Symbicort Turbuhaler 160/4.5 mcg is a combination maintenance inhaler designed for the long-term management of asthma and chronic obstructive pulmonary disease (COPD). It contains two active ingredients: budesonide, an inhaled corticosteroid that reduces airway inflammation, and formoterol, a long-acting beta2-agonist (LABA) that relaxes airway muscles. This dual-action formulation provides both anti-inflammatory and bronchodilatory effects, offering comprehensive control of respiratory symptoms, improved lung function, and a reduction in exacerbation frequency. It is indicated for patients requiring regular treatment to maintain disease control and is not intended for immediate relief of acute bronchospasm.

Features

• Contains budesonide 160 mcg and formoterol fumarate dihydrate 4.5 mcg per inhalation
• Delivered via the Turbuhaler® dry powder inhaler device
• Each inhaler contains 60 metered doses
• Does not require shaking or priming before use
• Dose counter indicates remaining inhalations
• Breath-activated mechanism for coordinated delivery

Benefits

• Provides dual therapy combining an anti-inflammatory agent and a bronchodilator in a single device
• Reduces the frequency and severity of asthma and COPD exacerbations
• Improves lung function measurements (FEV1) and overall symptom control
• Enhances quality of life by enabling greater participation in daily activities
• Offers convenient twice-daily dosing for adherence and routine management
• May reduce the need for rescue inhaler use when used consistently as prescribed

Common use

Symbicort Turbuhaler is commonly prescribed for the maintenance treatment of asthma in patients 12 years and older where a combination product is appropriate. It is also indicated for the symptomatic treatment of patients with severe COPD (FEV1 < 50% predicted normal) and a history of repeated exacerbations, who have significant symptoms despite regular bronchodilator therapy. It is used as a controller medication and should be taken regularly, even when symptoms are not present.

Dosage and direction

For asthma: The recommended dose is 2 inhalations twice daily (morning and evening). The maximum recommended dose is 4 inhalations twice daily. For COPD: The recommended dose is 2 inhalations twice daily. Always follow the specific dosage prescribed by your healthcare provider. To use the Turbuhaler, unscrew and lift off the cover. Hold the inhaler upright and turn the grip fully to the right until it clicks, then back to the left until it clicks. Exhale away from the mouthpiece, place it between your lips, and inhale deeply and forcefully. Remove the inhaler from your mouth and hold your breath for about 10 seconds. Replace the cover tightly after use. Rinse your mouth with water after inhalation to reduce the risk of oral candidiasis.

Precautions

• Not for relief of acute asthma attacks or bronchospasm; always have a fast-acting rescue inhaler available.
• Increased risk of pneumonia in patients with COPD; monitor for symptoms.
• May cause systemic corticosteroid effects such as hypercorticism and adrenal suppression with high doses or long-term use.
• Caution in patients with cardiovascular disorders (e.g., coronary artery disease, arrhythmias, hypertension), as beta2-agonists can cause cardiovascular effects.
• Use with caution in patients with diabetes mellitus; may increase blood glucose levels.
• Potential for paradoxical bronchospasm; discontinue immediately if it occurs.
• May reduce bone mineral density with long-term use; monitor in patients with osteoporosis risk.
• Use the lowest effective dose to minimize systemic exposure.

Contraindications

• Hypersensitivity to budesonide, formoterol, or any component of the formulation.
• Primary treatment of status asthmaticus or other acute episodes of asthma or COPD where intensive measures are required.
• Not recommended in children under 12 years of age for asthma indication.

Possible side effects

Common side effects may include:

• Headache
• Pharyngitis
• Upper respiratory tract infection
• Oral candidiasis (thrush)
• Hoarseness or dysphonia
• Cough
• Tremor
• Palpitations
• Nausea

Less common but serious side effects may include:

• Paradoxical bronchospasm
• Cardiovascular effects (tachycardia, arrhythmias, hypertension)
• Signs of systemic corticosteroid effects (e.g., Cushing’s syndrome, adrenal suppression)
• Hypokalemia
• Hyperglycemia
• Allergic reactions (rash, urticaria, angioedema)
• Glaucoma and cataracts with long-term use

Drug interaction

• Concomitant use with other beta-adrenergic drugs may potentiate sympathetic effects.
• Ketoconazole, itraconazole, or other potent CYP3A4 inhibitors may increase budesonide plasma concentrations.
• MAO inhibitors, tricyclic antidepressants, and QTc-prolonging agents may potentiate the cardiovascular effects of formoterol.
• Diuretics or corticosteroids may enhance hypokalemic effects.
• Beta-blockers may antagonize the effects of formoterol and produce severe bronchospasm in patients with asthma.

Missed dose

If a dose is missed, take it as soon as you remember, unless it is almost time for the next dose. Do not double the dose to make up for the missed one. Resume the regular dosing schedule.

Overdose

Overdose may lead to symptoms related to beta2-adrenergic stimulation, such as tachycardia, arrhythmias, tremor, headache, muscle cramps, nausea, and hyperglycemia. Excessive corticosteroid exposure may cause systemic effects like hypercorticism. Symptomatic and supportive treatment is indicated. Cardiac monitoring is recommended in cases of significant overdose. Consider the potential for hypokalemia.

Storage

Store at room temperature (15-30°C) in a dry place. Keep the cover tightly closed when not in use. Do not store in moist or humid areas (e.g., bathrooms). Do not puncture or incinerate, even when empty. Keep out of reach of children and pets.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Do not disregard professional medical advice or delay in seeking it because of something you have read here.

Reviews

(Note: Fictional examples based on typical patient experiences)

“After struggling with frequent COPD exacerbations, Symbicort Turbuhaler has significantly improved my daily breathing and reduced hospital visits. The twice-daily routine is easy to follow.” – John D., 68

“Effective for my moderate persistent asthma. I’ve noticed better peak flow readings and fewer nighttime symptoms. The inhaler is straightforward to use once you get the technique right.” – Maria L., 42

“My physician switched me to Symbicort, and the combination therapy has provided more consistent control than my previous separate inhalers. Minimal side effects—just occasional hoarseness, which rinsing helps.” – Robert T., 51