Symbicort

Symbicort Inhaler is an FDA-approved medication for asthma and COPD, combining Budesonide and Formoterol. The combination eases breathing by reducing airway inflammation and relaxing muscles. It is available in two strengths: 80 mcg/4.5 mcg and 160 mcg/4.5 mcg. The typically recommended dose is two puffs twice daily or as guided by a healthcare provider. It is suitable for adults and adolescents (6 years and older). Those with heart, blood pressure, liver, or kidney issues need caution while using it. Its common side effects include throat irritation, headache, and mouth fungal infections. You should rinse your mouth with water after each inhalation to prevent these infections. Missed doses should be taken promptly, but overdoses need medical attention. Store it at room temperature, avoiding moisture and heat. Lastly, when considering treatment options, discuss the Symbicort inhaler price with your healthcare provider or pharmacist to ensure it fits within your budget. 

Symbicort Inhaler is an FDA-approved medication used for the treatment of asthma and chronic obstructive pulmonary disease (COPD). Its active ingredients include Budesonide, an inhaled corticosteroid, and Formoterol, a long-acting beta-agonist bronchodilator. This combination works by reducing inflammation in the airways and relaxing the muscles around the airways, making it easier to breathe.

Symbicort Inhaler (budesonide formoterol fumarate) has two strengths: 80 mcg Budesonide/4.5 mcg Formoterol and 160 mcg Budesonide/4.5 mcg Formoterol per inhalation. It is typically administered as two puffs twice daily, although a healthcare professional should determine the dosage. While the medication can be used in adults and adolescents aged 6 years and above with asthma or COPD, it may not be suitable for everyone, particularly those with certain medical conditions like heart disease, high blood pressure, liver disease, or kidney impairment. Like all medications, Symbicort also has certain side effects, which may include throat irritation, coughing, headache, and fungal infections in the mouth. To minimize these risks, patients are advised to rinse their mouths with water after every use. If a dose of Symbicort is missed, it should be taken immediately unless it’s almost time for the next dose. Doubling up on doses should be avoided. In the case of an overdose, seek medical help. It should be stored at room temperature, away from moisture and heat. You should follow your healthcare provider’s advice regarding the proper use of Symbicort Inhaler and the potential risks associated with it.

It is used for the treatment of:

• Asthma symptoms in adults and children aged 6 years and older.
• Symptoms of chronic obstructive pulmonary disease (COPD), such as emphysema and chronic bronchitis.

[Important Warning: Symbicort Inhaler is not appropriate for treating sudden asthma attacks or bronchospasms. You should consult your doctor for personalized advice and proper usage.]

Symbicort is available as a metered-dose inhaler in two strengths:

• Symbicort Inhaler 80 /4.5 mcg (80 mcg of Budesonide and 4.5 mcg of Formoterol)
• Symbicort Inhaler 160 /4.5 mcg (160 mcg of Budesonide and 4.5 mcg of Formoterol)

What Is the Recommended Dosage for Symbicort Inhaler?

Symbicort inhaler is a combination of budesonide and formoterol drugs. So, patients need to be very of their doses to avoid any potential risks. Doctors usually prescribe a loading dose to their patients and gradually adjust them for the best results. However, not every patient has the same dosage recommendations. If you have been prescribed a different dose, do not make changes to it without consulting your medical practitioner. Here are some general recommendations for different patients:

For Adults and Adolescents (12 Years and Older) with Asthma:

• The initial Symbicort dosing is 2 inhalations 80/4.5 or 160/4.5 twice daily.
• The maximum recommended dosage is 2 inhalations of Symbicort 160/4.5 twice daily.
• Adjustments may be needed based on individual responses.

For Pediatric Patients (6 to Less Than 12 Years) with Asthma:

• The typically recommended Symbicort dosing is 2 inhalations of 80/4.5 twice daily.

For Chronic Obstructive Pulmonary Disease (COPD):

• The typically recommended dosage is 2 inhalations of Symbicort 160/4.5 twice daily.

[Note: Remember these recommendations for Symbicort dosing may vary from person to person. Discuss it with your healthcare professional, and they’ll decide your dosage accordingly.]

