Symbicort Turbohaler

Symbicort Turbohaler is a combination inhaler used to treat asthma by reducing inflammation and opening the airways. It can be used as both a preventer and a reliever inhaler, depending on your treatment plan, and contains 2 active ingredients:

1. Budesonide, a corticosteroid that reduces inflammation in the airways.
2. Formoterol, a long-acting bronchodilator that relaxes airway muscles.

Symbicort Turbohaler is a dry powder inhaler (DPI), which means it delivers medication directly into your lungs when you breathe in through the device. You do not need to press down on the inhaler to release the medication, instead the dose is prepared by twisting the bottom before breathing it in.

Symbicort Turbohaler contains an anti-inflammatory corticosteroid called budesonide and a bronchodilator called formoterol. Budesonide reduces inflammation in the lungs over time, while formoterol works quickly to relax the muscles around your airways.

This dual action helps reduce airway swelling while keeping the airways open, making it easier to breathe every day and during an asthma attack.

How long does Symbicort Turbohaler last?

Each dose of Symbicort provides relief and airway support for up to 12 hours. When used regularly, it helps maintain long-term asthma control.

How long does Symbicort Turbohaler take to work?

Formoterol starts working within a few minutes to open the airways, while budesonide takes around 2 weeks of regular use to reach its full effect.

How effective is Symbicort Turbohaler?

Clinical studies show that Symbicort Turbohaler is an effective treatment, especially compared to using budesonide on its own. After 12 weeks of use as a preventer inhaler, Symbicort Turbohaler was proven to:

• improve lung function
• improve asthma symptoms
• reduce asthma attacks

Another study looking at the use of Symbicort Turbohaler as part of a maintenance and reliever therapy (MART) treatment plan found it to be very effective in reducing severe asthma attacks compared to some other inhaler types. For example, in a year of treatment:

• 17.5% of patients using Symbicort Turbohaler as a preventer and reliever inhaler reported severe asthma attacks
• 26% of patients using Symbicort Turbohaler as a preventer with a formoterol reliever inhaler reported severe asthma attacks
• 33% of patients using Symbicort Turbohaler as a preventer with a terbutaline reliever inhaler reported severe asthma attacks

You should use Symbicort exactly as prescribed by your doctor. It can be used daily as a preventer and, depending on your plan, as a reliever inhaler when needed.

Using Symbicort Turbohaler for MART (maintenance and reliever therapy)

A MART asthma treatment plan means using the same inhaler as both a preventer and a reliever inhaler.

Use your Symbicort Turbohaler every day to help prevent asthma symptoms. Your usual dose will depend on what your doctor prescribes, but it may include:

• 1 inhalation in the morning and 1 in the evening
• 2 inhalations once a day (morning or evening)

Your doctor may increase this to 2 inhalations twice a day if needed.

You should also use Symbicort as a reliever inhaler to treat symptoms when they happen, and before triggers like exercise or allergens if your doctor has told you to do this. To use Symbicort as a reliever inhaler:

1. Take 1 inhalation when symptoms appear and wait a few minutes.
2. If your symptoms do not improve, take another dose.
3. Do not take more than 6 inhalations in one go. Call 999 if your inhaler does not relieve your symptoms or your asthma gets worse.

Do not take more than 12 inhalations of Symbicort Turbohaler in 24 hours.

Always carry your inhaler with you so you can use it when needed. If you regularly need 8 or more inhalations of your inhaler a day, speak to your GP or nurse as soon as possible. Your treatment may need to be reviewed.

Using Symbicort Turbohaler for AIR (anti-inflammatory reliever) therapy

AIR therapy involves using a combination inhaler as a reliever inhaler only. This may be prescribed for you if you have mild or infrequent asthma symptoms and do not need a daily preventer inhaler. New asthma guidelines mean that everyone should have an inhaler that contains both a steroid and a bronchodilator, rather than just a bronchodilator like salbutamol (blue inhaler).

To use Symbicort as a reliever inhaler:

1. Take 1 inhalation when symptoms appear and wait a few minutes.
2. If your symptoms do not improve, take another dose.
3. Do not take more than 6 inhalations in one go. Call 999 if your inhaler does not relieve your symptoms or your asthma gets worse.

Using Symbicort Turbohaler and a separate reliever inhaler

The usual dose is 1 or 2 inhalations, twice a day. This can be increased to 4 inhalations, twice a day or lowered to once a day if your symptoms are well controlled.

Only use Symbicort Turbohaler as a preventer, and use the separate reliever inhaler you’ve been prescribed if you get symptoms, or before doing something that could worsen your symptoms, like exercise.

How to use your inhaler

The first time you use your inhaler, you need to prepare it for use. To do this:

1. Unscrew the cover to take it off.
2. Hold it upright, with the red grip at the bottom.
3. Turn the grip as far as it will go in any direction. Then do the same thing in the other direction. You should hear a click either on the first or second twist.
4. Repeat this again, turning the grip in both directions.
5. Your inhaler is now ready to use.

