Description
How it works
Symbicort contains two medicines in one inhaler:
- Budesonide – an inhaled corticosteroid (ICS)
- Reduces swelling and inflammation in the airways
- Lowers mucus production
- Makes the lungs less sensitive to triggers (pollen, cold air, exercise, infections)
- Formoterol – a long-acting beta₂ agonist (LABA)
- Relaxes the muscles around the airways
- Opens the breathing tubes for around 12 hours
- Helps you breathe more easily and reduces wheeze and chest tightness
Together, they:
- Provide daily control of asthma symptoms
- Reduce flare-ups / attacks
- Improve lung function and quality of life
Symbicort is used regularly every day as a preventer. In some patients it can also be used as a reliever inhaler (maintenance and reliever therapy), if this has been specifically recommended in the asthma plan.
Who it may be suitable for
Symbicort Turbohaler 100/6 is licensed for adults, adolescents and children aged 6 years and over for the regular treatment of asthma when a combination inhaler is appropriate, for example:
- People whose asthma is not well controlled on an inhaled steroid plus a separate short-acting reliever inhaler
- People who are already controlled on an inhaled steroid and a separate long-acting bronchodilator and want to simplify to one combination inhaler
It can be used as:
- Maintenance therapy – regular daily doses, with a separate reliever inhaler
- Maintenance and reliever therapy (MART) – Symbicort is used every day and as-needed for symptoms
Who should not use Symbicort
Do not use Symbicort if:
-
You are allergic to budesonide, formoterol or lactose / milk proteins (the inhaler contains lactose with small amounts of milk protein).
Speak to a doctor before use if you have:
- Heart problems (angina, previous heart attack, heart failure, abnormal heart rhythm, high blood pressure)
- Overactive thyroid (hyperthyroidism)
- Diabetes
- Serious liver disease
- Low potassium levels (hypokalaemia) or are on medicines that can lower potassium
- Lung infections, including TB (past or present), or chronic chest infections
- Past or current eye problems such as glaucoma or cataracts
- Long-term use of steroid tablets in the past
Pregnancy and breastfeeding:
-
Use only on the advice of a doctor or specialist, who will weigh the benefits versus any potential risks.
Symbicort is not recommended for children under 6 years.
Side Effects
Like all medicines, Symbicort can cause side effects, although not everyone gets them. Many are mild and improve as your body adjusts.
Very common / common:
- Thrush (Candida) in the mouth or throat – white patches, soreness
- Hoarse voice, voice changes, throat irritation, cough after inhalation
- Headache
- Tremor (shakiness)
- Palpitations (feeling your heart beating or pounding)
Uncommon:
- Dizziness
- Nausea
- Bruising
- Muscle cramps
- Blurred vision
Rare / very rare (seek medical advice):
- Allergic reactions – rash, itching, swelling of face, lips or tongue, breathing difficulties
- Bronchospasm (sudden worsening wheeze and shortness of breath straight after using the inhaler)
- Irregular heartbeats, chest pain, changes in blood pressure
- Very low potassium levels – muscle weakness, cramps, irregular heartbeat
- Effects of steroids when used at high doses for long periods, such as:
- Cushing-like appearance (weight gain, rounded face)
- Adrenal suppression (very tired, low blood pressure, feeling faint)
- Slowed growth in children and adolescents
- Thinning of bones, cataracts or glaucoma
- Mood or behaviour changes (sleep problems, anxiety, irritability, depression)
If you notice thrush or a sore mouth/throat, do not stop the inhaler on your own – speak to a clinician. Treatment with an antifungal and checking your inhaler technique and mouth-rinsing routine usually helps.
