What is Symbicort?
Symbicort is a combined anti-inflammatory and bronchodilator drug for inhalation use. It contains formoterol and budesonide, which have different mechanisms of action and have an additive effect in reducing the frequency of exacerbations of asthma. The special properties of budesonide and formoterol make it possible to use their combination at the same time as maintenance therapy and for the relief of seizures, or as maintenance therapy for asthma.
Indications for use
- Bronchial asthma, adequately controlled by inhaled β2-adrenomimetics and glucocorticosteroids (GCS) of long-acting, or not sufficiently controlled by inhaled β2-adrenomimetics and short-acting GCS;
- Symbicort inhaler in the dosage of 80/4.5 mcg and 160/4.5 mcg can be used for the relief of seizures and as maintenance therapy;
- Chronic obstructive pulmonary disease (COPD) – symptomatic treatment of severe disease with forced expiratory volume (FEV) less than 1/2 of the estimated level, as well as regularly repeated exacerbations in history, if signs of the disease persist despite treatment with long-acting bronchodilators.
Mode of application and dosage
The drug is administered by inhalation of microscopic doses of budesonide and formoterol using an inhaler. The use of the inhaler is explained in detail in the attached instruction manual.
The recommended dosage is 1-2 doses 2 times a day.
For timely relief of seizures, the patient should have a separate inhaler with a short-acting β2-agonist stimulator.
The maximum number of inhalations per day does not exceed 8, but sometimes, for a short time, it is possible to increase the daily number of inhalations to 12. Patients who use more than 8 inhalations per day should consult their doctor to review the therapy.
It is desirable to use the minimum effective dose, inhaling 1 dose 1 time per day.
To make an inhalation:
- exhale the air from the lungs;
- press the buttons of the inhaler while taking a deep breath;
- hold your breath for as long as possible.
If the patient had nighttime attacks of bronchial asthma earlier, then this 1 dose is inhaled before going to bed. If daily attacks are more frequent, the dose is inhaled in the morning.
After inhalation, rinse the mouth with water to avoid oral candidiasis.
Elderly patients and patients with impaired renal or hepatic function do not need any special dosage adjustment.
Side effects
Symbicort can cause the following adverse reactions:
- oral candidiasis;
- bruises;
- muscle spasms, arthralgia, myalgia, limb fractures;
- allergic reactions – angioedema, rash, shortness of breath, anaphylactic shock;
- headache, trembling of the extremities;
- cataracts, glaucoma;
- tachycardias, arrhythmias;
- oppression of the adrenal glands, reducing bone mineralization, growth retardation in children;
- hypokalemia, hyperkalemia, hyperglycemia;
- nausea, dyspeptic symptoms;
- nervousness, insomnia.
Contraindications
- Absolute: children under 6 years of age; children under 12 years of age (for dosage budesonide 320 mcg + formoterol 9 mcg); hypersensitivity to any of the components of the drug;
- Relative (used with caution): active or inactive forms of tuberculosis; viral, bacterial or fungal infections of the respiratory system; severe arterial hypertension; diabetes; thyrotoxicosis; aneurysm of any localization; uncontrolled hypokalemia; pheochromocytoma; idiopathic hypertrophic subaortic stenosis; prolongation of the QT interval; severe heart failure; coronary heart disease; tachyarrhythmia.
Drug interaction
Symbicort inhaler can be used only after individual consultation with a specialist. There are some medications that can interact with budesonide and formoterol and weaken/change their action:
- beta-adrenergic blocking agents weaken the action of formoterol;
- simultaneous use with Disopyramide, Procainamide, Quinidine, antihistamines, phenothiazines, MAO inhibitors and tricyclic antidepressants increases the risk of developing ventricular arrhythmias;
- ethyl alcohol, L-thyroxin, L-dopa, oxytocin pathologically reduce the cardiovascular tolerance of beta-2-sympathomimetics;
- MAO inhibitors, furazolidone and procarbazine may cause an acute allergic reaction;
- systemic use of GCS in the form of inhalation is observed when taking higher dosages of the drug for a long time;
- interactions with other asthma medications are not revealed.
It’s recommended to consult a specialist before you buy Symbicort inhaler.
Special instructions
Abrupt withdrawal of the drug is not recommended. If treatment is no longer required, reduce the dose gradually. Symbicort at a dosage of 80/4.5 mcg and 320/9 mcg is not intended for the treatment of severe bronchial asthma. A maintenance dose of the drug should be taken regularly, even in the absence of symptoms of the disease.
Symbicort inhaler is not recommended for use in exacerbation or significant deterioration in the course of bronchial asthma. During treatment, glucose concentration should be monitored in people with diabetes. One dose of the drug contains less than 1 mg of lactose, which is not critical for patients with lactose intolerance.
The medication does not affect the ability to drive a car or other vehicles and perform work associated with increased concentration. However, some side effects of the drug (for example, dizziness) should be taken into account and caution should be exercised during their development.
This medication is not prohibited to use during pregnancy if the use of the mother outweighs the potential threat to the fetus. The drug is prescribed to pregnant women solely for medical reasons with regular monitoring of the woman’s condition by a competent specialist. Fetal pathologies were not observed, negative reviews are completely absent.