Canada Drug Warehouse

A Guide To Symbicort

Wednesday 1 May 2024
11 minute(s) read

Table of Contents

I. What is Symbicort Used For?

i. Symbicort for Asthma

ii. Symbicort for COPD

iii. Is Symbicort Suitable for Children?

II. Symbicort Safety Information

i. Precautions Before Taking Symbicort

ii. Symbicort and Pregnancy

iii. Symbicort Side Effects

III. How To Use the Symbicort Inhaler

i. Understanding Symbicort Dosages

ii. Symbicort Inhaler Instructions

iii. How to Store Symbicort

IV. Symbicort Interactions

i. Food Interactions

ii. Drug Interactions


Symbicort (budesonide/formoterol) is a combination inhaler used to treat symptoms of chronic obstructive pulmonary disease (COPD) and asthma. With long-term use, it can help improve lung function and decrease the need for a rescue inhaler. [1]

In this article, we'll explore how Symbicort works to relieve respiratory conditions like asthma and COPD. We'll discuss proper dosage and usage, potential side effects to be aware of, interactions with other drugs, and whether it's safe during pregnancy.

What is Symbicort Used For?

anatomical paper cut-out of lungs

Symbicort is a prescription inhaler that was FDA-approved in 2006 for the following conditions:

  • Treat asthma in patients 6 years and older.
  • Maintenance treatment of airflow obstruction in patients with COPD, including chronic bronchitis and emphysema. [1]

Symbicort contains a combination of two medications that work together to improve lung function:

  • Budesonide (inhaled corticosteroid): Budesonide helps reduce inflammation in the airways, allowing them to open more freely so you can breathe easier.
  • Formoterol (LABA): Formoterol relaxes the muscles surrounding the airways, leading to improved airflow and easier breathing. [1]

By combining these two complementary treatments in one inhaler, Symbicort offers a convenient way to address the underlying causes of asthma and COPD symptoms. 

Symbicort for Asthma

Your doctor may prescribe Symbicort if your asthma is not well controlled with other long-term controller medications or if your asthma is severe enough to warrant starting treatment with Symbicort. [2]

There are two main types of asthma treatments: controller medications (like Symbicort) and rescue medications.

  • Controller medications are taken regularly over the long term to control asthma. They work by reducing inflammation in your airways and keeping them open.

It is important to understand that Symbicort is not a replacement for a rescue inhaler. While using Symbicort, you may find that you need to rely less on your rescue inhaler, but it should still be readily available for sudden symptoms. [2]

Symbicort for COPD

If you have been diagnosed with COPD, your doctor may recommend Symbicort as a daily medication to help alleviate constriction and control inflammation in your airways. The goal of COPD treatment is to relieve symptoms and slow disease progression. [3]

With daily use, Symbicort can help:

  • Significantly improve lung function, beginning within 5 minutes of taking it.
  • Reduce your need for rescue inhalers. [3]

It's important to remember that Symbicort is meant for regular, daily use to manage COPD symptoms. It is not meant to replace your rescue inhaler for sudden breathing problems. You should continue using your rescue inhaler as needed while also taking Symbicort every day. [3]

Is Symbicort Suitable for Children?

Symbicort is FDA-approved for treating asthma in patients as young as 6 years old. [4] Extensive clinical studies demonstrate that Symbicort significantly improves asthma symptoms in children.

  • Improved FEV1: This measures how much air a person can exhale in one second. Low FEV1 indicates restricted airflow, a symptom of asthma and other respiratory diseases. In clinical trials, Symbicort boosted FEV1 within 15 minutes of use. After 12 weeks of treatment, FEV1 improved by 86% on average.
  • Improved lung function: In a 12-week study on Symbicort usage in children over the age of 6, Symbicort increased lung function in participants. [4]

Symbicort Safety Information

Precautions Before Taking Symbicort

Before starting Symbicort, it's important to discuss your medical history and any concerns with your doctor. This will help determine if Symbicort is right for you.

