What is Symbicort?
Symbicort is a prescription medication taken by people with asthma or chronic obstructive pulmonary disease (COPD) to help lessen and control their symptoms.
It’s inhaled directly into the lungs and airways using a Symbicort inhaler device called a Turbohaler. Symbicort reduces inflammation and relaxes your airways, helping you breathe more easily.
If your doctor has prescribed Symbicort to you, you may want to know more about what it is and how it works. Here we’ll explain what Symbicort is used for, how it works, its side effects, and more. We’ll also answer some of the most frequently asked questions about Symbicort.
What is Symbicort used for?
Symbicort is used to treat both asthma and chronic obstructive pulmonary disease (COPD).
It’s a medication you take every day, usually twice, 12 hours apart, over the long term to help you manage your symptoms. Symbicort contains two active ingredients, a corticosteroid, and a LABA medicine, that reduce inflammation and relax the muscles in your airways, making it easier for you to breathe.
The medication can be taken by adults and children over six years old with asthma. It’s used to control and prevent symptoms, like shortness of breath, wheezing, and coughing; and to reduce the risk of asthma attacks.
Symbicort is also taken by adults 18 years and over with COPD to lessen the symptoms of their condition and to reduce the number of flare-ups of severe symptoms, called exacerbations.
How does Symbicort work?
Symbicort contains two active ingredients, called budesonide and formoterol, that work together to help you breathe more easily and alleviate your symptoms.
Budesonide is a corticosteroid, a type of synthetic hormone that reduces inflammation. When you inhale Symbicort into your airways and lungs, budesonide enters your cells and blocks the action of substances your immune system uses to trigger inflammation. This reduces inflammation throughout your airways and lungs.
Formoterol is a type of drug called a long-acting beta-adrenoceptor agonist (LABA). When you inhale Symbicort, formoterol attaches to areas on the muscle cells in your airways called receptors. This stimulates the receptors, causing the muscle to relax, opening your airways up, and helping you breathe more easily.
Symbicort for Asthma
Asthma is a chronic (long-lasting) disease that causes inflammation in your airways and lungs. This inflammation restricts how much air you can get into your lungs which can make you feel short of breath, make your chest feel tight, make you wheeze and cough, and can lead to potentially dangerous asthma attacks where your asthma suddenly worsens.
Symbicort can be used by adults and children over six with asthma. You take Symbicort every day to reduce inflammation and relax the muscles in your airways and lungs, improving the flow of air in and out of your body. This can lessen and provide relief from your asthma symptoms on a daily basis (called maintenance therapy) and can reduce the risk of asthma attacks.
Symbicort is not for use to treat sudden onsets of severe symptoms, like asthma attacks. You should use your relief inhaler, or whatever medication you’ve been given for sudden and severe symptoms.
How effective is Symbicort in treating asthma?
In two studies of adults and children aged 12 years and over with asthma, the subjects who took Symbicort had a better improvement in the volume of air they could get in and out of their lungs than the subjects who didn’t take Symbicort. The improvement in air volume was over 9% in one study.
Subjects in both studies also reported a significant reduction in their symptoms and an improvement in their asthma-specific quality of life.
Symbicort for COPD
Chronic obstructive pulmonary disease (COPD) is a group of lung diseases, including emphysema and chronic bronchitis. COPD is caused by damage to your airways and lungs that makes it harder for you to breathe. This can make you cough and wheeze, feel short of breath, make your chest feel tight, and make you feel tired. As COPD progresses, breathing can become difficult when performing simple tasks or even when sitting still.
COPD can’t be cured, and it usually worsens over time, but you can use Symbicort to reduce the severity of your symptoms and slow the progression of the disease. You take Symbicort daily (usually twice a day) to relax your airways and lungs and reduce inflammation. This allows you to get more oxygen into your lungs, easing your symptoms and making exacerbations less likely. This can make it easier for you to live with your COPD.
How effective is Symbicort in treating COPD?
Two studies on the effects of Symbicort on lung function with people with COPD, found that the medication increased the volume of air that subjects could get in and out of their lungs more than those who took budesonide and formoterol on their own or who took nothing.
