by Dr. Manura Nanayakkara

Created on: July 18, 2010   Last Updated: July 19, 2010

Symbicort is an inhalation preparation, prescribed in bronchial asthma and COPD (Chronic obstructive pulmonary disease) patients. It consists of a steroid and a long acting bronchodilator. Steroid is Budesonide. Bronchodilator is Formeterol. These inhalation preparations have minimal side effects compared to the oral preparations.

How it acts?

In asthma and COPD, inflammation of the smaller airways block the airflow and causes symptoms. Inflammation causes edema and narrowing of the airways.

Steroids like Budesonide reduce the airway inflammation associated with bronchial asthma. They are prescribed to treat and to prevent asthma attacks. Inhalation steroids are preferred to oral in the long term treatment, because oral steroids need to go through the blood to reach the lungs. But inhalation steroids directly go into the lungs, bypassing other organs.

Formeterol is a long acting bronchodilator in the selective beta agonist family. They dilate already narrowed small airways in the lung. This gives a rapid response. Due to this bronchodilators are used to treat bronchial asthma. But longer acting drugs are prescribed to prevent attacks.

Symbicort is usually indicated in patients who have a poor response to long term inhalation steroids alone.

How it is used?

Symbicort is available as dry powder capsules designed for the Turbohaler (inhaler device). Usage instructions should be taken from the healthcare professionals.

What the doctor should know before prescription?

The doctor should know your complete medical history including over the counter medications you are on, before prescribing Symbicort. If you have hyperthyroidism, heart disease, hypertension, liver disease or diabetes mellitus then you need to discuss with your doctor before taking Symbicort. This medication is known to lower blood potassium levels. So doctors will monitor blood potassium levels in severe asthma.

Before prescribing this, the doctor should know whether you are pregnant or nursing as well.

What are the side effects?

Side effects due to the steroid Budesonide

High doses of inhaled steroids suppress natural steroid production. Due to this suppression you may need increased doses of steroids during illnesses.

So you should not stop the medication without consulting your doctor. Also you should have a Steroid card with you all the time if you are on high dose of steroids. This card is needed inform health care professionals that you are on steroids, if you are found unconscious.

High doses of inhaled Budesonide are associated with increased chance of having respiratory tract infections. Bone mineral density may be reduced, so patients may get osteoporosis.

Horseness of the voice and oral fungal infections can occur with this medication.

Side effects due to Formeterol

Palpitations, fine tremor, nervous tension and headache are the commonest side effects. Rarely nausea, increased heart rate, sleep disturbances and muscle cramps can occur.

Very rarely heart attacks, low blood pressure and allergies are reported.

Sources

BNF

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