From the Guidelines
Symbicort is a recommended treatment option for bronchitis, particularly for patients with chronic bronchitis and a history of exacerbations, as it combines an inhaled corticosteroid (budesonide) and a long-acting beta-agonist (formoterol) to reduce inflammation and bronchospasm 1.
Treatment Overview
When using Symbicort for bronchitis, it is essential to follow the prescribed dosage and administration instructions. The typical dosage for Symbicort is 160/4.5 mcg, two inhalations twice daily, and treatment duration depends on symptom severity. For chronic bronchitis, especially as part of COPD, longer-term use may be necessary, often at the same dosage.
Benefits and Side Effects
Symbicort works by reducing inflammation in the bronchial tubes while simultaneously relaxing the muscles around the airways, making breathing easier. It's particularly useful when bronchitis involves both inflammation and bronchospasm. However, antibiotics may be needed if the bronchitis is bacterial in origin. Side effects may include throat irritation, hoarseness, and oral thrush, and it is crucial to rinse the mouth after each use to prevent thrush.
Key Considerations
- Symbicort is more effective than individual components in improving lung function and health status and reducing exacerbations in patients with exacerbations and moderate to very severe COPD 1.
- Regular treatment with inhaled corticosteroids increases the risk of pneumonia, especially in those with severe disease 1.
- Triple inhaled therapy of ICS/LAMA/LABA improves lung function, symptoms, and health status and reduces exacerbations compared with ICS/LABA or LAMA monotherapy 1.
- In patients with chronic bronchitis, severe to very severe COPD, and a history of exacerbations, a PDE4 inhibitor improves lung function and reduces moderate and severe exacerbations 1.
Patient Guidance
When using Symbicort, it is essential to:
- Use the inhaler as directed
- Rinse the mouth after each use to prevent thrush
- Monitor for side effects, such as throat irritation, hoarseness, and oral thrush
- Follow up with a healthcare provider to adjust treatment as needed.
From the FDA Drug Label
1.2 Maintenance Treatment of Chronic Obstructive Pulmonary Disease BUDESONIDE AND FORMOTEROL FUMARATE DIHYDRATE INHALATION AEROSOL 160/4. 5 is indicated for the maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD) including chronic bronchitis and/or emphysema.
Symbicort is indicated for the maintenance treatment of chronic bronchitis as part of COPD management, specifically the 160/4.5 strength, to reduce exacerbations of COPD 2 2.
From the Research
Symbicort for Bronchitis
- Symbicort, a combination of budesonide and formoterol, is used in the management of chronic obstructive pulmonary disease (COPD) and asthma 3, 4.
- The US Food and Drug Administration has approved the combination of budesonide/formoterol for maintenance management of stable COPD 3.
- Studies have shown that budesonide/formoterol reduces sputum eosinophils and improves symptoms in the treatment of out-patient COPD exacerbations 5.
- Budesonide/formoterol has been found to be more effective than fluticasone/salmeterol in preventing exacerbations in COPD patients 6.
Efficacy of Symbicort in COPD
- Budesonide/formoterol has been shown to improve lung function, reduce symptoms, and prevent exacerbations in COPD patients 3, 5, 6.
- The combination of budesonide and formoterol has been found to be effective in reducing the risk of mild exacerbations and improving peak expiratory flow (PEF) in adults with moderate persistent asthma 4.
- Adjustable maintenance dosing with budesonide/formoterol has been associated with a lower overall dosage and reduced risk of exacerbations compared to fixed dosing 4.
Treatment of Chronic Bronchitis
- Chronic bronchitis is a phenotype of COPD, characterized by chronic cough and sputum production, and is often difficult to treat 7.
- Interventional bronchoscopic procedures, such as metered cryospray and bronchial rheoplasty, have been proposed as novel therapeutic approaches for chronic bronchitis 7.
- However, there is limited evidence on the use of Symbicort specifically for the treatment of chronic bronchitis, and further research is needed to determine its efficacy in this context.