What is Symbicort: Uses, Warnings & Interactions

What is Symbicort used for?

Symbicort is an inhaler manufactured by AstraZeneca, and it contains two ingredients. One is called budesonide, a long-acting inhaled corticosteroid used to reduce inflammation. The other ingredient is formoterol, which is a long-acting beta-2 agonist (LABA) used to open airways in the lungs. Symbicort is a brand-name drug. The generic version is called budesonide-formoterol. Symbicort and its generic version are only available by prescription.

In 2006, the Food and Drug Administration (FDA) approved Symbicort for the treatment of asthma in patients 12 years and older. The FDA approved Symbicort for the treatment of COPD in 2009. More recently, the FDA has approved Symbicort as a treatment for asthma in children 6 to 12 years of age.

Symbicort is used as a maintenance treatment for asthma and COPD. Because it is a long-acting bronchodilator, it should never be used as a “rescue” inhaler for COPD exacerbations or asthma attacks (a fast-acting inhaler like albuterol or levalbuterol is used to treat asthma attacks). Rather, a Symbicort inhaler should be used in the morning and evening to help manage symptoms.

Symbicort for asthma

Asthma is an allergic condition. People with asthma are sensitive to certain “triggers” in the air like dust, smoke, or dander. These cause an allergic reaction characterized by irritation and swelling of the lungs’ airways. The airways narrow, resulting in chest pain, shortness of breath, coughing, and wheezing. Symbicort helps alleviate symptoms of asthma by reducing swelling and causing the airways to expand and remain open. Symbicort inhaler is used twice a day for asthma. Regular use will improve patients’ baseline symptoms. Symbicort is not a rescue inhaler for treating asthma attacks. However, taking Symbicort regularly causes people to have fewer asthma attacks.

Symbicort is only prescribed after patients have tried other medications for asthma. The first medication doctors prescribe is usually albuterol. If that does not control symptoms, a healthcare provider will likely add a short-acting inhaled corticosteroid (ICS) like Flovent HFA (fluticasone) or QVAR (beclomethasone). If asthma control is not achieved with two medications, a doctor may prescribe Symbicort.

Symbicort for COPD

Chronic obstructive pulmonary disease is another lung disease characterized by swollen and damaged airways. COPD is different from asthma because the swelling and irritation is not caused by sensitivity to allergens. Instead, it is caused by long-term exposure to irritating chemicals such as cigarette smoke. There are two types of COPD: chronic bronchitis and emphysema.

Chronic bronchitis develops when mucus membranes that line the airways (called bronchial tubes) become inflamed. This causes extra mucus to be produced. The bronchial tubes become crowded with extra mucus, causing shortness of breath. Bronchitis is characterized by a hacking cough that usually brings up mucus. Add to that wheezing, sore throat, and bacterial respiratory infections.

Emphysema is characterized by damaged air sacs in the lungs. These air sacs normally stretch like a balloon when the lungs fill with air, and then deflate to release air out of the body. But when these sacs become damaged by irritants such as cigarette smoke, they lose their proper shape and elasticity. As a result, air does not easily move in and out of the lungs. People with emphysema experience breathlessness, wheezing and a productive cough.

Symbicort treats bronchitis and emphysema by reducing inflammation in the lungs and opening the airways. 

Before using Symbicort to treat COPD, doctors prescribe other treatments to see if they will control the patient’s symptoms. Treatments that come before Symbicort might include Ventolin HFA (albuterol), Combivent (albuterol with ipratropium), Spiriva (tiotropium), or other inhaled medications. If a patient still has worsening symptoms, the doctor may prescribe Symbicort.

While Symbicort is not used to treat COPD exacerbations, it does reduce the number of exacerbations in patients who take Symbicort 160/45 mcg twice daily.

How does Symbicort work?

Symbicort has two active ingredients that work in different ways to open airways. Budesonide is an inhaled corticosteroid (more specifically, it is a glucocorticoid), which reduces inflammation in the lungs. Formoterol fumarate dihydrate is a beta-2 adrenergic agonist that causes certain types of muscles to relax.

Smooth muscles control tubes that carry air into the lungs. These tubes are called bronchial airways. When the muscles in these tubs contract, the airways become narrow. Formoterol is a beta-agonist that attaches to these muscle cells, signaling them to relax. Consequently, the tubes become wider, allowing for more airflow.

Inflammation can narrow the airways by making the walls of the tube swollen. Swollen airways have less space through which air can travel. Additionally, there are mucous membranes on the walls of the tubes. Inflammation causes the mucus membranes to make too much mucus, which clogs the airways. Inflammation damages tissue, too. In the case of emphysema, inflammation injures the air sacs until they become misshapen and no long stretch properly. Thankfully, budesonide and formoterol decrease inflammation by reducing the activity of molecules involved in the body’s allergic and nonallergic inflammatory pathways.

Symbicort continues its effects for a long time after being inhaled. This creates a sustained benefit in lung function. Patients taking Symbicort report an improvement in baseline day and night symptoms. Research has demonstrated that patients taking Symbicort have fewer COPD flare-ups per year and fewer asthma attacks per year.

What form(s) does Symbicort come in

• Powder

• Liquid Under Pressure

What are common Symbicort doses?

• Inhaler 6GM of 160-4.5MCG/ACT

• Inhaler 6.9000000953674316GM of 80-4.5MCG/ACT

• Inhaler 10.199999809265137GM of 160-4.5MCG/ACT

• Inhaler 10.199999809265137GM of 80-4.5MCG/ACT