Symbicort Turbohaler

Symbicort Turbohaler is an inhaler that is used for the treatment of asthma in adults and adolescents between 12 and 17 years of age. It is also used for the symptomatic treatment of Chronic Obstructive Pulmonary Disease (COPD) in adults over the age of 18.

It contains two different medications: budesonide and formoterol fumarate dihydrate. Budesonide belongs to a group of medicines called "corticosteroids," and works by reducing and preventing inflammation in your lungs.

Formoterol fumarate dihydrate belongs to a group of medicines called "long-acting beta2-adrenergic agonists" or "bronchodilators" and works by relaxing the muscles in the airways, which helps you breathe easier.

The Symbicort Inhaler contains formoterol and budesonide; both components have different mechanisms of action and its effects are additive in reducing asthma exacerbations. The specific properties of budesonide and formoterol make the combination of both useful both in the treatment of maintenance and on-demand for symptom relief, such as maintenance treatment of asthma.

Budesonide is a glucocorticoid that, after inhalation, has an anti-inflammatory action on the airways. dose-dependent respiratory disturbances, resulting in reduced symptoms and fewer asthma exacerbations. Inhaled budesonide has fewer serious side effects than systemic corticosteroids. The exact mechanism is responsible for the anti-inflammatory effect of glucocorticoids.

Formoterol is a selective ad2 adrenergic agonist that, by inhalation, produces rapid relaxation and durable bronchial smooth muscle in patients with reversible airway obstruction. The bronchodilator effect is dose-dependent and starts 1-3 minutes after inhalation, staying up to at least 12 hours after a single dose.

Symbicort Turbohaler can be used for people with asthma in two different ways as a maintenance therapy to prevent symptoms and attacks, along with a separate relief inhaler; or as its only inhaler, used to suppress asthma and relieve respiratory difficulties associated with the disease.

Symbicort has also proven effective in the time it is able to relieve respiratory inflammation, boasting almost 12 hours of opened-up and relaxed airways.

Symbicort Turbohalers are useful in aiding the management of chronic obstructive pulmonary disease, or COPD, as well as treating asthma.

With the combination of budesonide and formoterol fumarate dihydrate, it minimises the use of oral steroids and reduces the likelihood of asthma attacks during exercises or stressful situations.  

Always use this medicine exactly as your doctor or pharmacist has told you. If in doubt, consult your doctor or pharmacist again. It is important to use Symbicort Turbuhaler daily, even if you do not have asthma or COPD symptoms at that time.

If you are using Symbicort Turbuhaler for asthma, your doctor will want to regularly check how your symptoms are going.

If you have been taking steroid tablets for asthma or COPD, your doctor may reduce the number of tablets you take, once you start treatment with Symbicort Turbuhaler. If you have been taking oral steroid tablets for a long time, your doctor may want to do a blood test from time to time. You may feel generally unwell when the number of oral steroid tablets is reduced, although your lung symptoms may be improving. In that case, some symptoms such as stuffy or runny nose, muscle or joint weakness or pain, and a rash (hives) may temporarily reappear. If you are concerned about any of these symptoms or have any other symptoms such as headache, tiredness, nausea, or vomiting, contact your doctor immediately. If allergic or arthritic symptoms develop, you may need to take another medicine. You should consult your doctor if you are concerned about whether you should continue to use Symbicort Turbuhaler.

Using Symbicort Turbuhaler and another separate inhaler for relief of symptoms

Use Symbicort Turbuhaler daily, as it helps prevent asthma symptoms from appearing.

Adults (from 18 years)

The usual dose is 1-2 inhalations, twice a day.

Your doctor may prescribe up to a maximum of 4 inhalations, twice a day.

If your symptoms are well controlled your doctor may ask you to use the medication once a day.

Adolescents (12 to 17 years old)

The usual dose is 1-2 inhalations, twice a day.

If your symptoms are well controlled your doctor may ask you to use the medication once a day.

There is a lower concentration of Symbicort Turbuhaler for children 6-11 years of age.

