DOSING: The recommended dose is 2 inhalations twice daily of 80 mcg/4.5 mcg or 160 mcg/5 mcg strengths. The dose for treating COPD is 2 inhalations of 160/4.5 strength twice daily.
DRUG INTERACTIONS: The following drugs may increase levels of budesonide in the body by reducing the breakdown of budesonide byliver enzymes. This may increase side effects of Symbicort.
- ritonavir (Norvir),
- atazanavir (Reyataz),
- clarithromycin (Biaxin),
- indinavir (Crixivan),
- itraconazole (Sporanox),
- nelfinavir (Viracept), and
- telithromycin (Ketek)
Monoamine oxidase inhibitors (for example, tranylcypromine) and tricyclic antidepressants (for example, amitriptyline [Endep]) may increase the effect of formoterol on the heart and blood pressure. Since Symbicort contains formoterol, it should not be used with or within two weeks of discontinuing monoamine oxidase inhibitors or tricyclic antidepressants.
Beta blockers block the therapeutic effects of beta 2-agonists, such as formoterol, a component of Symbicort, and may produce severe bronchospasm in patients with asthma. Therefore, patients with asthma should not be treated with beta- blockers.
PREGNANCY: Use during pregnancy has not been adequately evaluated. Symbicort harmed the fetus in animal reproductive studies.
NURSING MOTHERS: It is not known whether components of Symbicort are secreted in breast milk. Other medications in this class are secreted into breast milk. It is not known whether the small amounts of Symbicort components that may appear in breast milk have an effect on the infant.
REFERENCE: FDA Prescribing Information
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