Two separate studies found that for people with COPD, taking Symbicort reduced the number of exacerbations more effectively than subjects who took budesonide and formoterol separately or who took nothing. Annual exacerbations were reduced by 26% in one study and 35% in the other.
How long does it take Symbicort to work?
Research has shown that Symbicort can begin to open up your airways and reduce your symptoms in as little as five to 15 minutes. The maximum increase in airflow is felt, on average, after two to three hours, and symptoms are significantly reduced over 12 hours (you typically take Symbicort every 12 hours).
Symbicort and other drugs
Asthma and COPD often require a range of medications to help keep your symptoms at bay and reduce the risk of asthma attacks or exacerbations. Often this means at least one medication to manage your daily symptoms, called a maintenance medication, and at least one medication to help with asthma attacks and exacerbations called a rescue medication.
Symbicort is a maintenance medication, as you take it twice daily to help keep your symptoms at bay and to reduce your chances of having an asthma attack or an exacerbation.
Symbicort can’t be used as a rescue medication. If you have a sudden onset of severe symptoms, like an asthma attack. You need a short-acting medication that can give you dramatic relief from symptoms in a short period of time. Examples of inhaled rescue medications include Ventolin HFA, Proventil HFA, or ProAir HFA.
Alternative medications for asthma
Symbicort isn’t the only maintenance medication available for asthma. Alternatives include:
Other combined inhaled corticosteroids and LABAs such as:
Long-acting beta-adrenoceptor agonists (LABAs) used on their own, like:
- Salmeterol (Serevent)
- Formoterol (Perforomist)
Inhaled corticosteroids used on their own, like:
Oral corticosteroids, like:
- Methylprednisolone (Medrol)
- Prednisolone (Orapred)
- Prednisone (Deltasone)
Leukotriene receptor antagonists (a type of medication that reduces inflammation) like:
Alternative medications for COPD
Other maintenance medications available for COPD include:
Other combined inhaled corticosteroids and LABAs, such as:
- Vilanterol and fluticasone (Breo Ellipta)
- Fluticasone and salmeterol (Advair)
- Mometasone and formoterol (Dulera)
Long-acting beta-adrenoceptor agonists (LABAs) used on their own, like:
- Salmeterol (Serevent)
- Formoterol (Perforomist)
- Indacaterol (Arcapta Neohaler)
- Olodaterol (Striverdi Respimat)
Anticholinergic medications, such as:
Combined LABA and anticholinergic medications, such as:
A combined LABA, anticholinergic, and inhaled corticosteroid medication, like:
How much does Symbicort cost?
Without insurance, prices for Symbicort will depend on the dose you buy (80 mcg/4.5 mcg or 160 mcg/4.5 mcg) and the size of the Turbohaler inhaler you buy (6.9 gm or 10.2 gm). Prices can also vary by retailer. As a guide, one 10.2gm, 160 mcg/4.5 mcg strength Turbohaler will cost around $500.
How to use Symbicort?
You should always use your Symbicort exactly as described by the doctor who prescribed it to you. Follow the directions in the packaging that comes with your Symbicort for the exact details of how to take it.
You take Symbicort by inhaling it into your airways and lungs through your mouth. The medicine comes in an inhaler device, called a Symbicort Turbohaler.
To use a Symbicort Turbohaler, you shake it well for five seconds then take off the mouthpiece cover. You breathe out, put the Turbohaler to your mouth, then breathe in as you press down on the top of the Turbohaler to release the Symbicort. You hold your breath, then you release the Turbohaler and breathe out.
You typically do this twice each time you use Symbicort to give yourself two puffs of the medicine. This is usually done twice a day, with two puffs in the morning and two puffs in the evening.
Symbicort is available in two strengths, 80 mcg/4.5 mcg or 160 mcg/4.5 mcg. There are two numbers for each strength, as Symbicort contains two active ingredients – the first number is the amount of budesonide, the second the amount of formoterol.
You usually take two puffs of Symbicort twice a day, 12 hours apart (in the morning and evening).
Symbicort dosage for asthma
For adults with asthma, the typical Symbicort dose is two puffs, twice a day of either 80 mcg/4.5 mcg or 160 mcg/4.5 mcg.