Symbicort Turbuhaler is not recommended for use in children under 6 years of age

How to inhale

Every time you need to inhale, follow these instructions:

1. Unscrew and lift the cover that covers the Turbuhaler. A small “click” is heard when the lid is unscrewed.
2. Hold your Symbicort Turbuhaler inhaler upright with the red thread on the bottom.
3. Do not hold the mouthpiece when you load your Symbicort Turbuhaler inhaler. To load your Symbicort Turbuhaler inhaler with one dose, turn the red thread all the way in one direction.
4. Then turn it back to the stop in the other direction (it doesn't matter which direction first). In one of the two directions, you should hear a characteristic "click". Your Symbicort Turbuhaler inhaler is now ready for use. Only charge your Symbicort Turbuhaler inhaler when you are going to use it.
5. Keeping your Symbicort Turbuhaler inhaler away, slowly blow the air out of your mouth (without making it uncomfortable). Do not blow through your Symbicort Turbuhaler inhaler.
6. Gently position the mouthpiece between your teeth, close your lips, and breathe deeply and vigorously through your mouth. Do not bite or press hard on the mouthpiece.
7. Remove your Symbicort Turbuhaler inhaler from your mouth and gently expel the air. The amount of medicine inhaled is very small, which means you may not notice any taste after inhalation. However, if you have followed the instructions for use you can be sure that you have inhaled the dose and that the medicine has reached your lungs.
8. If you need to take another inhalation, repeat steps 2 to 6.
9. Replace the cover firmly after use.
10. Rinse your mouth with water after the daily morning and/or evening doses. Don't swallow it.

Like all medicines, this medicine can cause side effects, although not everybody gets them. If any of the following occurs, stop using Symbicort Turbuhaler and contact your doctor immediately:

Your face is swollen, particularly around your mouth (tongue and/or throat and/or difficulty swallowing) or hives along with breathing difficulties (angioedema) and/or a sudden feeling of fainting, indicating that you may be suffering from an allergic reaction. This occurs rarely, affecting less than 1 in 1,000 patients. You have sharp "whistles" or shortness of breath immediately after using your inhaler. If any of these symptoms happen to you, stop using Symbicort Turbuhaler immediately and use your "reliever inhaler". Contact your doctor immediately as you may need to change your treatment. This occurs very rarely, affecting less than 1 in 10,000 patients.

Other possible side effects:

Common (may affect up to 1 in 10 patients)

• Palpitations (note heartbeat), tremors. When these effects appear, they are usually mild and disappear when you continue to use your Symbicort Turbuhaler.
• Muguet (fungal infection) in the mouth; this effect is less likely if you rinse your mouth with water after using your Symbicort Turbuhaler.
• Mild throat irritation, cough, hoarseness.
• Headache
• Pneumonia (infection in the lungs) in patients with COPD.

Tell your doctor if you have any of the following symptoms while inhaling Symbicort Turbuhaler, they could be symptoms of a lung infection:

• Fever or chills
• Increased mucus production, change in mucus color
• Increased cough or increased difficulty breathing

Uncommon (may affect up to 1 in 100 patients)

• Agitation, restlessness, nervousness.
• Difficulty to sleep.
• Dizziness
• Nausea (feeling sick).
• Accelerated heart rate.
• Bruising on the skin
• Muscle cramps.
• Blurry vision.

Rare (may affect up to 1 in 1,000 patients)

• Rash, itching
• Bronchospasm (a contraction of the muscles of the airways, causing "whistles"). If this happens to you suddenly just after using Symbicort Turbuhaler, stop using it and see your doctor immediately.
• Low levels of potassium in the blood.
• Irregular heartbeat.

Very rare (may affect up to 1 in 10,000 patients)

• Depression
• Changes in behavior, especially in children.
• Pain or tightness in the chest (angina pectoris).
• Increase in the amount of sugar (glucose) in the blood.
• Alterations in taste, such as an unpleasant taste in the mouth.
• Variations in blood pressure.

Inhaled corticosteroids can affect the normal production of steroid hormones in the body, especially if high doses are used for a long time. These effects include:

• changes in bone mineral density (decreased bone).
• cataracts (loss of transparency of the lens in the eye).
• glaucoma (increased eye pressure).
• growth retardation in children and adolescents.
• effects on the adrenal glands (small glands next to the kidneys).

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