How does the Symbicort Turbohaler work?
The Symbicort inhaler gets to work slowly, which is why it is very important you use the treatment each day – even at times when you feel that your breathing is fine. You can use it two ways: either as a "preventer" inhaler only, to be used every day alongside a separate fast-acting "reliever" inhaler; or as both a "preventer" AND a "reliever" -- where the Symbicort is used on a regular daily basis, and also on an as-required basis when your breathing needs it. You should have spoken with your doctor about which of these approaches is the right one for you, and have discussed the recognised step-wise approach to the treatment of asthma.
Symbicort inhalers are prescribed for people whose asthma has not been controlled well enough by using a regular steroid inhaler, together with a short-acting reliever inhaler whenever required; or for people who are already well controlled using a regular steroid inhaler with a separate regular long-acting reliever (bronchodilator), because Symbicort combines both types of medicine into one inhaler.
While you’ve probably already been given advice from your doctor or asthma nurse about what you should do in the case of an asthma attack, if you’re unsure, it’s worth contacting them to discuss it again.
How to use the Symbicort Turbohaler
Symbicort (budesonide and formoterol) Turbohalers are available in three different strengths:
- "Symbicort Turbohaler 100/6", containing budesonide 100 micrograms and formoterol fumarate dihydrate 6 micrograms, per inhalation.
- "Symbicort Turbohaler 200/6", containing budesonide 200 micrograms and formoterol fumarate dihydrate 6 micrograms, per inhalation.
- "Symbicort Turbohaler 400/12", containing budesonide 400 micrograms and formoterol fumarate dihydrate 12 micrograms, per inhalation.
The right strength for you will be determined by the doctor based on the severity of your asthma symptoms. For use as a "preventer" only, the normal dose is one or two inhalations twice a day. However, sometimes patients will be moved on to a once-daily dosage. For use as a "preventer" and a "reliever", for adults only, the dose is the same as above, but you can also inhale an extra dose of Symbicort as required, when your breathing worsens – up to a maximum of six inhalations on any occasion. You should not need to use more than eight inhalations a day – if you do, please seek medical advice.
Symbicort is not recommended for children under 6 years old.
If your asthma symptoms are bad now, or get worse in the future, talk to your doctor or asthma nurse. If your asthma is not very well controlled then there is likely to be a better way of managing it.
You should be confident you’re using your inhaler in the right way. Your doctor, pharmacist or asthma nurse should have shown you how it is done, but it’s always worthwhile double-checking you’re doing it right to make sure the inhaler is performing as effectively as possible for you. You can find a useful guide at the Asthma UK website showing techniques for the most common types of inhalers.
It’s always best to rinse your mouth out with water or brush your teeth after each use of the inhaler to avoid some of the powdered medicine from the inhaler getting left behind in your mouth. If this happens and you don’t rinse, you’ve got a higher chance of contracting a mouth infection.
If you are using a high dose of this or any other inhaler containing a steroid, you shouldn’t stop using it suddenly without having talked to your doctor first, as this can cause side effects and make you feel unwell.
Is Symbicort suitable for me?
There are some situations in which the Symbicort (budesonide and formoterol) Turbohaler should be used with caution or may not be recommended at all – this is the same with all medicines. You might be advised against this inhaler if, for example, you are pregnant or breastfeeding. It’s not always recommended in children or adolescents, people who notice that their asthma is getting worse, people who have (or have had) pulmonary tuberculosis or any fungal or viral infections of the airways, and people with problems with their heart rhythm. Similarly, it’s not always advised for people with reduced liver function or cirrhosis, diabetes, and anyone with an allergy to budesonide or formoterol, or any of the inactive ingredients.
Please warn the online doctor if you are taking any other medicines, either from your doctor or purchased from a pharmacy. Medicines that the doctor should be made aware of include beta-blockers (including beta-blocker eye drops, often used for glaucoma), quinidine, disopyramide, procainamide, phenothiazines, levodopa, digoxin, anti-depressants, ketoconazole, itraconazole, ritonavir, and steroids.
Be honest about your asthma and general health during the consultation to ensure the doctor is provided with all the information required to assess your individual situation, and the appropriateness of any recommended treatments for you.
What are the side effects of the Symbicort Turbohaler?
You should be advised that Symbicort can cause side effects. Reported side effects include oral thrush (which can be minimised by rinsing the mouth after each inhalation), hoarseness of the voice, headache, tremor, palpitations, and a cough or throat irritation. Meanwhile, the less common side effects that you may experience include skin rashes, dizziness, lowered potassium levels, anxiety or depression or behavioural changes (mostly in children), and an unexpected increase in wheezing after using the inhaler. Should you experience an increase in wheezing after use, you need to use a fast-acting "reliever" inhaler immediately and seek medical advice.
Because budesonide is a steroid, if it is used at high doses over long periods of time, it can cause steroid-like side effects in the body, which are described in more detail in the product leaflet.
Please read the patient leaflet provided in the pack before starting treatment of Symbicort (budesonide and formoterol) Turbohaler – this will give you all the information you need regarding side effects and all other important information. The leaflets can also be viewed online below: