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Symbicort

Also called budesonide and formoterol

Key points about Symbicort

Symbicort® is used to treat the symptoms of asthma and COPD and to prevent them from recurring.
Symbicort is also called budesonide and formoterol.
Find out how to take it safely and possible side effects.

HN 1734 symbicort counselling in consult room

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Symbicort is a combination of 2 medicines, budesonide and formoterol, in a single inhaler. Symbicort is used to treat the symptoms of asthma and COPD and to prevent them from recurring.

Budesonide is a corticosteroid. When inhaled, it prevents swelling and irritation in the walls of the small air passages in your lungs. It's also called a preventer, because when it's used every day it prevents shortness of breath and wheezing.
Formoterol is a long-acting, fast onset bronchodilator. It relaxes and opens up your air passages, making breathing easier.

In Aotearoa New Zealand, Symbicort is available in different strengths: Symbicort 100/6, Symbicort 200/6 and Symbicort 400/12.

To get the most benefit, it's important to use the correct technique. Ask your healthcare provider to show you how to use a Turbuhaler® device. Even if you've been shown before, ask your healthcare provider to explain how to use a Turbuhaler if you still have any questions.

The video and diagram below provides some guidance on how to use a Turbuhaler device. The Turbuhaler is the name of the device used to deliver the medicine to your lungs and airways. There are different names for each Turbuhaler depending on the medicines inside the device.

Your Turbuhaler may be a different colour to the one in the video below. It's important to know the name and colour of your Turbuhaler, eg, Symbicort®, Pulmicort®, Bricanyl® or Oxis®. Read more about understanding your medicines.

Video: How to use a Turbuhaler device

(Healthify He Puna Waiora & Auckland District Health Board, NZ, 2018)

Using a Turbuhaler device

How to use your Symbicort Turbuhaler
	Open: Unscrew and remove the cap. Hold the Turbuhaler upright.
	Load the dose: Twist the base anticlockwise and then back in the other direction until you hear a click. Your Turbuhaler is now loaded with 1 dose of medicine.
	Breathe out: Breathe out, away from the Turbuhaler. Don't blow directly into the Turbuhaler.
	Inhale your dose: Place the mouthpiece in your mouth and form a seal with your lips. Breathe in deeply. Remove the Turbuhaler and hold your breath for up to 10 seconds.
	Close: Replace the cap and twist until it's on properly.

If you're using Symbicort for COPD, it must be used regularly twice a day every day as a preventer, to prevent flare-ups (your symptoms suddenly getting worse).
It's called maintenance therapy for COPD. Read more about medicines for COPD.

If you're using Symbicort for asthma, it can be used as a preventer and/or a reliever.

Reliever: Use 1 inhalation when needed for shortness of breath.

You can repeat as required, up to a maximum of 12 inhalations in 1 day.
If you need to take more and more doses each day, see your healthcare provider to assess your treatment.
A reliever treats the immediate symptoms of asthma such as tightened airways. It starts to work in a few minutes.
Note: the high dose 400/12 mcg strength Symbicort can't be used as a reliever.

Preventer: The usual dose is 1 to 2 inhalations every day, once or twice daily. The dose of Symbicort will be different for different people depending on the severity of your symptoms and the strength of your turbuhaler.

A preventer helps to reduce the risk of asthma attacks, by making your airways less sensitive to triggers and reducing inflammation and swelling in your airways.

Read more about medicines used to manage asthma.

Mild asthma

If you have mild asthma, you can use one dose of Symbicort as a reliever when needed for shortness of breath, without needing to use it regularly. This is called AIR therapy (anti-inflammatory reliever therapy).

Moderate to severe asthma

If you have moderate to severe asthma, you can use your Symbicort as both a preventer and also as a reliever. This is called SMART (which stands for single maintenance and reliever therapy). This means that you use your Symbicort regularly each day for symptom prevention, and also when needed for symptom relief. Read more about the SMART action plan(external link).

Here are some things to know when you're using Symbicort. Other things may be important as well, so ask your healthcare provider what you should know about.

Always use your inhaler exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.
Symbicort turbuhalers are available in different strengths. Ask your doctor or pharmacist which strength you're taking. If your inhaler looks different to what you were expecting, ask your pharmacist about this.
Rinse your mouth after each use. Symbicort can cause a sore throat and hoarse voice. Rinse your mouth after each use to prevent this.
Cleaning: Wipe the mouthpiece with a clean dry tissue regularly, at least once a week. Don't use water or liquids when cleaning the mouthpiece or
any part of the Symbicort turbuhaler.
Storage: Keep your Symbicort in a cool, dry place with the cover firmly in place. Don't store it in the bathroom or near a sink. Keep the cap on when you're not using it. The device may clog up if you breathe out through it, dribble into it or keep it an place where there is high humidity (moisture in the air) with the cap off or unsealed.

There's a window under the mouthpiece on the outside of the Turbuhaler called a dose indicator. The inhaler is empty when the '0' on the red background has reached the middle of the window.

Note:

The dose indicator tells you how many doses are left in your inhaler.
The dose indicator doesn't show each individual dose and moves slowly after 10 doses have been loaded. This means you may not notice movement for each single dose.
When the inhaler is empty the loading grip will still move, but the dose indicator will stop moving and the 0 on the dose counter won't change.

Like all medicines Symbicort can cause side effects, although not everyone gets them. Often side effects improve as your body adjusts to the new medicine.

Side effects	What should I do?
Change in voice (hoarse voice) Different taste in your mouth Dry mouth or throat Cough	These are quite common when you first start using your inhaler and usually go away with time. Rinse your mouth after each use Tell your doctor if these bother you.
Signs of oral thrush (a fungal infection in your mouth) such as a very sore tongue, throat or mouth, with white sores on your tongue or in your mouth	Tell your doctor or pharmacist.
Feeling shaky Nervousness Tremor Headache Muscle cramps Problems sleeping	These are quite common when you first start using your inhaler and usually go away with time. Tell your doctor if these bother you.
Changes in your heartbeat (faster) Chest pain Sudden changes in mood Blurred vision or changes to your eyesight	Tell your doctor or phone Healthline 0800 611 116.