For children 13 to 18 years old with asthma, the typical Symbicort dose is two puffs, twice a day of either 80 mcg/4.5 mcg or 160 mcg/4.5 mcg.
For children between six and 12 years old with asthma, the typical Symbicort dose is two puffs, twice a day of 80 mcg/4.5 mcg.
Symbicort dosage for COPD
For adults with COPD, the typical Symbicort dose is two puffs, twice a day of 160 mcg/4.5 mcg.
The above doses are typical recommended doses, but your doctor may prescribe a different dose for you, based on your individual situation. Always take your Symbicort as directed by your doctor.
What if I miss a Symbicort dose?
If you miss a Symbicort dose, wait until your next dose before taking any more. For instance, if you miss your morning dose, don’t take any Symbicort until the time of your usual evening dose.
Don’t take a double dose of Symbicort, and don’t take a dose when you realize you’ve missed your dose, as you may take it too close to your next dose and risk taking too much Symbicort (a Symbicort overdose).
If you take too much Symbicort (a Symbicort overdose), you increase your risk of side effects, including serious side effects (see Symbicort side effects below).
Common symptoms of a Symbicort overdose include chest pain, a rapid heartbeat, feeling shaky, and nervousness.
If you’ve taken too much Symbicort, you should seek emergency medical attention.
What should I avoid while using Symbicort?
You should avoid grapefruit and grapefruit juice when taking Symbicort. An ingredient in grapefruit juice can increase the rate at which your body absorbs the active ingredient budesonide, increasing your risk of side effects.
There are also certain medications you should avoid when taking Symbicort, as they can interact with Symbicort. See Symbicort interactions below for more information.
Symbicort side effects
The most common side effects of Symbicort include:
- A sore throat
- A hoarse voice
- Back pain
- A fast heartbeat
- Trembling or shaking
- Stomach problems
- Fungal infections (thrush) in your mouth and throat (this is less likely if you rinse your mouth out with water after taking your Symbicort)
- An increased risk of respiratory infections, like colds and the flu
- An increased risk of infection and inflammation of the mucous membranes in your airways (bronchitis)
- Inflammation of the mucous membranes in your sinuses (sinusitis)
In rare instances, Symbicort can cause more serious side effects, including:
- Reduced immune system function, making you more vulnerable to infections, including serious infections like pneumonia and tuberculosis
- Severe allergic reactions to the medication that can cause anaphylaxis – a potentially life-threatening condition where your immune system overreacts, causing swelling in your face, mouth, and throat that can make it hard to breathe
- Increases in blood pressure
- Swelling of your blood vessels
- Increases in blood sugar levels (diabetes)
- Decreases in the amount of potassium in your blood (hypokalemia)
- Reduced adrenal gland function (adrenal insufficiency) that can be fatal in serious cases
- Falls in bone density (osteoporosis), particularly in people who are at a greater risk of developing osteoporosis
- An increased risk of eye problems, including glaucoma, cataracts, and blurred vision
- Slowed rates of growth in children
Your doctor will assess your risk of side effects versus the benefits of taking Symbicort.
Symbicort can interact with other medications including:
- Any other medications taken to treat asthma or other breathing problems
- Any medications taken to treat bacterial, viral, or fungal infections
- Beta-blocker medications, usually taken to treat high blood pressure
- Any diuretics (water pills), taken to treat high blood pressure
- Any medications taken for a fast or uneven heartbeat, like quinidine
- Any medications to treat heart failure, like digoxin
- Any steroid medications taken orally
- Tricyclic antidepressants, like amitriptyline
- HIV-protease inhibitor medications, like ritonavir
- Any medications for thyroid problems, such as levo-thyroxine
- Any medications to treat Parkinson’s disease, like leva-dopa
If you’re unsure if you’re taking any of these, take the packaging of all your medications and supplements to your doctor or pharmacist.
Symbicort is for everyday use to manage your asthma and COPD symptoms. It shouldn’t be used to relieve attacks of sudden and severe symptoms, like a bronchospasm or asthma attack. You should use a rescue inhaler in this situation, or whatever medication your doctor has prescribed for sudden and severe breathing problems.
