Symbicort: What is it, Risks and Side Effects

Although it helps to prevent the symptoms of asthma, symbicort is not for use in treating asthma or a bronchospasm attack. This product is used to control and prevent symptoms (wheezing and shortness of breath) caused by asthma or ongoing lung disease (chronic obstructive pulmonary disease-COPD, which includes chronic bronchitis and emphysema) and Symbicort has many side effects that you need to learn about. 

What is Symbicort?

Symbicort is a mixture of budesonide and formoterol. Budesonide is a corticosteroid that reduces inflammation in the body while formoterol is a long-acting bronchodilator that relaxes muscles in the airways to improve breathing. Symbicort is used to control and prevent the symptoms of asthma in adults and children at least 6 years old. Sometimes your doctor may tell you to stop using this medicine once your asthma is well-controlled.

People with asthma use Symbicort only if asthma is severe yet it is not a rescue medicine. Symbicort will not work fast enough to help an asthma or bronchospasm attack. 

Why do budesonide and formoterol need to be combined? 

We know that Symbicort contains 2 medications: Budesonide and Formoterol. 

Budesonide belongs to a class of drugs called corticosteroids. It works by reducing the irritation and swelling of the airways. Formoterol belongs to the class of drugs called long-acting beta agonists. It  functions by opening airways in the lungs to make breathing easier. The benefits of controlling symptoms of breathing problems is a decreased time lost from work or school.

Formoterol when used alone can increase the risk of fatality or death in people with asthma. But this risk decreases when the budesonide and formoterol compounds are used together as a combination product. 

However, when used alone, long-acting beta agonists (such as formoterol) may rarely increase the risk of serious (sometimes fatal) asthma-related breathing problems. The combination inhaled corticosteroid and long-acting beta agonists, such as this product, do not increase the risk of serious asthma-related breathing problems. For asthma patients, Symbicort should be used when breathing problems are not well controlled with one asthma-control medication (such as inhaled corticosteroid) or if your symptoms need combination treatment. For patients 12 years of age and older, the dosage of Symbicort is 2 inhalations twice daily (morning and evening, approximately 12 hours apart). 

Before taking this medication

First, symbicort may interact with antibiotics, beta-blockers, antifungal medication, antidepressants, MAO inhibitor or diuretics (water pills) so tell your doctor all medications you are taking. 

Secondly, For pregnant women, Symbicort should be used ONLY when prescribed since budesonide passes into breast milk but is not confirmed if formoterol passes into breast milk.  That being said, it is not known whether budesonide or formoterol will harm an unborn baby. However, having untreated or uncontrolled asthma during pregnancy can cause complications such as premature birth, low birth weight, or eclampsia (dangerously high blood pressure that can lead to medical problems in both mother and baby). The benefit of treating asthma may outweigh any risks to the baby. Budesonide can affect growth in children. If your child is not growing at a normal rate while using this medicine, consult your doctor immediately. 

Thirdly, never use Symbicort if you are allergic to budesonide or formoterol. Budesonide can weaken your immune system and be very toxic. 

Lastly, communicate strongly with your doctor about any illness or infection you’ve had within the past several weeks. And in order to confirm if Symbicort is safe for you, tell your doctor if you have ever had:

  • heart disease, high blood pressure;
  • a seizure;
  • a drug allergy;
  • a weak immune system;
  • liver disease;
  • osteoporosis;
  • glaucoma, cataracts, or other vision problems;
  • diabetes;
  • tuberculosis;
  • a thyroid disorder; or
  • an electrolyte imbalance (such as low potassium levels in your blood).

How do I use Symbicort?

Symbicort medication always comes with a medication guide for safe and effective use, and the instruction and directions for priming and cleaning the Symbicort inhaler device are also inside. 

To consume symbicort, follow all directions on your prescription label and read all medication guides. Use the medicine exactly as directed, as consuming too much of this medicine can cause life-threatening side effects. 

  • If you also use an oral steroid medication, dont stop using it suddenly. Follow your doctor’s instructions about tapering your dose in a gradual manner.
  • Symbicort only if asthma is severe yet it is not a rescue medicine. Use only fast-acting inhalation medicine for an attack. Consult a doctor if your breathing problems get worse quickly, or if you think your asthma medications are not working as well.
  • Never allow a young child to use Symbicort without help from an adult.
  • Wash your mouth with water after every use of your inhaler.
  • It may take up to 1 week before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms show no signs of improvement. 
  • Your dosage can change if you have surgery, are under stress,  are ill or have recently had an asthma attack. Do not change your medication schedule and dosage without your doctor’s consent. 
  • If you are using a peak flow meter, tell your doctor if your numbers are lower than normal.
  • Store at room temperature in an upright position, with the mouthpiece down. Keep away from open flames or high heat as the canister can explode if it gets too heated. Do not puncture an empty inhaler canister.
  • Throw the canister away when the inhalation counter shows a 0, or if it has been longer than 3 months since you first took the canister out of its foil pouch.

