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Drug Info

How long does Symbicort stay in your system?

It stays in your system for 24 hours or more, depending on these factors
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By | Apr. 21, 2025 Medically reviewed by Jessica Swirble, Pharm.D.
An inhaler and a clock | How long does Symbicort stay in your system?

Key takeaways

  • Symbicort is an inhaler medication that combines budesonide and formoterol fumarate to manage asthma and COPD.

  • This medication can stay in the body for 1 or 2 days before it’s completely eliminated; however, its benefits may last longer.

  • Age, liver function, and medication interactions are some factors that can influence how long it lasts.

In this article:

Symbicort is a drug that healthcare professionals prescribe to treat asthma and chronic obstructive pulmonary disease (COPD). It contains two active ingredients: budesonide and formoterol fumarate dihydrate. 

Budesonide is a long-acting inhaled corticosteroid that helps relieve inflammation in the lungs and airways, while formoterol is a long-acting beta-2 agonist (LABA) that helps keep the airways open (a bronchodilator) by relaxing the smooth muscles around them. A combination of budesonide and formoterol can remain in your system for up to 24 hours or more.

It is important to note that Symbicort is a maintenance medicine that needs to be taken continuously over a long period of time to manage asthma symptoms and flare-ups. The United States Food and Drug Administration (FDA) has not approved it as a quick-relief medicine for acute constriction of the airway muscles (bronchospasm) or sudden breathing problems.

How long does Symbicort stay in your system?

The time Symbicort stays in your system depends on the half-life of budesonide and formoterol. A drug’s half-life is the time it takes for the concentration of the starting dose to reduce by half in the body.

“Budesonide has a half-life of about 4.7 hours, while formoterol’s half-life is around 7.9 hours. And in general, it takes about five half-lives for a drug to clear from the body,” says Edmond Hakimi, DO, Medical Director at Wellbridge. This means that budesonide is eliminated in roughly 24 hours, while formoterol takes around 40 hours.

Dr. Hakimi, however, notes that even after the drugs are eliminated, their effects—such as reduced lung inflammation—can last longer. Also, factors such as age and metabolism can influence the duration the medication lasts in each individual.  

Factors that influence how long Symbicort stays in your system

The following factors may affect how long Symbicort stays in your system.

Metabolism

Metabolism is the process by which drugs (and even foods) are broken down so they can be excreted after they have been absorbed and distributed throughout the body.

Drug metabolism can affect drug concentrations in the blood. People with slower metabolisms may retain medications longer in their systems, which can lead to a toxic buildup of active drugs or their metabolites.

Dr. Hakimi explains that if someone metabolizes Symbicort too quickly, they might not get the full benefit, while slow metabolizers could experience more side effects.

Liver function

The liver has enzymes that convert some drugs from inactive to active forms. This organ is significantly involved in the metabolism of many drugs, including budesonide and formoterol. 

“Since budesonide and formoterol are processed through the liver, people with liver disease or reduced liver function may take longer to clear the medication from their system,” says Dr. Hakimi. 

Age

Age also affects drug metabolism. The rate of drug metabolism slows down as people age, and according to Dr. Hakimi, older adults may retain Symbicort in their system for longer because of this. 

Medication interactions

Drug-drug interactions can also affect metabolism, causing an abnormal increase or decrease in the blood concentrations of a drug. Dr. Hakimi says some drugs, like ketoconazole (an antifungal) and ritonavir (an antiretroviral for HIV), may slow down the breakdown of budesonide and formoterol, making them last longer than expected.

To ensure optimal efficacy, it is vital that you use Symbicort precisely as prescribed, avoid missing doses, and inform your healthcare provider of any other medications you might be taking. Regular follow-ups with a healthcare provider can help monitor how well the medication works and whether adjustments are needed.