Get urgent medical help if you:
- Have sudden severe breathlessness or wheeze after using Symbicort
- Notice swelling of the face, lips, tongue or throat, or difficulty breathing
- Have severe chest pain or feel very unwell
Patient Information Leaflet
Please see HERE for the Patient Information Leaflet
Additional Info
- Active ingredients: budesonide 100 micrograms and formoterol fumarate dihydrate 6 micrograms per metered dose (80/4.5 micrograms per delivered dose)
- Medicine type: Combination inhaled corticosteroid + long-acting beta₂ agonist (ICS/LABA)
- Device: Breath-activated dry powder Turbohaler
- Excipient: Contains lactose (with small amounts of milk protein) – not suitable for patients with a severe milk protein allergy
- Age: Licensed for adults, adolescents and children 6+
- Not for the initial management of asthma or for use during a sudden, severe attack on its own – follow your asthma action plan
- Dose should always be titrated to the lowest level that keeps symptoms under control, with regular review
Possible important interactions (not a full list):
- Strong CYP3A4 inhibitors (e.g. ketoconazole, itraconazole, clarithromycin, some HIV medicines) – can increase budesonide levels; using Symbicort as MART may not be recommended with these
- Beta-blockers (including some eye drops for glaucoma) – can reduce the effect of formoterol
- Medicines that affect heart rhythm or lower potassium (e.g. certain diuretics, xanthines, other steroids, some antidepressants and antihistamines)
- Other beta₂ agonists or anticholinergic bronchodilators – may add to bronchodilator effects
Always tell your prescriber and pharmacist about all medicines you are taking, including over-the-counter and herbal products.
Directions
Use Symbicort exactly as prescribed in your asthma action plan. It is only for inhalation through the mouth.
There are two main ways Symbicort may be prescribed:
1. Maintenance therapy (with separate reliever)
You use Symbicort every day to prevent symptoms and keep control, and carry a separate fast-acting reliever inhaler for sudden symptoms.
Typical doses (your prescriber may adjust this):
- Adults (18+):
- 1–2 inhalations twice daily (morning and evening)
- Some may need up to 4 inhalations twice daily (maximum maintenance dose)
- Adolescents (12–17 years):
- 1–2 inhalations twice daily
- Children (6–11 years):
- 1–2 inhalations twice daily
When asthma is well controlled, your doctor may reduce the dose (for example, once daily in some patients).
2. Maintenance and reliever therapy (MART)
With MART, Symbicort is used as both your daily preventer and your reliever inhaler.
Adults and adolescents (12+ years):
- Maintenance dose:
- 2 inhalations per day – either:
- 1 inhalation in the morning + 1 in the evening, or
- 2 inhalations once daily (morning or evening), as advised
- 2 inhalations per day – either:
- Reliever dose:
- Take 1 additional inhalation as needed if you get symptoms
- If symptoms persist after a few minutes, you may take one more inhalation
- Maximum:
- No more than 6 inhalations on a single occasion
- A total of more than 8 inhalations a day is rarely needed
- Up to 12 inhalations per day may be allowed for a short period on medical advice
- If you regularly need more than 8 inhalations per day, you must see a doctor as your asthma may be poorly controlled
Children (6–11 years) on MART:
- Usual maintenance: 1 inhalation once daily, or 1 inhalation twice daily if needed
- Reliever: 1 additional inhalation as needed; may repeat once after a few minutes if still symptomatic
- Max 4 inhalations on a single occasion, and usually no more than 4 per day (up to 8/day for a short period only on medical advice)
Children must understand and follow the dosing plan carefully and should be supervised as advised by their clinician.
How to use the Symbicort Turbohaler
The Turbohaler is breath-activated – a dose is released when you breathe in strongly and deeply through the mouthpiece.
Step-by-step:
- Open
- Unscrew and remove the white cover.
- Load the dose
- Hold the Turbohaler upright (red grip at the bottom).
- Twist the red grip as far as it will go in one direction, then back as far as it will go the other way until you hear a click.
- Your dose is now loaded.
- Breathe out
- Hold the device away from your mouth.
- Breathe out gently (as far as is comfortable).