To properly use your inhaler, read the medication guide for detailed administration and follow the below-mentioned step-by-step guide:

• Prepare the inhaler by removing the cap from the mouthpiece and shaking it well for 5 seconds.
• Breathe out gently to empty your lungs before using the inhaler.
• Hold the inhaler upright with the mouthpiece facing you, ensuring your thumb is at the base, and your index and middle fingers are on top of the canister.
• Seal your lips tightly around the mouthpiece to prevent air leaks.
• Press down firmly on the canister while breathing in deeply and slowly through your mouth.
• After inhaling, remove the inhaler from your mouth and hold your breath for about 10 seconds.
• Exhale slowly and gently away from the inhaler.
• Rinse your mouth with water to prevent mouth irritation or thrush.
• Replace the cap on the mouthpiece to keep it clean until your next dose.
• After each use, wipe the mouthpiece with a dry tissue or cloth to maintain cleanliness.

[Note: Your healthcare professional will determine the correct Symbicort dosing for you based on your condition, following guidelines and studies on the drug. Your doctor may adjust it as needed over time.]

The Symbicort Inhaler operates through the collaboration of its two key components. Budesonide, a corticosteroid, alleviates airway inflammation, thwarting swelling and constriction to manage and prevent symptoms of asthma and COPD. Simultaneously, Formoterol, a long-acting bronchodilator, relaxes airway muscles, promoting dilation and enhancing airflow. This dual action helps individuals breathe more easily, offering comprehensive relief from respiratory conditions by addressing inflammation and facilitating improved lung function.

Common Side Effects of Symbicort Inhaler: While well-tolerated, Symbicort inhaler (budesonide formoterol fumarate) can cause several side effects. These reactions are usually temporary, lasting from a few days to weeks. However, if these effects stay more than the mentioned period or get intense over time, reach out to a medical expert. Common side effects of Symbicort inhaler may include:

• Headache: Higher doses of Symbicort may cause headaches. While it is temporary and often disappears with time, if you experience bothersome headaches that do not go away, seek medical assistance.
• Throat Irritation: Symbicort’s drugs often irritate the throat, leading to laryngitis or inflammation of the voice box. You may also experience cough or voice changes.
• Thrush (Oral Yeast Infection): Inhaled corticosteroids can raise the risk of developing oral thrush. In such a situation, you will notice white patches and redness in the mouth, causing pain and loss of taste.
• Nausea: It is a feeling of stomach discomfort, making you feel like vomit. 
• Upset Stomach: Budesonide may cause stomach discomfort, especially when taken in higher doses. To avoid this side effect, talk to your doctor. They may suggest an alternative or adjust the dosage accordingly.
• Diarrhea: It is a common side effect that happens when you have loose bowel movements more than usual. If the condition becomes worse, consult your doctor.
• Tremor: It is a neurological condition in which you feel shakiness or trembling movements in many parts of the body. 
• Nervousness or agitation, commonly affecting hands.
• Dry Mouth: The inhaled drugs of Symbicort may result in dry mouth or xerostomia, making it difficult to speak or swallow anything. Its symptoms may include bad taste, foul breath, mouth ulcers, and oral fissures. 
• Dizziness: Formoterol, one of the drugs in the Symbicort inhaler, can affect the cardiovascular system, which can fluctuate your blood pressure. As a result, you may feel dizzy or lightheaded, especially when standing up.
• Nasal Congestion: Budesonide and Formoterol can cause inflammation in the nasal passages, causing nasal congestion.
• Muscle Cramps: Symbicort can affect the muscles’ ability to contract or relax as they should, resulting in muscle cramps. If these spasms become uncontrollable, see a doctor.
• Sleep Disturbances: You may have difficulty falling or staying asleep during your treatment with the Symbicort inhaler. However, this side effect usually happens at the initial stage and gets back to normal within a few weeks.
• Increased Heart Rate: Formoterol helps relax the muscles around the airways but may sometimes cause a faster heart rate or tachycardia. This side effect likely happens when you take higher doses. 
• Muscle Weakness: Symbicort may disturb the functioning of your muscles, leading to muscle weakness. The risk of this side effect increases with prolonged use of the inhaler.
• Increased Sweating: It is an indication that your body’s system is reacting to the medicine, thus resulting in excessive sweating. If the condition does not improve, talk to a medical practitioner.