Side effects and risks of Symbicort

Common side effects of Symbicort include:

  • Headache
  • Throat irritation
  • Thrush
  • Vomiting
  • Back pain
  • Nasal congestion
  • Gastrointestinal discomfort

The medication can also cause more serious side effects like:

  • Chest pain and irregular heartbeat
  • Lower respiratory tract infection
  • High blood pressure
  • Allergic reaction
  • Immune system effects and increased risk of infections like sinusitis
  • Eye problems like cataracts and glaucoma
  • Increased risk of osteoporosis (a bone condition characterized by a decrease in bone density and thickness)
  • Pneumonia
  • Decrease in blood potassium levels (hypokalemia)
  • Increase in blood sugar levels

Notably, Symbicort can interact with certain drugs, causing reduced efficacy and increased risk of side effects. According to Brian Pacanowski, Pharm.D., Assistant Professor of Clinical Sciences and Director of Experiential Education at High Point University’s Fred Wilson School of Pharmacy, there are four drug classes known to have adverse drug interactions with Symbicort:

  • Inhibitors of cytochrome P4503A4 (CYP3A4): CYP3A4 is an important enzyme that helps break down many corticosteroids, like budesonide. Medications that interfere with this enzyme could cause delayed breakdown of budesonide, leading to more systemic exposure to it. This can increase the risk of side effects like adrenal insufficiency. Such medications include ketoconazole, itraconazole, clarithromycin, indinavir, nefazodone, and ritonavir.
  • Monoamine oxidase inhibitors and tricyclic antidepressants: Symbicort should be administered with caution along with or within two weeks of discontinuing a monoamine oxidase inhibitor (MAOI), as this may lead to drops or increases in blood pressure, pulse irregularities, and/or arrhythmias. Caution should also be exercised when Symbicort is used with tricyclic antidepressants, as this drug combination has not been adequately studied.
  • Beta blockers: Beta blockers may produce bronchospasm in patients with asthma; however, certain cardio-specific beta blockers may be used in conjunction with Symbicort if there are no suitable alternatives.
  • Non-potassium-sparing diuretics: EKG (electrical activity of the heart) changes and hypokalemia caused by these medications can be worsened by Symbicort.  Examples include furosemide and hydrochlorothiazide. 

How long does it take for side effects to go away after stopping Symbicort?

How long side effects last after stopping Symbicort depends on the individual as well as the specific symptoms. “Since budesonide and formoterol clear from the system within 1-2 days, most short-term side effects, like jitteriness, headache, or mild throat irritation, should subside within that timeframe,” Dr. Hakimi says. However, some other effects, such as hoarseness or mild oral thrush, might take longer to resolve. 

Optimal use of Symbicort

Symbicort is not a tablet. It is a medication designed to be inhaled and comes as a metered-dose inhaler. Knowing how to use it correctly is important for maximizing its benefits and minimizing side effects.

Dr. Hakimi explains this step-by-step guide for using Symbicort for the best result: 

  • Start by shaking the Symbicort inhaler well for about 5 seconds before each use. 
  • Exhale fully to empty your lungs before bringing the inhaler to your mouth. 
  • Place the mouthpiece between your lips, forming a tight seal, and take a slow, deep breath while pressing down on the inhaler to release the medication. 
  • Hold your breath for about 10 seconds before exhaling to allow the medication to reach deep into your lungs. 
  • If a second puff is needed, wait 30 seconds before repeating the process.

Proper inhaler technique ensures the medication is delivered effectively, improving symptom control and reducing the risk of complications. If you are unsure about how to take Symbicort correctly, you can always speak to your healthcare provider or pharmacist. You can suggest that they watch you use the inhaler while they give you feedback or corrections.

After using Symbicort, it is important to rinse your mouth (or gargle) with water and spit it out. This helps remove part of the inhaled drug that may be deposited in your mouth and pharynx and helps prevent mouth thrush (a fungal infection) and other localized side effects like hoarseness.

The usual dosage of Symbicort is two inhalations twice daily, and it’s important that you do not use it with any other medication that also contains LABA. If your symptoms do not get better or get worse when using Symbicort, it’s best to seek immediate medical attention, as this inhaler does not serve as a substitute for a rescue inhaler. 

Symbicort alternatives

There are several drug alternatives to Symbicort that contain both a corticosteroid and a long-acting beta agonist (LABA). “These can be prescribed if the prescriber and/or patient prefers, or if the patient’s insurance does not provide good coverage for Symbicort,” says Dr. Pacanowski. A few of these include:

Dr. Pacanowski further explains that while Symbicort is not known to cause typical withdrawal symptoms that are associated with drugs of dependency, stopping the medication without replacement therapy, especially abruptly, may result in the worsening of the underlying asthma or COPD symptoms it was managing.

Hence, it is important to discuss with your healthcare provider about how this medication is working for you. If there is a need to stop or switch to another alternative, they will offer medical advice and help you make the right treatment decision.