How to use Symbicort HFA Aerosol With Adapter

  • Read the Patient Information and Instructions for Use provided by your pharmacist before you start using this medication and each time you get a refill. 
  • Follow the instructions for priming the inhaler if you are using it for the first time, if you have not used it for more than 7 days, or if the inhaler was dropped. When priming the inhaler, ensure to spray away from the face so that you do not get the medication in  your eyes.
  • Shake the inhaler well for 5 seconds before every use and inhale this medication by mouth as directed by your doctor, usually twice daily (once in the morning and once in the evening, at least 12 hours apart).
  • If your prescribed dose is 2 puffs, wait at least 1 minute between them. If you are using other inhalers at the same time, wait at least 1 minute between the use of each medication, and use this drug at the absolute last. 
  • Gargle and rinse your mouth with water after using this medication to help prevent irritation and yeast infections (thrush) in the mouth and throat. Do not swallow the rinse water.
  • Use a dry cloth to clean the inhaler once a week but not take the inhaler apart.
  • This medication works best if used at evenly spaced times and use it at the same times each day. Never increase your dose or use this medication more often, or stop using it without consulting with your doctor. Never use other long-acting beta agonists (such as formoterol which may rarely increase the risk of fatal asthma-related breathing problems) while using this medication.
  • If you are regularly taking a different corticosteroid by mouth (such as prednisone), you should not stop taking it unless directed by your doctor. 
  • Some conditions like allergies and asthma may become worse when the drug is suddenly stopped. If you suddenly stop taking the drug, you may also have withdrawal symptoms (such as weight loss, weakness, nausea, headache, muscle pain, tiredness, dizziness). To help withdrawal, your doctor can slowly lower the dose of your old medication after you begin using budesonide/formoterol gradually. Tell your doctor or pharmacist right away if you have started withdrawal. 
  • If you have been using a quick-relief inhaler (such as albuterol/ salbutamol) on a regular daily schedule (such as 4 times daily), stop this schedule and only use the quick-relief inhaler as needed for sudden shortness of breath/asthma attacks. Consult your doctor for details.
  • It can take upto 1 week or longer before you get to experience the full benefit of this drug. Consult with your doctor if your symptoms do not improve or if they worsen.
  • Learn which of your daily inhalers to use and identify the one you should use if your breathing suddenly worsens (quick-relief drugs). 
  • Ask your doctor in advance what you should do if you have new or worsening cough or shortness of breath, waking up at night with trouble breathing, increased sputum, wheezing, worsening peak flow meter readings, if you use your quick-relief inhaler more often (more than 2 days a week), or if your quick-relief inhaler does not seem to be working well. 
  • Learn how and when to treat sudden breathing problems by yourself and when you must get medical help right away.

What should I avoid doing while using Symbicort?

If symbicort gets in your eyes, then rinse with water and call your doctor if you have a severe eye redness or irritation.

Avoid being near people who are sick or have infections such as chickenpox or measles. Call your doctor for prevention treatment in case you are exposed to measles or chickenpox. These conditions can be fatal in people who are using a steroid such as budesonide.

Do not use a second inhaled bronchodilator that contains formoterol or a similar medicine (such as formoterol, arformoterol, olodaterol, indacaterol, salmeterol, or vilanterol).

What other drugs will affect Symbicort?

It is not safe to use certain medications at the same time with symbicort. Certain drugs can affect the blood levels of other drugs you take and increase side effects or make the medications less effective.

A lot of drugs interact with budesonide and formoterol including prescription and over-the-counter medicines, herbal products and even vitamins and more. It’s very important to communicate with your doctor about all your current medicines and any medicine you start or stop using.

Symbicort side effects

If you have signs of an allergic reaction to Symbicort, get emergency medical help and call your doctor at once if you have:

  • tremors, chest pain, fast or pounding heartbeats
  • swelling of your  lips, face, tongue, throat, hives
  • feeling short of breath
  • difficulty with breathing, worsened breathing problems
  • pain when swallowing or sores/ white patches in your mouth and throat, 
  • ear congestion
  • loss of voice, choking, wheezing,or other breathing problems after using this medication;
  • Headache, blurred vision, tunnel vision, eye pain or redness, or seeing halos around lights;
  • flu symptoms – fever, chills, body aches, unusual tiredness
  • increased thirst, increased urination, dry mouth, fruity breath odor, high blood sugar 
  • low potassium level – leg cramps, constipation, irregular heartbeats, fluttering in your chest, numbness or tingling, muscle weakness or limp feeling; or

 tiredness or weakness, feeling light-headed, nausea, vomiting (signs of a hormonal disorder)

  • Body aches or pain
  • muscle aches
  • pain or tenderness around the eyes and cheekbones
  • sneezing
  • sore throat, cough with mucus,
  • stuffy or runny nose
  • tightness of the chest

Common Symbicort side effects may include:

  • throat pain or irritation;
  • stomach discomfort, vomiting;
  • back pain, headache;
  • flu symptoms; or
  • cold symptoms such as stuffy or runny nose, sneezing, sinus pain, sore throat.
  • white patches in your mouth or throat;

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