Serious Side Effects of Symbicort Inhaler: Budesonide and Formoterol can lead to several adverse reactions, which can cause life-threatening situations if left untreated. If you suspect any unusual signs that seem serious to you, seek immediate medical attention. Serious side effects of Symbicort inhaler may include:

• Allergic Reactions: Many active and inactive components in the Symbicort inhaler can cause severe hypersensitivity. These reactions are rash, itching, swelling of the face, tongue, or throat, severe dizziness, or trouble breathing.
• Worsening Breathing Problems: Certain patients have reported paradoxical bronchospasm due to Symbicort. In this situation, the airways suddenly contract after use, thus making it difficult to breathe.
• Cardiovascular Effects: Formoterol, one of the active ingredients in Symbicort, often stimulates beta-adrenergic receptors present in the heart, resulting in various problems like increased blood pressure, chest pain, or irregular heartbeat.
• Osteoporosis: Prolonged use of this inhaler can weaken the bones, leading to fractures due to low bone density.
• Glaucoma or Cataracts: Budesonide can increase the risk of eye pressure and result in glaucoma or cataracts. If you have this condition, use this medication cautiously, as it can worsen glaucoma symptoms, including severe eye pain, nausea, or vomiting.
• Adrenal Insufficiency: This condition occurs when your adrenal glands cannot produce enough cortisol (the body’s stress hormone). Some of its symptoms may include abdominal pain, weight loss, fatigue, headache, and craving for salty foods.
• Hypokalemia: Symbicort may reduce potassium levels in your blood. While it is a rare side effect, it can cause serious complications. If you experience signs like muscle spasms, rapid heart rate, constipation, dizziness, and muscle weakness, visit your doctor. 
• Immune System Suppression: While Symbicort helps reduce airway inflammation, it can suppress the immune system. This happens as a small amount of the Symbicort drug (Budesonide) gets absorbed into the bloodstream, increasing infection risk.

[Note: Remember, this list may not cover all possible side effects of Symbicort Inhaler. Always consult with your healthcare giver for medical advice about Symbicort side effects.]

Are There Any Warnings for Symbicort Inhaler?

Yes, there are several warnings for Symbicort inhalers as they contain a combination of Budesonide and Formoterol that can affect certain medical conditions in patients. If you have any medical history or active problems, talk to a medical professional, and they will determine the best option for you. However, the following are some warnings that you must know before using this inhaler:

• Excessive Use and Concurrent LABAs: Overuse of Symbicort Inhaler or combining it with other LABAs can lead to adverse effects, including cardiovascular events and fatalities. Avoid using Symbicort Inhaler more frequently or at higher doses than recommended.
• Deterioration and Acute Episodes: Symbicort inhalers should not be initiated during rapidly deteriorating asthma episodes. Increasing use of short-acting beta2-agonists may indicate worsening asthma and requires reevaluation. Symbicort inhalers are not for acute symptom relief; short-acting bronchodilators are used for acute symptoms.
• Local Effects: Symbicort inhalers may cause localized infections in the mouth and pharynx. You should rinse your mouth after inhalation to minimize this risk.
• Lower Respiratory Tract Infections: Your healthcare professional should monitor you for pneumonia and other lower respiratory tract infections, especially in the case of COPD. Although lung infections occurred more frequently with Symbicort Inhaler in clinical studies, pneumonia incidence did not significantly increase.
• Immunosuppression: If you are on immunosuppressive drugs, you are more susceptible to infections. Caution should be exercised to avoid exposure to chickenpox and measles. Consider prophylactic measures if exposed.
• Transferring from Systemic Corticosteroids: Carefully transition patients from systemic corticosteroids to Symbicort Inhaler to avoid adrenal insufficiency. Patients requiring systemic corticosteroids during stress or severe asthma attacks should resume oral corticosteroids immediately.
• Hypercorticism and Adrenal Suppression: Prolonged use of Symbicort Inhaler at higher than recommended doses may lead to systemic corticosteroid effects, including hypercorticism and adrenal suppression. Monitor patients for signs and symptoms of adrenal insufficiency.
• Drug Interactions: Caution is advised when using Symbicort Inhaler with potent CYP3A4 inhibitors, as it may increase systemic exposure to Budesonide.
• Paradoxical Bronchospasm and Hypersensitivity Reactions: Symbicort inhalers may cause paradoxical bronchospasm and immediate hypersensitivity reactions. Discontinue use if these occur and initiate alternative therapy.
• Cardiovascular and Central Nervous System (CNS) Effects: Beta-adrenergic stimulation may lead to cardiovascular and CNS effects. Use Symbicort Inhaler cautiously in patients with cardiovascular disorders.
• Reduction in Bone Mineral Density: Long-term use of Symbicort Inhaler may decrease bone mineral density. Consider monitoring BMD in patients with risk factors for reduced bone mass.
• Effect on Growth of Children: Pediatric patients may experience reduced growth velocity with long-term Symbicort Inhaler use. Monitor growth regularly and titrate to the lowest effective dose.
• Glaucoma and Cataracts: Long-term use of inhaled corticosteroids like Budesonide may increase the risk of glaucoma and cataracts. Monitor patients with a history of increased intraocular pressure or glaucoma.
• Eosinophilic Conditions and Churg-Strauss Syndrome: Rare cases of systemic eosinophilic conditions, including Churg-Strauss syndrome, have been reported with inhaled corticosteroids. Monitor patients for signs of vasculitis.
• Hypokalemia and Hyperglycemia: Symbicort inhalers may cause hyperglycemia or hypokalemia in some patients. Monitor blood glucose and serum potassium levels periodically.

