What is the recommended daily dosage of Symbicort (budesonide/formoterol) for an adult?

Recommended Dosage of Symbicort for Adults

The maximum recommended dosage of Symbicort for adults is 2 inhalations twice daily (4 total puffs per day) of the prescribed strength. 1

Dosage Information by Strength

• Symbicort 80/4.5 mcg:

  • Recommended dosage: 2 inhalations twice daily (4 total puffs per day) 1
  • Used for patients 12 years and older with mild to moderate asthma 1
  • Also approved for children 6 to less than 12 years at this strength 1

• Symbicort 160/4.5 mcg:

  • Recommended dosage: 2 inhalations twice daily (4 total puffs per day) 1
  • Used for patients 12 years and older with moderate to severe asthma 1
  • Also the recommended strength for COPD patients 1

Important Safety Considerations

• Do not exceed the recommended dosage: More frequent administration or a higher number of inhalations is not recommended as patients are more likely to experience adverse effects with higher doses of formoterol 1

• Do not use additional LABA: Patients using Symbicort should not use additional long-acting beta2-agonists (LABA) for any reason 1

• Rescue medication: If asthma symptoms arise between doses, an inhaled short-acting beta2-agonist should be used for immediate relief, not additional Symbicort 1

Efficacy and Onset of Action

• Improvement in asthma control can occur within 15 minutes of beginning treatment 1
• Maximum benefit may not be achieved for 2 weeks or longer after beginning treatment 1
• Individual patients will experience variable time to onset and degree of symptom relief 1

Treatment Adjustments

• For patients who do not respond adequately to the starting dose after 1-2 weeks of therapy with Symbicort 80/4.5, replacement with Symbicort 160/4.5 may provide additional asthma control 1

• If a previously effective dosage regimen fails to provide adequate control, the therapeutic regimen should be re-evaluated and additional therapeutic options should be considered 1

Maintenance and Reliever Therapy

• Some studies have evaluated using Symbicort as both maintenance and reliever therapy (SMART approach), which may reduce overall medication use while maintaining asthma control 2
• However, this approach is not included in the FDA-approved labeling for Symbicort in the US 1

Long-term Safety

• Symbicort has demonstrated good tolerability in long-term studies, even at higher doses 3
• In a 52-week study, Symbicort was delivered at up to double the maximum dose (640/18 mcg twice daily) and demonstrated a safety profile similar to budesonide alone 3

Remember that exceeding the recommended dosage of 2 inhalations twice daily is not advised due to potential adverse effects from the formoterol component.