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Detailed Symbicort Inhaler Instructions

Monday 6 May 2024
6 minute(s) read

Table of Contents

I. Using Symbicort for Asthma

II. Using Symbicort for COPD

III. Changing Your Dose

IV. Treatment Period

V. How to Use Symbicort

VI. Conclusion

When it comes to any medication, it's crucial to understand the dosing instructions and treatment plan prescribed by your doctor. This is especially true for respiratory medications like Symbicort, which is used for both asthma and chronic obstructive pulmonary disease (COPD). [1] While Symbicort can treat both conditions, there are important differences in the recommended doses and length of treatment.

In this article, we'll discuss the typical Symbicort dosages for asthma, the common dosage for COPD, what to know about changing your dose, and how long you can expect to use Symbicort for both asthma and COPD

Using Symbicort for Asthma

Symbicort is FDA-approved for the treatment of specific cases of asthma in patients older than 6 years of age. Your doctor may prescribe Symbicort if your asthma:

  • Is not adequately controlled with an inhaled corticosteroid (ICS) alone.
  • Needs to be treated with both an ICS and a long-acting bronchodilator. [2]

There are two types of asthma medicines: controllers and rescue.

  • Controller medicines are taken daily over the long term to reduce inflammation and keep airways open.

Symbicort is a controller medication, meaning it is taken regularly to control asthma by decreasing inflammation and opening airways. It does not act quickly enough to be used as a rescue inhaler. So, it's important to have a separate quick-relief inhaler available for sudden symptoms. [2]

The recommended Symbicort usage depends on your age, severity of asthma symptoms, and previous inhaled corticosteroid (ICS) usage.

  • Patients between 6 to 12 years old
  • Take 2 inhalations of 80/4.5 mcg twice daily
  • Patients 12 years and older
  • Medium to high previous ICS dose: 2 inhalations of 160/4.5 mcg twice daily.
  • Low to medium previous ICS dose: 2 inhalations of 80/4.5 mcg twice daily.
  • No previous ICS dose: 2 inhalations of 160/4.5 or 80/4.5 mcg twice daily (based on asthma severity). [3]

When used properly, Symbicort can start improving lung function within 15 minutes of use. Over time, you may also need less rescue medication as Symbicort controls your symptoms. However, it’s important to always keep a rescue inhaler on hand for sudden asthma attacks. [2]

Using Symbicort for COPD

Symbicort is a long-term treatment for COPD, including chronic bronchitis and emphysema. Its goal is to:

  • Improve your lung function.
  • Make breathing easier.
  • Reduce flare-ups over time. [4]

The standard Symbicort dosage for COPD is two puffs from the 60/4.5 mcg inhaler twice daily. [3]

When used regularly as prescribed by your doctor, Symbicort starts working within 5 minutes to open your airways and make breathing easier. It can also decrease your need for a rescue inhaler over the long run. However, Symbicort is not meant to replace a rescue inhaler for quick relief of sudden symptoms since it does not work fast enough for that purpose. [4]

It’s important to understand that Symbicort is a maintenance medication, meaning you must take it daily to experience the benefits, even if you start to feel better. While your breathing should improve over time, you must continue using Symbicort to control your COPD and maintain symptom relief. [4]

Changing Your Dose


a woman using an inhaler

When starting a new medication like Symbicort, it's common for the initial prescribed dosage not to be fully effective for your asthma or COPD symptoms. Finding your optimal dosage takes some trial and error. It's important to communicate with your doctor if your current Symbicort dosage does not adequately control your symptoms.

Symbicort comes in two different strengths, and your doctor will determine the dosage based on your symptom severity and condition:

  • Two inhalations of 80/4.5 mcg twice daily
  • Two inhalations of 160/4.5 mcg twice daily (maximum dose) [1]

If your symptoms are still not well-controlled at the maximum dose, your doctor cannot prescribe a higher daily dose or additional inhalations. [3] Exceeding the maximum daily dose of formoterol (the active ingredient in Symbicort) can lead to concerning side effects such as:

  • Seizures
  • Chest pain
  • Blood pressure changes
  • Fast heartbeat
  • Heart arrhythmias
  • Nervousness
  • Tremor
  • Heart palpitations
  • Muscle cramps
  • Nausea
  • Dizziness
  • Sleep disturbances
  • High blood sugar
  • Low potassium [3]

To prevent an accidental overdose, it's essential to follow proper dosing of Symbicort:

  • Do not take more than 4 inhalations per day.
  • Do not take Symbicort more than twice daily. [3]

Treatment Period

a doctor

Symbicort is meant to be used as a long-term maintenance treatment for chronic lung diseases like asthma and COPD. While you may feel some initial improvement in your breathing after starting Symbicort, the full effects can take longer to manifest. Symbicort works by reducing inflammation and opening the airways in your lungs - changes that happen gradually with regular use. [2]

The treatment period for patients with COPD and asthma differ slightly:

  • Asthma: Your doctor will closely monitor your condition to determine when your asthma is well-controlled. Once your asthma is well-managed, they may recommend switching you to a different long-term controller medication, like an inhaled corticosteroid alone. [2]
  • COPD: You will likely stay on Symbicort for as long as your doctor recommends. When used consistently over time, Symbicort can help reduce COPD exacerbations and improve lung function by decreasing inflammation and opening up the airways. [4]

How to Use Symbicort

Before using your Symbicort inhaler for the first time or if you haven’t used it in over a week, it’s important to prime it. Priming means releasing a few test sprays to ensure the correct dosage. [5]

To prime your Symbicort inhaler, follow these steps:

  • Shake the inhaler for 5 seconds.
  • Point the mouthpiece of the inhaler away from you.
  • Press down on the canister to release a spray.
  • Repeat this process one more time. [5]

Once your Symbicort inhaler is primed, it’s ready to be used:

  • Shake the inhaler for 5 seconds.
  • Breathe out away from the inhaler.
  • Seal your lips around the mouthpiece and aim it toward the back of your throat.
  • Press down on the canister once to release a spray while inhaling slowly and deeply.
  • 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 oral thrush. [5]


Symbicort offers a convenient and effective treatment option for those living with COPD or asthma. Combining two medications into one easy-to-use inhaler streamlines therapy and improves adherence. Numerous studies have shown Symbicort enhances lung function in both diseases.

However, the effectiveness of any medication depends on its proper use. Be sure to use Symbicort exactly as your doctor and pharmacist have directed. Ask them any questions you may have about proper dosing, timing, and technique.

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.