- What is budesonide/formoterol? What is budesonide/formoterol used for?
- What are the side effects of budesonide/formoterol?
- What is the dosage for budesonide/formoterol?
- Which drugs or supplements interact with budesonide/formoterol?
- Is budesonide/formoterol safe to take if I'm pregnant or breastfeeding?
- What else should I know about budesonide/formoterol?
What is budesonide/formoterol? What is budesonide/formoterol used for?
Symbicort is a combination of inhaled drugs that is used to treat asthma and chronic obstructive pulmonary disease (COPD). In patients with asthma or COPD the smaller airways (bronchioles) through which air moves in and out of thelungs can be narrowed by accumulation of mucus, spasm of the muscles that surround these airways, or swelling of the lining of the airways due to inflammation. Airway narrowing leads to symptoms of shortness of breath, wheezing, cough, and congestion. Medications used in treating asthma or COPD include those that open airways, called bronchodilators, and those that reduce inflammation.
Symbicort contains a combination of formoterol, a long acting beta-2 adrenergic agonist (LABA) bronchodilator, and budesonide, an anti-inflammatory corticosteroid. Beta-2 agonists are medications that attach to beta-2 receptors on the smooth muscle cells that surround the airways, causing the muscle cells to relax and open the airways. Budesonide is a synthetic (man-made) corticosteroid of the glucocorticoid family which is related to the natural hormone, cortisol or hydrocortisone, produced by the adrenal glands. Glucocorticoid steroids have potent anti-inflammatory actions. In asthmatic patients and people with COPD, the suppression of inflammation within the airways reduces the swelling caused by inflammation that narrows the airways. At the same time, production of mucus is reduced.
When used in lower doses, very little inhaled budesonide is absorbed into the body and side effects are infrequent. When higher doses are used, budesonide is absorbed and may cause side effects elsewhere in the body. The FDA approved Symbicort in July 2006.
What brand names are available for budesonide/formoterol?
Is budesonide/formoterol available as a generic drug?
Do I need a prescription for budesonide/formoterol?
What are the side effects of budesonide/formoterol?
The most common side effects associated with Symbicort are:
- common cold
- back pain
- stomach discomfort
- upper respiratory tract infection
- Oral fungal infections (candidiasis)
Higher doses of budesonide may cause suppression of the body's ability to make its own natural glucocorticoid in the adrenal gland. People with suppression of their adrenal glands (which can be diagnosed by a doctor) would need increased amounts of glucocorticoids, probably by the oral or intravenous route, during periods of high physical stress or acute illness when glucocorticoids are particularly important. Inhaled steroids may cause growth suppression, weaken the immune system, and may increase the risk of glaucoma, and cataracts.
What is the dosage for budesonide/formoterol?
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.
Which drugs or supplements interact with budesonide/formoterol?
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.
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Is budesonide/formoterol safe to take if I'm pregnant or breastfeeding?
Use during pregnancy has not been adequately evaluated. Symbicort harmed the fetus in animal reproductive studies.
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.
What else should I know about budesonide/formoterol?
What preparations of BUDESONIDE/FORMOTEROL-INHALATION are available?
Aerosol: 80/4.5 mcg per spray; 160/4.5 mcg per spray
How should I keep BUDESONIDE/FORMOTEROL-INHALATION stored?
Budesonide should be kept at room temperature, 20 C to 25 C (68 F to 77 F). It should be shaken well before each use.
Budesonide and formoterol fumarate inhaler aerosol (Symbicort) is a combination of drugs prescribed to treat asthma and chronic obstructive pulmonary disease (COPD). Side effects, drug interactions, storage, dosing, and pregnancy and breastfeeding safety information should be reviewed prior to taking any medication.
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Asthma: Over the Counter Treatment
Patients who have infrequent, mild bouts of asthma attacks may use over-the-counter (OTC) medications to treat their asthma symptoms. OTC asthma medicines are limited to epinephrine and ephedrine. These OTC drugs are best used with the guidance of a physician, as there may be side effects and the drugs may not be very effective.
Asthma is a condition in which hyperreactive airways constrict and result in symptoms like wheezing, coughing, and shortness of breath. Causes of asthma include genetics, environmental factors, personal history of allergies, and other factors. Asthma is diagnosed by a physician based on a patient's family history and results from lung function tests and other exams. Inhaled corticosteroids (ICS) and long-acting bronchodilators (LABAs) are used in the treatment of asthma. Generally, the prognosis for a patient with asthma is good. Exposure to allergens found on farms may protect against asthma symptoms.
COPD (Chronic Obstructive Pulmonary Disease)
COPD or chronic obstructive pulmonary disease is a lung condition caused by smoking tobacco, exposure to secondhand smoke, and/or air pollutants. Conditions that accompany COPD include chronic bronchitis, chronic cough, and emphysema. Symptoms of COPD include shortness of breath, wheezing, and chronic cough. Treatment of COPD includes GOLD guidelines, smoking cessation, medications, and surgery. The life expectancy of a person with COPD depends on the stage of the disease.
Emphysema is a COPD (chronic obstructive pulmonary disease) that often occurs with other obstructive pulmonary problems and chronic bronchitis. Causes of emphysema include chronic cigarette smoking, exposure to secondhand smoke, air pollution, and in the underdeveloped parts of the world. Symptoms of emphysema include chronic cough, chest discomfort, breathlessness, and wheezing. Treatments include medication and lifestyle changes.
Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least three months, two years in a row. Causes of chronic bronchitis include cigarette smoking, inhaled irritants, and underlying disease processes (such as asthma, or congestive heart failure). Symptoms include cough, shortness of breath, and wheezing. Treatments include bronchodilators and steroids. Complications of chronic bronchitis include COPD and emphysema.
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Exercise-induced asthma is asthma triggered by vigorous exercise. Symptoms include coughing, shortness of breath, chest tightness, wheezing, and fatigue while exercising. Preventing exercise-induced asthma attacks involves using inhaled medicines before exercising, performing warm-up exercises and cooling down afterward, avoiding exercising outdoors when pollen counts are high, restricting exercise when you have a viral infection, and wearing a mask over your nose and mouth when exercising in cold weather.
Emphysema, Chronic Bronchitis, and Colds
If you have a COPD such as emphysema, avoiding chronic bronchitis and colds is important to avoid a more severe respiratory infection such as pneumonia. Avoiding cigarette smoking, practice good hygeine, stay away from crowds, and alerting your healthcare provider if you have a sinus infection or cold or cough that becomes worse. Treatment options depend upon the severity of the emphysema, bronchitis, or cold combination.
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