Is Symbicort (budesonide and formoterol) used to treat asthma?

Is Symbicort Used to Treat Asthma?

Yes, Symbicort (budesonide/formoterol) is FDA-approved and guideline-recommended for the treatment of asthma in adults and children 6 years and older who are not adequately controlled on inhaled corticosteroids alone. 1

Primary Indication and Patient Population

• Symbicort is specifically indicated for asthma control and prevention of symptoms such as wheezing in adults and children ages 6 and older 1
• The combination is recommended for patients with moderate to severe persistent asthma requiring step 3 care or higher who remain symptomatic on low-to-medium dose inhaled corticosteroids alone 2
• Symbicort should NOT be used in patients whose asthma is already well controlled on low-to-medium dose inhaled corticosteroids alone 1

Mechanism and Rationale for Combination Therapy

• Symbicort combines two complementary mechanisms: budesonide (an inhaled corticosteroid) decreases airway inflammation, while formoterol (a long-acting beta-agonist) provides bronchodilation lasting at least 12 hours 2, 1
• The combination of budesonide/formoterol is more effective than doubling the dose of inhaled corticosteroids alone for moderate to severe persistent asthma 3, 2
• Adding a long-acting beta-agonist like formoterol to inhaled corticosteroids is the preferred treatment strategy over increasing corticosteroid doses in adults and children older than 5 years 3

Standard Dosing Regimen

• For moderate to severe asthma in adults and children ≥12 years, the standard dose is budesonide/formoterol 160/4.5 mcg, two inhalations twice daily 2
• For children 5-11 years with moderate to severe asthma, lower doses may be appropriate based on age and severity 2
• The medication is administered approximately 12 hours apart (twice daily) 2

Critical Safety Considerations and Common Pitfalls

• FORMOTEROL (THE LABA COMPONENT) MUST NEVER BE USED AS MONOTHERAPY FOR ASTHMA CONTROL - patients taking LABAs without inhaled corticosteroids have an increased risk of death from asthma problems 2, 1
• Symbicort is NOT a rescue inhaler and should not be used to treat sudden severe breathing problems - patients need a separate short-acting beta-agonist for acute symptom relief 1
• Frequent use of rescue medication (>2 days/week) indicates inadequate asthma control and requires treatment reassessment 2
• Children and adolescents taking LABA medicines may have an increased risk of hospitalization for asthma problems 1

Unique SMART Therapy Option

• Formoterol's rapid onset of action (within minutes) makes it suitable for Single Maintenance And Reliever Therapy (SMART) regimens, where budesonide/formoterol can be used both as maintenance therapy and for symptom relief 2
• This approach provides immediate additional anti-inflammatory medication in response to asthma symptoms and has been shown to reduce severe asthma exacerbations compared to conventional regimens 4

Monitoring and Follow-Up

• Assess symptom control, exacerbation frequency, and lung function at regular intervals 2
• Monitor for potential side effects including oral thrush, dysphonia, and cough 2
• Patients should rinse their mouth after inhalation to reduce local side effects 2
• When asthma is well controlled, titrate to the lowest effective dose 2, 1