Specifically, tell your doctor if you:

  • Have any ongoing health conditions or have had health issues in the past. Symbicort may affect certain medical conditions.
  • Have heart problems. Symbicort can increase your risk of cardiovascular side effects.
  • Have diabetes. Symbicort can increase blood sugar levels. Your doctor may want to monitor your blood sugar closely.
  • Have low potassium levels or thyroid problems. These conditions can interact with Symbicort. Your doctor may want to check your levels more regularly.
  • Have seizures or epilepsy. Symbicort can potentially trigger seizures in some people. Let your doctor know if you have a history of seizures.
  • Have severe liver disease like cirrhosis. Your liver helps process medications, so liver problems can impact how Symbicort works in your body.
  • Are taking systemic steroids. Transferring from systemic to oral steroids can cause impaired adrenal function. Your doctor will gradually taper you off systemic steroids before starting Symbicort.
  • Have had allergic reactions to Symbicort ingredients like budesonide or formoterol. You may be allergic to Symbicort.
  • Are pregnant, planning pregnancy, or breastfeeding. Safety has not been established, so risks and benefits must be weighed. [5]

Symbicort and Pregnancy

nurse helping pregnant woman with inhaler

Symbicort contains two active ingredients: formoterol and budesonide. When it comes to the safety of using Symbicort during pregnancy, it's important to consider the individual components.

  • Formoterol: While there are currently no human trials on inhaled formoterol usage in pregnant women, animal studies have raised concerns. These studies have shown that formoterol injections can increase the risks of both congenital anomalies and pregnancy loss. Therefore, it is advisable to exercise caution when considering the use of formoterol during pregnancy.
  • Budesonide: Clinical trials of budesonide have demonstrated its safety when used by pregnant women. However, it's worth noting that budesonide can pass into breast milk. [1]

It’s important to note that uncontrolled asthma during pregnancy can be harmful to you and your baby. Poorly controlled asthma lowers the amount of oxygen in your blood, which also means less oxygen reaches your developing baby. This can restrict fetal growth and threaten the pregnancy. For the health of your pregnancy and child, it is critical to keep your asthma under control. [1]

If you have asthma and are pregnant or planning a pregnancy, talk to your doctor about the pros and cons of Symbicort for your situation. They can help determine if the benefits of symptom relief outweigh any potential risks to you and your baby. [1]

Symbicort Side Effects

Symbicort may cause side effects in some people. The side effects that you may experience depend on whether you’re using Symbicort to treat COPD or asthma.

If you have COPD, side effects may include:

  • Throat irritation
  • Thrush in the mouth and throat
  • Bronchitis
  • Sinusitis
  • Upper respiratory tract infection [2]

If you have asthma, side effects may include:

  • Throat irritation 
  • Headaches 
  • Upper respiratory tract infection
  • Sinusitis 
  • Flu
  • Back pain
  • Nasal congestion
  • Stomach discomfort
  • Vomiting 
  • Thrush in the mouth and throat [2]

How To Use the Symbicort Inhaler

Understanding Symbicort Dosages

Symbicort dosages can seem confusing when you first start using this medication. However, understanding what's in Symbicort can help make sense of the dosage amounts.

Symbicort contains two active ingredients that work together to open airways and improve breathing:

  • Budesonide: An anti-inflammatory steroid that reduces swelling in the airways
  • Formoterol: A fast-acting bronchodilator that relaxes tightened airway muscles [1]

The dosages on Symbicort inhalers reflect the amount of each ingredient in micrograms (mcg):

  • The budesonide dosage is listed first.
  • The formoterol dosage is listed second. [1]

For example, the 80/4.5 inhaler contains 80 mcg of budesonide and 4.5 mcg of formoterol per puff.

The two Symbicort strengths available are:

  • 80/4.5 inhaler: 80 mcg of budesonide and 4.5 mcg of formoterol
  • 160/4.5 inhaler: 160 mcg of budesonide and 4.5 mcg of formoterol [1]

Understanding the role of each medication and how the dosages are structured takes the mystery out of the numbers. If you have any questions about your prescribed Symbicort dosage, speak with your doctor or pharmacist. 

Symbicort Inhaler Instructions

To ensure your Symbicort inhaler works properly and provides maximum relief, it’s critical to prime it before first use or if you haven’t used it for over a week. Priming simply means releasing a few test sprays to prepare the inhaler for use. [6]

To prime your Symbicort inhaler correctly, follow these steps:

  • Shake the Symbicort inhaler for 5 seconds to mix the medication.
  • Point the inhaler away from you and press down on the canister to release a spray.
  • Repeat this process one more time. [6]

Once your Symbicort inhaler is primed, it’s ready to be used. Follow these steps to use Symbicort properly:

  • Shake the inhaler for 5 seconds to mix the medication.
  • Breathe out to empty your lungs.
  • Seal your lips around the mouthpiece and aim it toward the back of your throat.
  • Inhale slowly and deeply while pressing down on the canister to release a spray.
  • Remove your mouth from the inhaler and hold your breath for 10 seconds.
  • Breathe out away from the device.
  • For your second puff, shake the inhaler for 5 seconds and repeat this process.
  • Rinse your mouth with water to prevent side effects like oral thrush. [6]

