Symbicort dosage, forms, and strengths

Symbicort (budesonide and formoterol inhalation) is a combination product of an inhaled corticosteroid (ICS) and a long-acting bronchodilator. Symbicort is used for asthma control and prevention in children and adults age 5 and older. It’s also FDA-approved to treat adults with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. 

Symbicort works by reducing inflammation and opening the airway and lungs, making it easier to breathe. It comes in a metered-dose inhaler (MDI) and is typically taken twice daily, but may also be used as needed. However, Symbicort is not a short-acting, rescue inhaler and should not be used to treat an acute asthma attack or COPD exacerbation.

The most common side effects of Symbicort include throat discomfort, stomach pain and vomiting, oral thrush, back pain, headaches, sinusitis, and upper respiratory tract infections. Serious adverse effects are less common and include adrenal insufficiency, paradoxical bronchospasm (sudden wheezing immediately after taking Symbicort), low bone mineral density, delayed growth in children, glaucoma, and allergic reactions. People with COPD are also at increased risk of contracting pneumonia and other lung infections when using inhaled corticosteroids.

RELATED: Learn more about Symbicort | Get Symbicort discounts 

Symbicort forms and strengths

Symbicort comes as a metered-dose inhaler (MDI), which is a device containing a mouthpiece and pressurized canister of medication. When the MDI is pumped, a reliable dose of Symbicort is released and inhaled by the user. Symbicort inhalers come in two strengths, with each inhaler containing either 60 or 120 puffs.

• Metered-dose inhaler (MDI): 80 mcg/4.5 mcg per actuation, 160 mcg/4.5 mcg per actuation

Symbicort dosage for adults

Symbicort is approved for use in adults with COPD and asthma. The dosage instructions vary depending on the severity of the patient’s condition.

For COPD maintenance treatment, adults inhale two puffs of Symbicort 160 twice daily. Adults with asthma typically take two puffs of Symbicort, twice daily. Your daily dose will depend on how severe your asthma symptoms are. 

Symbicort dosage for COPD

Symbicort is approved for adults who have COPD. The starting dose is two puffs of Symbicort 160 twice daily. You should not exceed four puffs daily.

Symbicort dosage for asthma

Symbicort is also approved for the treatment of asthma in adults. Dosing varies depending on the severity of your condition. The recommended starting dose is two inhalations of Symbicort 80 twice daily. 

If symptoms are not improving or controlled after seven to 14 days, your doctor may increase your dosage to two puffs of 160 mcg/4.5 mcg twice daily. It’s up to your doctor to determine your starting and maintenance dosage.

For moderate-to-severe asthma, the standard dosage is one to two puffs of Symbicort 160 inhaled daily or twice daily, then one to two puffs inhaled every four hours, as needed.

Related: COPD vs. asthma: Which is worse?

Symbicort dosage for children

Symbicort can be used in children with asthma ages 6 and older. For children between the age of 6 and 11, the standard dosage for asthma maintenance is two puffs of Symbicort 80 inhaled twice daily. The maximum dosage is four puffs per day. 

For children between the age of 5 and 11 with moderate-to-severe persistent asthma, the standard dose is one to two puffs twice daily, then one to two puffs inhaled every four hours, as needed.

For children ages 12 and older, the standard dosage for asthma maintenance is two puffs of Symbicort 80 inhaled twice daily. The maximum dosage is 12 puffs per day. Your doctor may increase your Symbicort to 160 mcg/4.5 mcg after one to two weeks if asthma symptoms are not controlled.

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Symbicort dosage restrictions

Symbicort is not for everyone.

• You should not take Symbicort if you’ve had a hypersensitivity reaction (rash, hives, swelling of the face and throat) to any of the ingredients of Symbicort in the past.

• Use caution when using in patients with a family history of osteoporosis. Symbicort can decrease bone mineral density, increasing the risk of osteoporosis.

• The use of Symbicort in patients with renal impairment has not been defined. Use caution when taking this medication.

• Patients with severe liver impairment should use caution when taking Symbicort. Your doctor should consider alternatives.

• Tell your doctor if you have any cardiovascular conditions, including high blood pressure. Symbicort can have serious heart-related side effects that are potentially life-threatening.

• Those with thyroid conditions like thyrotoxicosis should talk to their doctor before taking Symbicort, as this medication may cause increased or worsening side effects. 

• Patients with diabetes should use Symbicort with caution to avoid hyperglycemia.

• People with eye conditions such as glaucoma or cataracts should be monitored for changes in vision.

• Use caution in patients with a history of seizures.

Symbicort dosage for pets 

Symbicort may be prescribed for cats and dogs with chronic asthma or other respiratory disorders. It should never be used to treat acute asthma attacks in animals. Symbicort is available in two strengths: 80 mcg/4.5 mcg and 160 mcg/4.5 mcg. The dosage depends on the weight and severity of your pet’s condition.

Your veterinarian may recommend a canine aerosol mask to make sure your pet is receiving the full dose of medication. The mask fits around your pet’s mouth to ensure the Symbicort is inhaled fully into the lungs.

How to take Symbicort

Symbicort comes in a metered-dose inhaler and is inhaled into the lungs. Brand-new inhalers need to be primed before taking your first dose.