What Are the FDA Boxed Warning for Symbicort Inhalers?

FDA-boxed warnings, also known as black box warnings, are among the stringent FDA guidelines. The authority issues these guidelines to alert doctors and patients about the adverse effects of a particular drug. Symbicort also has a boxed warning, which is mentioned below:

• Asthma-Related Death Risk: Long-acting beta2-adrenergic agonists (LABAs) like Formoterol in Symbicort Inhaler increase the risk of asthma-related death. Concurrent use with inhaled corticosteroids may not fully mitigate this risk. Symbicort inhalers should only be used when other asthma control medications are inadequate or if disease severity warrants both an inhaled corticosteroid and LABA.

Symbicort inhaler is not an ideal option for every asthma and COPD patient. Therefore, when considering treatment with this inhaler, you must know the following precautions to avoid potential risks:

• Do not use a Symbicort inhaler if you are allergic to formoterol budesonide, arformoterol, or any of the medication’s ingredients. The product may contain some inactive components that cause serious complications.
• Inform your doctor about any medical conditions you have before using Symbicort Inhaler. These conditions are:
  • Heart disease
  • Overactive thyroid
  • Eye problems
  • Tuberculosis or herpes
  • High blood pressure
  • Aneurysm
  • Diabetes
  • Liver issues
  • Adrenal gland tumor
• Use Symbicort inhalers regularly as prescribed by your doctor, even if you have no symptoms.
• Do not use Symbicort inhalers to treat sudden asthma attacks. Use a rescue inhaler for immediate relief.
• Avoid getting the inhaler medication in your eyes. Rinse thoroughly with water if it happens.
• Do not exceed the prescribed dosage of Symbicort inhaler.
• Consult your doctor before using the inhaler if you are pregnant or breastfeeding.
• If you have surgery or undergoing any medical procedure, including dental visits, inform the practitioner or surgeon about the products you use. This includes all prescription drugs, over-the-counter drugs, and herbal products.
• Keep Symbicort inhalers away from extreme heat or cold and out of reach of children.
• If you experience worsening asthma symptoms or difficulty breathing after using Symbicort Inhaler, seek medical help immediately.
• Formoterol, one of the active drugs in the Symbicort inhaler, may lead to QT prolongation in certain patients. This condition affects heart rhythm and causes concerning complications like irregular heartbeat, dizziness, and fainting. Such patients should consult a medical expert for treatment.
• If you use any water pills or diuretics while using Symbicort, you may experience low potassium and magnesium levels in the blood, increasing the risk of QT prolongation. If you notice symptoms like excessive sweating, vomiting, or diarrhea, talk to your doctor right away.
• You may not notice infection signs while using this medication, increasing the chances of developing infections or worsening current ones. So, avoid contact with infected people like chickenpox, measles, flu, or COVID-19.
• If you have switched from an oral corticosteroid to a Symbicort inhaler in the past 12 months or are using higher doses than usual, your body may become sensitive to physical stress. So, if you get sick or injured, tell your doctor immediately.
• Symbicort may affect your child’s growth if used for a prolonged period of time. Therefore, visit your doctor frequently to check your child’s height.

While Symbicort inhaler is not a high-risk medication, it is not recommended for use in patients with the following conditions:

• Hypersensitivity to any of the ingredients in Symbicort inhaler.
• Primary treatment of status asthmaticus or acute episodes of asthma or COPD requiring intensive measures.

