Symbicort (Budesonide/Formoterol) Dosage for Asthma Treatment
For asthma treatment, Symbicort should be administered as 2 inhalations twice daily (morning and evening, approximately 12 hours apart) with dosage strength based on asthma severity: 80/4.5 mcg for mild-moderate asthma or 160/4.5 mcg for moderate-severe asthma. 1, 2
Dosage Recommendations by Age Group
Adults and Adolescents (≥12 years):
- Starting dose options:
- Mild to moderate persistent asthma: Symbicort 80/4.5 mcg, 2 inhalations twice daily (total daily dose: 320/18 mcg)
- Moderate to severe persistent asthma: Symbicort 160/4.5 mcg, 2 inhalations twice daily (total daily dose: 640/36 mcg) 1
- Maximum recommended dosage: 160/4.5 mcg, 2 inhalations twice daily
Children (6 to <12 years):
- Recommended dose: Symbicort 80/4.5 mcg, 2 inhalations twice daily 1
Administration Guidelines
Proper technique:
- Shake inhaler well for 5 seconds before each use
- Exhale completely before inhaling
- Hold breath for 10 seconds after inhalation
- Rinse mouth with water after use (without swallowing) to prevent oral candidiasis 1
Priming requirements:
- Prime before first use with 2 test sprays
- Re-prime if not used for >7 days or if dropped 1
Efficacy and Clinical Considerations
- Improvement in asthma control may begin within 15 minutes of first dose, though maximum benefit may take 2 weeks or longer 1
- If inadequate response after 1-2 weeks with 80/4.5 mcg strength, consider increasing to 160/4.5 mcg 1
- For rescue/immediate relief of symptoms, patients should use a short-acting beta2-agonist, not additional doses of Symbicort 1
Important Safety Considerations
- Symbicort is NOT indicated for relief of acute bronchospasm 1
- Never use Symbicort as monotherapy for asthma; the LABA component (formoterol) should always be used with an inhaled corticosteroid 2, 3
- More frequent administration or higher doses than recommended are not advised due to increased risk of adverse effects 1
- Regular assessment of asthma control is essential; increased use of rescue medication indicates inadequate control 2
- Consider reducing the dose after achieving 3 months of good asthma control 2
Comparison with Other Treatment Options
Clinical studies have shown that the combination of budesonide/formoterol provides better asthma control than either component alone 4, 5. The combination has demonstrated:
- Greater improvements in lung function (FEV1 and PEF) compared to budesonide alone 5
- Reduced exacerbation rates compared to higher-dose inhaled corticosteroids alone 6
Common Pitfalls to Avoid
- Failure to rinse mouth after use: Can lead to oral candidiasis (thrush)
- Using as rescue medication: Symbicort is not approved for acute symptom relief
- Stopping inhaled corticosteroids: When adding Symbicort, patients should not discontinue other controller medications without medical advice
- Improper inhaler technique: Ensure proper administration technique for optimal drug delivery
By following these dosage recommendations and administration guidelines, Symbicort can effectively control asthma symptoms, improve lung function, and reduce exacerbation risk in appropriate patients.