The medication should not be taken by anyone under the age of six for treating asthma or anyone under 18 for treating chronic obstructive pulmonary disease.
Talk to your physician before taking Symbicort if you:
- Have or have had any heart problems, like narrowing of the arteries, an uneven heartbeat, or heart failure
- Have any problems with your immune system
- Have a current lung infection
- Currently have any other form of infection
- Have recently been around someone who had measles or chickenpox
- Have diabetes
- Have severe liver problems
- Have high blood pressure (hypertension)
- Have ever had a seizure
- Have problems with your adrenal glands or thyroid gland
- Have osteoporosis
- Have low levels of potassium in your blood
- Have any eye problems, like glaucoma or cataracts
- Have an intolerance to any sugars (Symbicort contains lactose)
- Are pregnant or are planning to become pregnant
- Are breastfeeding or are planning to breastfeed
Can Symbicort affect pregnancy?
It’s not known if Symbicort can harm your unborn baby. Talk to your doctor about taking Symbicort if you are pregnant or are planning to become pregnant.
One of the active ingredients of Symbicort, budesonide, can pass into breast milk. Talk to your doctor about taking Symbicort if you are breastfeeding or plan to breastfeed. Or if you plan to express milk in another way, such as with a breast pump.
Symbicort expiration and storage
Store your Symbicort with the mouthpiece down, at room temperature – between 68°F to 77°F (20°C to 25°C). Don’t expose your Symbicort inhaler or canisters to high temperatures, naked flames, or high pressures. Keep your Symbicort out of the sight and reach of children.
Dispose of your Symbicort canisters either when the counter reaches zero or three months after you’ve taken them out of their foil pouch, whichever comes first.
Don’t use your Symbicort after the expiry date on the carton or on the label of your inhaler. The expiry date refers to the last day of that month.
Is Symbicort a steroid?
Symbicort contains two active ingredients called budesonide and formoterol. Formoterol is a long-acting beta antagonist (LABA), whilst budesonide is a steroid medication (it’s an inhaled corticosteroid). So yes, Symbicort does contain a steroid.
What does Symbicort do to lungs?
Symbicort combines two medications that have complementary effects on your airways and lungs. Budesonide reduces inflammation in your lungs and airways, whilst formoterol relaxes muscle tissue in your airways. This opens up your airways and lungs, helping you breathe more easily, reducing your asthma and COPD symptoms and making sudden attacks of severe symptoms less likely.
What inhaler is an equivalent to Symbicort?
Symbicort is an inhaled maintenance medication taken to help manage the symptoms of asthma and COPD. Other inhaled maintenance medications that are alternatives to Symbicort include Advair (contains fluticasone and salmeterol), Dulera (contains mometasone and formoterol), and Breo Ellipta (contains vilanterol and fluticasone).
How often can you take Symbicort?
You should take your Symbicort exactly as directed by the doctor who prescribed it to you. Typically, you take it twice a day, 12 hours apart, usually two puffs in the morning and two puffs in the evening.
How long can you be on Symbicort?
There are no specific reported risks of long-term Symbicort use. However, research has shown that long-term use of inhaled corticosteroids (Symbicort contains an inhaled corticosteroid) can increase the risk of lung disease and eye problems, like cataracts and glaucoma, in some people. Your doctor should periodically monitor you for side effects as you take your Symbicort.
What are the dangers of Symbicort?
Like all medications, Symbicort can cause side effects in some people. Serious side effects are rare but can include severe allergic reactions, a risk of serious infections, high blood pressure, and high blood sugar. Your doctor will assess your risk of side effects versus the benefits of taking Symbicort.
Does Symbicort weaken the immune system?
One of the active ingredients in Symbicort, called budesonide, is a steroid. Steroids can weaken your immune system and increase your chances of contracting infections, including serious infections.
Can you stop Symbicort suddenly/how to quit Symbicort?
Some medications can cause withdrawal symptoms if you stop taking them suddenly. Symbicort isn’t thought to do this, although some people can have withdrawal symptoms if they stop taking some steroid medications (Symbicort contains a steroid). Talk to your doctor if you want to stop taking Symbicort, just to be sure.