Generally, patients are advised not to miss any doses of their medication, and when it comes to lung diseases, taking your doses timely becomes more important than ever. However, if you forget to take a dose of Symbicort Inhaler, simply skip the missed dose and continue with your usual Symbicort dosing schedule. Make sure you are not taking double doses to make up for the missed one. It’s essential to stay within four inhalations per day. To avoid skipping any doses in the future, you can use medication apps or set reminders on your phone. If you are still unsure, consult a medical practitioner; they will suggest alternate options. 

[Note: If you have missed a dose of Symbicort inhaler and are still determining when to take the next one, immediately consult your doctor or pharmacist.]

Inhaled drugs, including Symbicort, should not be used more often or at higher doses. Doing so may cause an overdose, affecting the cardiovascular system. Some of the Symbicort’s overdose symptoms may include:

• Headache
• Heart palpitations (irregular heartbeat)
• Chest pain
• Excessively high or low blood pressure
• Seizures
• Nausea
• Lightheadedness
• Muscle cramps
• Nervousness
• Insomnia (trouble sleeping)

[Note: If you consumed more than the recommended Symbicort dosing, get medical help right away or call the Poison Help line at 1-800-222-1222.]

• Keep your Symbicort Inhaler at room temperature away from moisture, heat, and direct sunlight.
• Store it in a dry place and avoid exposing it to extreme temperatures.
• Keep the inhaler tightly closed when not in use.
• Keep your Symbicort Inhaler out of the reach of children and pets.
• Check the expiration date on the inhaler and discard it if it has expired.
• Do not use a medication if its expiration date has passed. The expiration date is the last day of the month mentioned on the back of the prescription label or carton.
• You should dispose of the medications in such a way that children and animals cannot consume them. Doing so may cause accidental overdose and death if someone else consumes them.
• The best way to eliminate unwanted medications is to give them in the medicine take-back program.

[Note: Discuss with your healthcare professional about the proper disposal of any unused Symbicort Inhaler and any questions you may have regarding its storage.]

What Medications Interact with Symbicort?

Co-administration of two or more drugs together at the same time can result in drug interactions. When this happens, it may increase the risk of developing side effects or change how a medication functions. Either way, it results in adverse reactions. Therefore, when considering treatment with budesonide formoterol fumarate (drugs used in Symbicort inhaler), be cautious of the following interactions:

• Corticosteroids: This group of drugs is used to treat conditions like breathing problems, inflammation, and many allergic reactions. Co-administration of Symbicort and corticosteroids may raise the chances of developing side effects from both drugs. Some of the drugs are beclomethasone, prednisone, and fluticasone.
• Beta-Blockers: They are used to treat angina and hypertension. Simultaneously, using Symbicort with a beta-blocker will prevent the formoterol from working effectively. It may include metoprolol, nebivolol, and atenolol.
• Antifungal Drugs: These medications help treat yeast infections, but when you take such drugs while using your inhaler, they block the CYP3A4 from working, which is responsible for breaking down budesonide. As a result, the drug buildup in your body will rise, leading to severe side effects. Some of its examples are ketoconazole, ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, and telithromycin.

What Are the Other Symbicort Interactions?

Other than the above drugs, the medications present in your inhaler may have several more interactions, which are:

• Supplements: Many herbs, supplements, and vitamins may interact with Symbicort and cause serious complications. So, when considering using this inhaler, share every information with your doctor to prevent any possible interactions. 
• Food: Symbicort contains Budesonide and Formoterol, which can interact with foods like grapefruit, echinacea tea, grapefruit juice, and coffee. Co-administration of caffeine and Symbicort can raise the heart rate, leading to many heart-related side effects. 
• Cannabis: Marijuana and cannabis products have shown interactions when taken during treatment with Symbicort. Cannabis may lower or raise the budesonide levels in the body, resulting in serious complications.

[Note: This isn’t a complete list, and there could be other drugs that interact with Symbicort Inhaler. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Every patient’s response to treatment is different. What’s best for one person may not be suitable for another due to their varying medical conditions. Therefore, it is important for patients to consult a medical practitioner before using any medication. They will decide which medication is best suited for you and suggest alternatives accordingly. Here are some of the substitutes that can be taken in place of the Symbicort inhaler:

• Advair Diskus (fluticasone/salmeterol)
• Breo Ellipta (fluticasone/vilanterol)
• Dulera (mometasone/formoterol)
• Breztri (fluticasone/umeclidinium/vilanterol)
• Trelegy (fluticasone/umeclidinium/vilanterol)

[Note: Your doctor will choose the best alternative of Symbicort Inhaler for you. Only use these alternative medications after consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

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