To prime your Symbicort inhaler:

1. Hold your inhaler in an upright position and shake for five seconds.

2. Remove the mouthpiece cover and hold it away from your face.

3. Press down on the top of your inhaler to release one spray.

4. Repeat the process by shaking for another five seconds and release a second spray.

5.  After releasing two test sprays, your Symbicort inhaler is primed and ready.

If you drop your inhaler or haven’t used it for more than seven consecutive days, you’ll need to repeat the priming process.

To take Symbicort:

1. Shake the Symbicort inhaler before each use.

2. Remove the cap and ensure the mouthpiece is clean. 

3. Then exhale, releasing as much air out of the lungs as possible. 

4. With the canister upright, place the mouthpiece in front of your mouth, and breathe in slowly and deeply through your mouth while firmly pressing down on the top of the canister once. 

5. Hold your breath for five to 10 seconds, then breathe out slowly. Avoid spraying the medication in your eyes.

6. Wait one to two minutes before inhaling the second puff. 

7. Repeat the entire process, beginning with shaking the inhaler.

8. After each dose, rinse your mouth out with water. Do not swallow the water. This is done to prevent oral fungal infections such as.

RELATED: How to properly administer an inhaler to your child

Symbicort dosage FAQs

How long does it take Symbicort to work?

Symbicort begins working quickly, within 15 minutes of inhaling for asthma-related symptoms. You must continue to use Symbicort as directed by your doctor to see the full benefit of treatment. Maximum results are seen after consecutive use for at least two weeks.

For COPD, users may start to notice improvement within five minutes of inhaling Symbicort. Lung function will continue to improve after using Symbicort consistently for several weeks. 

How long does Symbicort stay in your system?

The amount of time Symbicort stays in your body depends on the strength you’re taking. Symbicort contains two active ingredients: budesonide and formoterol. Combined, these medications typically stay in your body for 12 hours. Many people take Symbicort twice a day to ensure a consistent amount of medication in the body.

What happens if I miss a dose of Symbicort?

If you miss a dose of Symbicort, continue with your normal schedule by taking your next dose at the regular time. Symbicort should be taken 12 hours apart to ensure consistent management of your breathing condition.

How long can you take Symbicort?

Symbicort is a long-term treatment option for asthma and COPD. It is not effective for the treatment of acute asthma attacks or COPD exacerbations. You should continue taking Symbicort until your doctor tells you to stop.

How do I stop taking Symbicort?

If you stop taking Symbicort suddenly, you may experience withdrawal symptoms including:

• Exacerbation of asthma or COPD symptoms, such as shortness of breath

• Weakness

• Fatigue

• Dizziness

• Muscle cramps or discomfort

• Headache

• Nausea

You should never stop taking your medication without speaking to your doctor. If your healthcare provider discontinues Symbicort, they may taper the drug down over time to prevent withdrawal symptoms. Talk to your doctor to seek medical advice before you stop taking Symbicort.

What is the maximum dosage for Symbicort?

The maximum dosage of Symbicort depends on your age and condition. Adults with COPD should not exceed 640/18 mcg per day, which is equal to four puffs of Symbicort 160. Adults with moderate-to-severe asthma should not exceed 12 puffs of Symbicort 160 per day.

Adolescent patients between the ages of 6 and 11 should not exceed eight puffs of Symbicort 80 per day. Children 12 years of age and older should not exceed 12 puffs of Symbicort 80 per day.

Can you overdose on Symbicort?

Taking too much Symbicort can lead to dangerous adverse reactions including:

• Chest pain

• Trembling or shaky

• Excessive nervousness

• Nausea

• Fast or irregular heartbeat

• Convulsions

• Headache

If you suspect an overdose of Symbicort, seek emergency medical attention at your nearest hospital.

What interacts with Symbicort?

Some drug interactions are possible when taking Symbicort. Some medications that may interact with Symbicort include:

• Beta blockers may cause a dangerous increase in bronchospasms (tightening of the airway).

• Diuretics such as furosemide may reduce the medication efficacy and increase the risk of hypokalemia (low potassium levels).

• Antidepressants including tricyclic antidepressants may increase your risk of heart-related side effects, like arrhythmias.

• Antivirals may also increase the level of budesonide in your body, leading to dangerous side effects.

• CYP3A4 inhibitors such as ketoconazole may increase the level of budesonide in the body, leading to dangerous side effects.

• Desmopressin nasal spray or tablets may increase blood pressure and decrease sodium and should not be used with Symbicort.

• Other long-acting beta-agonist (LABA) inhalers should not be used with Symbicort.

Tell your doctor about all prescription drugs, over-the-counter medications, and herbal supplements before starting Symbicort.

What happens when you mix Symbicort and alcohol?

Symbicort is not believed to interact with alcohol but may put you at increased risks for side effects. Talk to your doctor about drinking alcohol while taking Symbicort.

Is it safe to take Symbicort during pregnancy?

There is not enough data to determine if Symbicort is safe during pregnancy. If you are pregnant or plan to become pregnant while taking Symbicort, discuss your treatment options with your healthcare professional before beginning treatment.

RELATED: How to manage your asthma during pregnancy

Is it safe to take Symbicort while breastfeeding?

Symbicort contains two active ingredients: budesonide and formoterol. Human data shows no known risks of taking the budesonide/formoterol combo during lactation and breastfeeding. 

If you’re breastfeeding, talk to your doctor about the risks before beginning treatment with Symbicort.

Related resources for Symbicort dosages:

• Medication guide

• Symbicort prescribing information

• Adult dosing

• Pediatric dosing

• Prescribing inhaled therapy in dogs and cats

• Taking Symbicort