What is the use of Symbicort (Budesonide and Formoterol)?

From the Guidelines

Symbicort is a recommended medication for the treatment of asthma and chronic obstructive pulmonary disease (COPD), as it combines the anti-inflammatory effects of budesonide with the bronchodilatory effects of formoterol, a long-acting beta-agonist 1.

Key Points

• For asthma, Symbicort is typically prescribed as 1-2 inhalations twice daily, with common strengths being 80/4.5 mcg or 160/4.5 mcg per inhalation, as part of a long-term control strategy that aims to reduce inflammation and prevent exacerbations 2.
• The budesonide component reduces inflammation in the airways, which is a key aspect of managing asthma, as it attenuates the underlying inflammation characteristic of the disease 2.
• Formoterol, the long-acting beta-agonist in Symbicort, helps relax airway muscles for improved breathing, and its use in combination with an inhaled corticosteroid like budesonide is preferred for moderate or severe persistent asthma 2.
• Symbicort should be used regularly as prescribed, not as a rescue inhaler for sudden symptoms, and patients should rinse their mouth after each use to prevent thrush (oral fungal infection) 2.
• Common side effects include throat irritation, headache, and mild tremors, but the medication is generally well-tolerated, with a safety profile that supports its long-term use 1.

Clinical Considerations

• The choice of Symbicort as a treatment option should be based on the severity of the patient's asthma or COPD, as well as their response to initial therapy and any history of exacerbations 2, 1.
• Regular monitoring of lung function and symptoms is essential to assess the effectiveness of Symbicort and to adjust the treatment plan as needed 2.
• Patients should be educated on the proper use of Symbicort, including the importance of regular use and the need to seek medical attention if symptoms worsen or if they experience any side effects 2, 1.

From the FDA Drug Label

Inform patients of potential worsening of existing tuberculosis, fungal, bacterial, viral, or parasitic infections, or ocular herpes simplex.

Hypercorticism and Adrenal Suppression: Advise patients that budesonide and formoterol fumarate dihydrate may cause systemic corticosteroid effects of hypercorticism and adrenal suppression

Additionally, inform patients that deaths due to adrenal insufficiency have occurred during and after transfer from systemic corticosteroids.

Patients should taper slowly from systemic corticosteroids if transferring to budesonide and formoterol fumarate dihydrate

The main ingredients of Symbicort are budesonide (an inhaled corticosteroid) and formoterol (a long-acting beta2-adrenergic agonist).

• Budesonide helps to decrease inflammation in the lungs.
• Formoterol helps the muscles around the airways in the lungs stay relaxed to prevent symptoms such as wheezing, cough, chest tightness, and shortness of breath. Symbicort is used for asthma and COPD as follows:
• Asthma: Symbicort is used to control symptoms of asthma, and prevent symptoms such as wheezing in adults and children ages 6 and older.
• COPD: Symbicort is used long-term, as 2 inhalations 2 times each day, to improve symptoms of COPD for better breathing and to reduce the number of flare-ups. Key warnings:
• Do not use Symbicort to treat sudden severe symptoms of asthma or COPD.
• If you are allergic to any of the ingredients in Symbicort.
• Symbicort contains formoterol, which can increase the risk of death and hospitalizations from asthma problems when used alone.
• Symbicort is not for adults and children with asthma who are well controlled with an asthma-control medicine, such as a low to medium dose of an ICS.
• It is not known if Symbicort is safe and effective in children less than 6 years of age with asthma. 3 4

From the Research

Symbicort Overview

• Symbicort is a combination inhaler containing budesonide (an inhaled corticosteroid) and formoterol (a long-acting beta2-agonist) 5, 6, 7, 8.
• It is used for the maintenance and reliever therapy in patients with asthma, and has been shown to improve asthma control, reduce exacerbations, and decrease reliever medication use 5, 6, 7.

Adjustable Maintenance Dosing

• Adjustable maintenance dosing with Symbicort has been shown to be effective in improving asthma control and reducing exacerbations compared to fixed-dose regimens 5, 7, 8.
• This approach allows patients to adjust their maintenance dose according to their asthma severity, which can lead to better asthma control and reduced medication use 5, 8.

Comparison to Other Therapies

• Symbicort has been compared to other combination inhalers, such as salmeterol/fluticasone, and has been shown to be as effective or more effective in improving asthma control and reducing exacerbations 5, 7.
• Symbicort has also been used in patients with COPD and phenotypic features of asthma, and has been shown to improve lung function, reduce exacerbations, and improve health-related quality of life compared to dual therapies 9.

Benefits and Advantages

• Symbicort offers a convenient and effective treatment option for patients with asthma, allowing for both maintenance and reliever therapy in a single inhaler 6, 7.
• The adjustable maintenance dosing approach can lead to better asthma control, reduced medication use, and improved patient outcomes 5, 7, 8.