The usual recommended dosage for adults and adolescents (12 years and older) is typically 200/6 micrograms (mcg) taken as two inhalations twice daily, with a maximum total daily dose of 800/24 mcg.

For patients already on lower doses of either component, healthcare providers may recommend starting with a lower dose, such as 100/3 or 160/4. In the case of existing COPD patients, the same dosage guidelines generally apply.

Patients should use Symbicort regularly, even when they feel well, to maintain effective control over their symptoms. Before each use, it is essential to shake the inhaler well, exhale fully, and
then inhale deeply and slowly while pressing down on the inhaler to ensure proper medication delivery. If multiple doses are prescribed, patients should wait about 30 seconds between inhalations.

To minimize the risk of side effects like oral thrush, patients are advised to rinse their mouths with water after using the inhaler. It is crucial to follow the specific dosage instructions provided by a healthcare professional for effective management of asthma or COPD.

Always use this medication exactly as your clinician has told you. Check with our clinical team or your GP or pharmacist if you are not sure.

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or /any side effect.

Common Side Effects

• Oral Thrush (Candidiasis): This is a common side effect due to the immunosuppressive effects of budesonide on the oral mucosa. Symptoms include white patches, soreness, or a burning sensation in the mouth and throat.
• Hoarseness and Dysphonia: Many users report changes in their voice, including hoarseness and difficulty speaking clearly, often due to irritation of the vocal cords.
• Cough: Patients may experience a persistent cough after inhalation, which could be due to throat irritation or an adverse reaction to the medication.
• Headache: Mild to moderate headaches are frequently reported by patients using Symbicort.

Less Common Side Effects

• Nausea: Gastrointestinal upset, including nausea, can occur in some patients using Symbicort.
• Dizziness: Lightheadedness or dizziness may occur, occasionally interfering with daily activities.
• Palpitations: Patients may notice an increased heart rate or palpitations, especially due to the formoterol component.

Rare Side Effects

• Paradoxical Bronchospasm: Rarely, patients may experience worsening of wheezing and breathlessness immediately after using the inhaler. If this occurs, it requires immediate medical attention and discontinuation of the medication.
• Adrenal Suppression: Long-term use, particularly at high doses, can lead to suppression of the adrenal glands, leading to insufficient steroid production.
• Growth Suppression in Children: Prolonged use of inhaled corticosteroids in children may potentially affect growth velocity.
• Respiratory Infections: Some patients may experience an increased risk of respiratory infections, including pneumonia.
• Hypokalemia: There is a potential for reduced potassium levels in the blood, which can lead to muscle weakness, cramps, or arrhythmias.

For full information on side effects and correct use, see the patient information leaflet. If any side effects concern you, or you are experiencing any of the side effects mentioned in the patient information leaflet whilst taking this medication, please contact our clinical team or speak to your GP.

While it is effective in controlling respiratory symptoms, there are essential cautions and warnings associated with its use. Here’s a detailed overview:

Cautions

• Systemic Corticosteroid Effects: Prolonged use of inhaled corticosteroids like budesonide can lead to systemic effects, especially at high doses. Patients should be monitored for adrenal suppression, Cushing’s syndrome, and changes in bone density.
• Oral Candidiasis: There is a significant risk of developing oral thrush due to local immunosuppression. Patients should be advised to rinse their mouths with water after using Symbicort to help prevent this condition.
• Growth Monitoring in Children: Long-term use of inhaled corticosteroids may potentially affect growth velocity in children. Regular monitoring of growth is recommended for paediatric patients on Symbicort.
• Cardiovascular Conditions: Caution is advised in patients with pre-existing cardiovascular diseases, such as arrhythmias, ischemic heart disease, or hypertension, as the formoterol component may lead to increased heart rate and cardiovascular effects.
• Diabetes Management: Budesonide can increase blood glucose levels. Diabetic patients should monitor their blood sugar levels closely during treatment with Symbicort.
• Liver Impairment: Caution should be exercised in patients with hepatic impairment, as it may alter the metabolism of budesonide, leading to higher systemic exposure.
• Seizure Disorders: Patients with a history of seizures or epilepsy should use Symbicort caution as beta-agonists can lower the seizure threshold.
• 
  

Warnings

• Not for Acute Relief: Symbicort is not a rescue medication and should not be used for the immediate relief of acute asthma attacks or bronchospasms. Patients should have a short-acting beta-agonist inhaler available for such situations.
• Paradoxical Bronchospasm: In rare cases, Symbicort can cause paradoxical bronchospasm, characterized by worsening wheezing and difficulty breathing immediately following inhalation. If this occurs, the medication should be discontinued, and medical attention should be sought.
• Underlying Systemic Steroid Use: If patients are transitioning from systemic corticosteroids to Symbicort, careful monitoring is necessary, as there may be a risk of adrenal insufficiency. Doses may need adjustment as the body acclimates to lower steroid levels.
• Monitoring: Regular follow-ups are essential for patients on Symbicort, especially for long-term use. Healthcare providers should monitor lung function, symptom control, and any potential side effects.

Get emergency medical help if you have signs of an allergic reaction to this medication. These include:

• Hives
• Dizziness
• Fast or pounding heartbeats
• Wheezing
• Difficult breathing
• Swelling of your face, lips, tongue, or throat.

It is important that you let us know which prescription, over-the-counter medicines and recreational drugs you are currently taking. You must also tell us about any other medical conditions that you currently have (or had in the past). This will help us ensure the prescribed medication is safe and appropriate for you to take.

For full information on warnings, medication interactions and contraindications, refer to the Patient Information Leaflet. Please read all packaging and the Patient Information Leaflet before taking any new medicine and inform our clinical team or your GP of medicines you are taking or intend to take.