Symbicort Formulations
No, Symbicort is not available only as an inhaler—it comes in two distinct inhaler forms: a metered-dose inhaler (MDI) and a dry powder inhaler (DPI). 1
Available Formulations
According to FDA labeling, Symbicort (budesonide/formoterol) is available as:
- Metered-dose inhaler (MDI): A hydrofluoroalkane (HFA)-propelled pressurized metered-dose inhaler supplied with a red plastic actuator and gray dust cap 1
- Dry powder inhaler (DPI): Referenced in multiple clinical guidelines and studies as "Symbicort Turbuhaler" 2, 3
Both formulations contain the same active ingredients—budesonide (an inhaled corticosteroid) and formoterol (a long-acting beta-agonist)—in two strength combinations:
- 80 mcg budesonide/4.5 mcg formoterol
- 160 mcg budesonide/4.5 mcg formoterol
Each strength is available in canisters containing either 60 or 120 actuations 1.
Clinical Considerations
The choice between MDI and DPI depends on patient-specific factors, including:
- Inspiratory flow capability: DPIs require adequate inspiratory flow, which may be compromised in young children or during severe exacerbations 2
- Coordination ability: MDIs require coordination between actuation and inhalation, though this can be overcome with spacer devices 4
- Patient preference: Studies show most patients prefer multi-dose DPIs when offered a choice 2
- Environmental considerations: DPIs have a significantly lower carbon footprint than MDI formulations 2
The evidence indicates that when used correctly, both delivery systems provide equivalent bronchoprotective effects 4. However, prescribing guidance in England has noted that some documents reference "Symbicort as an option, but do not clarify if it is the DPI or MDI version" 2, highlighting the importance of specifying the formulation when prescribing.