Symbicort (budesonide/formoterol)

Reviewed by: HU Medical Review Board | Last reviewed: June 2023

Symbicort® (budesonide/formoterol) is approved for long-term treatment of asthma in people 6 years of age and up. It is also approved to treat chronic obstructive pulmonary disease (COPD).1,2

Symbicort combines an inhaled corticosteroid and a long-acting beta-agonist (LABA). It comes as a metered-dose inhaler. The US Food and Drug Administration (FDA) approved a generic version of Symbicort in 2022.1,3

Experts have recommended an effective treatment for asthma called SMART (single maintenance and reliever therapy). This means the same medicine is used as the controller and rescue inhaler. SMART reduces asthma flare-ups. Your doctor will determine if you are a good candidate. SMART therapy is currently only recommended for combination steroid/long-acting beta-agonist (LABA) inhalers that contain formoterol. Symbicort is one example of this type of combination inhaler.4,5

What are the ingredients in Symbicort?

Symbicort contains 2 active ingredients:1

  • Budesonide, which is a synthetic corticosteroid (a natural body chemical that reduces inflammation)
  • Formoterol, which is a LABA

How does Symbicort work?

The 2 ingredients in Symbicort work in different ways to treat asthma. Budesonide is an inhaled corticosteroid that reduces airway inflammation. Formoterol is a type of LABA. It binds to a protein in your cells called the beta-adrenergic receptor. This relaxes airway muscles and opens the airway. It also blocks chemicals that increase inflammation.1

The FDA approved a generic version of Symbicort in 2022. Generic drugs work the same way as brand-name drugs. They have the same active ingredients, side effects, and dosage. The approval of a generic drug increases competition. This can lower the price of the brand-name drug. More people can then access the drug.3,6,7

What are the possible side effects?

The most common side effects of Symbicort include:1

  • Throat pain or irritation
  • Upper respiratory tract infection
  • Sinus infection (sinusitis)
  • Headache
  • Allergic reactions
  • Increased wheezing
  • Low bone density
  • Slow growth in children
  • Eye problems, such as glaucoma and cataracts
  • Low blood sugar and potassium levels
  • Back pain
  • Vomiting

Inhaled corticosteroids can cause thrush. This is a fungal infection in the mouth and throat. Rinse your mouth and clean your device after inhaling Symbicort to help prevent thrush. Contact your doctor if you notice symptoms of thrush, such as:1

  • Throat discomfort or pain
  • Hoarse voice
  • Red or white patches in your mouth

Corticosteroids can weaken your immune system. This increases your risk of getting an infection. Avoid contact with people who have chickenpox, measles, or other contagious diseases. Call your doctor if you show symptoms of an infection, such as:1

  • Fever
  • Fatigue
  • Aches and pains
  • Chills
  • Nausea and vomiting

Inhaled corticosteroids can increase the risk of adrenal insufficiency. This is a potentially life-threatening condition. It happens when your adrenal glands do not make enough steroid hormones. Talk to your doctor if you notice symptoms of adrenal insufficiency, including:1

  • Tiredness
  • Weakness
  • Nausea and vomiting
  • Low blood pressure

These are not all the possible side effects of Symbicort. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with Symbicort.

Other things to know

Take Symbicort as your doctor describes. It comes as a metered-dose inhaler. Your doctor will teach you how to use, store, and clean your inhaler.1,2

Your doctor will determine your dose based on age and asthma severity. Your symptoms may not improve for a few weeks. Once symptoms improve, your doctor may switch you to a medicine that has only an inhaled corticosteroid. This can help prevent side effects from LABAs.1

If symptoms do not improve after 2 weeks, your doctor may increase your dosage. Do not stop using Symbicort unless your doctor tells you to. If you miss a dose, take your next scheduled dose when it is due. Do not take Symbicort more often or use more puffs than prescribed.1

Symbicort can worsen current infections. Tell your doctor about active infections, including tuberculosis or herpes simplex virus.1

Do not use Symbicort if:1

  • You are trying to treat an acute asthma attack
  • You are taking another LABA
  • Your asthma can be controlled by an inhaled corticosteroid alone
  • You are allergic to budesonide, formoterol, or any other ingredient in Symbicort

Symbicort may interfere with other medicines or worsen certain conditions. Tell your doctor if you:1

  • Have any heart problems, seizures, high blood pressure, or diabetes
  • Have had any problems with your liver, thyroid, eyes, immune system, or bone health
  • Have any current infections
  • Are planning to have surgery
  • Are pregnant or breastfeeding

Before beginning treatment for asthma, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

For more information, read the full prescribing information of Symbicort.