Symbicort® (budesonide/formoterol)

Reviewed by: HU Medical Review Board | Last reviewed: October 2021. | Last updated: November 2021

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 is a combination of an inhaled corticosteroid and a long-acting beta-agonist (LABA). It comes as a metered-dose inhaler.1,2

Experts have recommended an effective treatment for asthma called SMART (single maintenance and reliever therapy). Studies have shown SMART effectively reduces asthma flare-ups. Your doctor will determine if you are a good candidate for this. Symbicort is the only drug approved for SMART.3

What are the ingredients in Symbicort?

Symbicort contains 2 active ingredients:1,2

  • Budesonide, which is a synthetic corticosteroid. Corticosteroids are natural body chemicals that reduce inflammation.1-2
  • 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.1,2

Formoterol is a type of LABA. This means it binds 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. Long-acting means it has a prolonged effect of keeping the airways open. LABAs should never be used alone and should always be used in a combined drug such as Symbicort.1,2

What are the possible side effects of Symbicort?

Possible side effects of Symbicort include:1,2

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

Inhaled corticosteroids like Symbicort can cause thrush. This is a fungal infection in the mouth and throat. Rinse your mouth and regularly clean your device after inhaling Symbicort to help prevent thrush. Contact your doctor if you notice symptoms of thrush, such as:1,2

  • 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:1,2

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

Symbicort can worsen current infections. Tell your doctor about active infections, including tuberculosis or herpes simplex virus.1,2

The inhaled corticosteroids in Symbicort 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:1,2

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

LABAs such as Symbicort can increase the risk of asthma-related death when taken alone. LABAs should only be taken with another medicine, such as an inhaled corticosteroid. We do not know if the inhaled corticosteroid in Symbicort reduces the risk of asthma-related death. Get emergency help if:1,2

  • Breathing problems worsen quickly
  • Your rescue inhaler does not relieve breathing problems

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.

Things to know about Symbicort

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. You may not notice improvement in symptoms for a few weeks. Once symptoms stabilize, your doctor may switch you to a medicine that has only an inhaled corticosteroid. This can help prevent side effects from LABAs.1-2

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 you have been prescribed.1,2

Do not use Symbicort if:1,2

  • 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:1,2

  • 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.

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