- Do not breathe out into the inhaler.
- Inhale the medicine
- Place the mouthpiece between your teeth and close your lips around it.
- Breathe in as deeply and as hard as you can through your mouth.
- Do not bite or chew the mouthpiece.
- Hold your breath
- Remove the inhaler and hold your breath for 5–10 seconds, then breathe out slowly.
- Repeat if instructed
- If you need a second inhalation, repeat steps 2–5.
- Close and rinse
- Replace the cover firmly.
- Rinse your mouth, gargle with water and spit it out after your maintenance dose to reduce the risk of thrush and hoarseness.
You may not taste or feel the powder – this is normal if you have followed the steps correctly.
Missed a dose?
- If you forget a scheduled dose, take it as soon as you remember unless it is almost time for your next dose.
- If it is nearly time for the next one, skip the missed dose and take the next dose at the usual time.
- Do not take a double dose to make up for a forgotten dose.
If you are using Symbicort as maintenance and reliever therapy, you can still use your as-needed doses for symptoms, within the maximum number of inhalations per day prescribed for you.
Never stop Symbicort suddenly, especially if you have been on a high dose or previous steroid tablets. Your doctor will usually advise a gradual dose reduction.
FAQs
What is Symbicort Turbohaler 100/6 used for?
It is used for the regular treatment of asthma in adults, adolescents and children aged 6+ who need both an inhaled steroid and a long-acting bronchodilator in a single inhaler. It helps prevent symptoms such as wheeze, breathlessness, chest tightness and night-time coughing.
Is Symbicort a preventer or a reliever inhaler?
Primarily it is a preventer inhaler. It may also be used as a reliever inhaler in specific patients under a maintenance and reliever therapy (MART) plan, where the same inhaler is used both every day and when needed for symptoms. Your asthma plan should clearly state how you are meant to use it.
How quickly does it work?
Formoterol starts to open the airways within 1–3 minutes, giving fast relief. Budesonide works more slowly to control inflammation over days to weeks. For best results, Symbicort must be used regularly, even when you feel well.
Do I still need a blue (short-acting) inhaler?
If you are on maintenance therapy only, yes – you will normally still need a separate reliever inhaler and should carry it with you. If you are on a MART regimen, you may be told to use Symbicort itself as both your maintenance and reliever inhaler, follow your individual asthma plan and ask if you are unsure.
Is there a steroid in Symbicort? Will it cause weight gain?
Symbicort contains budesonide, an inhaled steroid. Because it is inhaled, the amount reaching the rest of the body is much lower than with steroid tablets, so side effects like weight gain are less likely, especially at low-to-moderate doses. However, high doses over long periods can still cause steroid-related effects, so the goal is always to use the lowest effective dose.
What can I do to reduce the chance of thrush and hoarseness?
Use your inhaler with the correct technique, rinse your mouth, gargle and spit out after your maintenance dose, do not exceed your prescribed dose. If you develop white patches or soreness in your mouth or throat, speak to a clinician – usually the inhaler can be continued with treatment for thrush and improved mouth care.
Can children use Symbicort?
Yes. Symbicort Turbohaler 100/6 can be used in children aged 6 years and over, but the dose is lower and must be tailored by a doctor. Children on long-term steroid inhalers should have their height checked regularly, and treatment reviewed to ensure the lowest effective dose is used.
What should I do if I need my inhaler more often than usual?
This may mean your asthma is getting worse. You should: check your inhaler technique, follow your written asthma action plan, arrange a review with a doctor or asthma nurse as soon as possible.Seek urgent medical help if you are very breathless, struggle to speak in full sentences, or your reliever doses are not working.
How long can I stay on Symbicort?
Many people use combination inhalers long term. The key is: regular asthma reviews, using the lowest dose that keeps symptoms controlled, adjusting treatment up or down as your asthma changes. Your prescriber will advise when it is appropriate to step down or change treatment.
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