How to Store Symbicort

Storing Symbicort properly is important to ensure it remains effective. Here are some tips:

  • Store the inhaler at room temperature, between 68°F and 77°F.
  • Store the inhaler with the mouthpiece pointed down.
  • Never expose the inhaler to extreme heat or puncture it, as this could cause the pressurized canister to burst. Don't leave it in direct sunlight or near any heat sources.
  • Try to bring the inhaler to room temperature before using for best results.
  • Check the expiration date periodically and replace Symbicort before it expires. [1]

Symbicort Interactions

Food Interactions

Certain foods can interact with Symbicort and either reduce its effectiveness or increase side effects. Two foods to be particularly mindful of are:

  • Caffeine: Drinking caffeinated beverages like coffee, tea and energy drinks when taking Symbicort should be done in moderation. Both caffeine and Symbicort can cause an increase in your heart rate. Consuming too much caffeine when on Symbicort may further elevate your heart rate to an unhealthy level. [1]
  • Grapefruit and any grapefruit-related products: Symbicort contains budesonide, a corticosteroid, which relies on an enzyme called cytochrome P4503A4 to break it down in your body. Grapefruit inhibits this enzyme, which can then lead to increased levels of budesonide in your blood. It is best to avoid eating grapefruit and drinking grapefruit juice altogether when taking Symbicort to prevent unwanted side effects. [7]

Drug Interactions

inhaler, tablets, and stethoscope on table

When starting any new medication, it’s crucial to let your doctor know of any other medications you’re taking. This can include prescription drugs, over-the-counter drugs, herbal supplements, and vitamins.

Symbicort has a few drug interactions to be aware of:

  • Inhibitors of cytochrome P4503A4: Symbicort contains budesonide, a corticosteroid that is metabolized in the body through a compound called cytochrome P4503A4. If you are taking medications that inhibit cytochrome P4503A4, the metabolism and elimination of budesonide may be affected. This can lead to an increased amount of budesonide in your body, potentially causing unwanted side effects.
  • Monoamine oxidase inhibitors and tricyclic antidepressants: Symbicort contains formoterol (LABA) that helps relax airway muscles. However, it is important to note that formoterol can also have an impact on the cardiovascular system, increasing heart rate and blood pressure. If you are taking monoamine oxidase inhibitors or tricyclic antidepressants alongside formoterol, the effects on your cardiovascular system may be intensified.
  • Beta-blockers: Symbicort contains a drug called formoterol, which belongs to a class called beta-agonists. If you take beta-blockers with formoterol, it can block the benefits of formoterol in the lungs. Furthermore, patients with asthma should not take beta-blockers as it can lead to severe bronchospasms.
  • Loop or thiazide diuretics: These diuretics eliminate potassium from the body through urine, and the use of beta-agonists like formoterol can potentially worsen a condition called hypokalemia (low potassium levels). [1]


Is Symbicort a rescue inhaler?

Symbicort is not a rescue inhaler and cannot be used to provide immediate relief from sudden symptoms. However, many people find they rely less on their rescue inhaler once their condition is well-controlled with Symbicort. [2]

How long can you be on Symbicort?

If you're using Symbicort to treat asthma, your doctor will monitor your condition to determine when your asthma is well-controlled. At that point, they may advise discontinuing Symbicort and switching you to a different long-term asthma maintenance medication, such as an inhaled corticosteroid alone. [2]

With COPD, Symbicort is used as a long-term treatment to help keep your symptoms at bay and reduce exacerbations. You will likely stay on Symbicort for as long as your doctor recommends. [3]

What is a cheaper alternative to Symbicort?

The generic version of Symbicort (Budesonide/Formoterol) can help you save on medication costs. The generic version contains the same active ingredients at a much lower price. Generic medications go through the same strict approval process by the FDA as brand-name drugs and are just as safe and effective. [8]

One way to maximize savings on brand-name and generic Symbicort is to order from a reputable online Canadian pharmacy. Canada enforces regulations that cap prescription drug prices at more reasonable rates compared to the U.S. [9] Online Canadian pharmacies are then able to acquire medications at these lower costs and pass substantial savings on to customers - up to 90% less than what you would pay at a U.S. pharmacy.

How long does Symbicort take to work?

If taken for asthma, Symbicort can help improve lung function starting within 15 minutes. [2]

If taken for COPD, Symbicort can help improve lung function starting within 5 minutes. [3]

However, it's important to remember that Symbicort is a long-term medication. While you may experience some immediate relief, it is crucial to continue using Symbicort consistently over time to achieve optimal results. [2]

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.