two major metabolites that have little activity compared with the parent drug. Formoterol is metabolized via glucuronidation and O-demethylation to inactive metabolites via CYP2D6 and CYP2C.
Contraindications
The use of Symbicort is contraindicated in people who have had a hypersensitivity reaction to it in the past. Symbicort is also contraindicated in the treatment of people with status asthmaticus or acute episodes of asthma or COPD requiring urgent or emergent treatment. Other treatment options are considered standard care.
Storage
Symbicort tablets should be stored at room temperature (68°F to 77°F/20°C to 25°C) with the mouthpiece down. Avoid storing this medication in areas where it could be exposed to heat or open flame. Don’t expose it to temperatures greater than 120°F (49°C) or the canister can burst.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.