When you need to use your inhaler, follow these steps, which are also available in your patient information leaflet:

1. Unscrew and remove the cap.
2. Hold the inhaler upright and twist the base all the way in one direction, then the other. It does not matter which way you choose first, as long as you turn it as far as it will go both ways. You should hear a click sound on either the first or second turn. Your dose is now primed inside the inhaler.
3. Breathe out away from the inhaler.
4. Place the mouthpiece gently between your teeth, and inhale deeply.
5. Remove the inhaler from your mouth and hold your breath for around 10 seconds, or as long as comfortable, then breathe out slowly.
6. Repeat these steps if you need to take more than 1 inhalation.
7. Replace the cap after use.
8. Rinse your mouth with water and spit it out.

Symbicort Turbohaler can cause side effects, although not everyone will get them. These are usually mild and improve as your body adjusts to the medication.

Common side effects (may affect up to 1 in 10 people) include:

• headache
• throat irritation or hoarseness
• oral thrush, a fungal infection in the mouth
• cough
• palpitations
• pneumonia (in COPD patients)
• trembling or shaking

Uncommon side effects (may affect up to 1 in 100 people) include:

• dizziness
• muscle cramps
• anxiety or restlessness
• sleep disturbances
• blurred vision
• bruising
• fast heartbeat
• feeling sick (nausea)

Rare side effects (may affect up to 1 in 1,000 people) include:

• skin allergic reactions, such as itching or rash
• irregular heartbeat
• tight airway muscles
• low blood potassium levels

Very rare side effects (may affect up to 1 in 10,000 people) include:

• blood pressure changes
• depression or other behavioural changes
• increased blood sugar levels
• taste changes
• pain or tightness in the chest

Rarely or very rarely, Symbicort Turbohaler can cause some serious side effects. Call 999 straight away if you get:

• signs of a severe allergic reaction, such as swelling of your face, particularly around your mouth, hives (rash), difficulty breathing, chest pain/tightness and a sudden feeling of faintness
• shortness of breath or sudden, acute wheezing right after using Symbicort

For a full list of side effects, please see the patient information leaflet that comes with your inhaler.

Information on long-term use of corticosteroids

Inhaled corticosteroids can affect the body’s natural production of steroid hormones, especially when taken for a long time at a higher dose. This may lead to:

• reduced bone mineral density (weaker or thinner bones)
• cataracts (clouding of the eye lens)
• glaucoma (increased pressure in the eye)
• slowed growth in children and adolescents
• reduced adrenal gland function

However, these effects are much less common with inhaled corticosteroids compared to steroid tablets, such as prednisolone. To minimise this risk, your doctor will monitor your symptoms and prescribe the lowest dose needed to manage your asthma. Make sure to tell them of any changes to your symptoms.

How long do Symbicort Turbohaler side effects last?

Most side effects improve within a few hours to a few weeks as your body gets used to treatment. They may be more likely if you take more than usual, such as if you take it as a preventer inhaler, then also need to use it the same day for symptom relief.

In some cases, side effects can continue until you stop treatment. If your side effects do not get better, speak to your doctor as you may need to try a different medication.

What to do if you get Symbicort Turbohaler side effects

If you get side effects on Symbicort Turbohaler and they are mild, see if they get better as you continue treatment. Speak to your doctor if side effects persist or worsen. Seek urgent medical help by calling 999 if you have signs of a serious allergic reaction or worsening breathing.

Things you can do at home to help include:

• rinsing your mouth after each dose to reduce irritation and thrush
• taking over-the-counter painkillers like paracetamol to help with headaches and pains – do not take ibuprofen without speaking to a doctor, as in some cases it can worsen asthma
• avoiding caffeine and other stimulants if you get side effects like palpitations and shaking
• staying hydrated to keep your mouth healthy

Symbicort Turbohaler may not be suitable for everyone. Your doctor will check your medical history before prescribing to make sure it is safe and appropriate for you.

Do not use Symbicort Turbohaler if you:

• are allergic to budesonide, formoterol, or any other ingredients in the inhaler

Speak to your doctor before using Symbicort Turbohaler if you have:

• heart problems, including narrowing of the arteries or heart failure
• high blood pressure
• diabetes
• thyroid or adrenal gland disorders
• lung infections, such as tuberculosis
• low potassium levels
• severe liver problems
• blurred vision or visual disturbances

If you’re pregnant, breastfeeding, or planning to become pregnant, speak to your doctor or midwife before using Symbicort Turbohaler. While it may be safe to use, it depends on you and your baby's health.

Symbicort Turbohaler and other medications

Symbicort Tuborhaler may interact with other medications, making them unsafe or not work as they should. Tell your doctor if you take any medications, including prescription, over-the-counter, and herbal, especially:

• beta-blocker tablets or eye drops
• medication for a fast or uneven heartbeat, such as quinidine
• digoxin, often used to treat heart failure
• diuretics (water tablets), such as furosemide
• antifungal medications, like ketoconazole
• certain antibiotics, such as clarithromycin
• other asthma medications, including steroid tablets like prednisolone, xanthine medications like theophylline, or other inhalers
• antidepressants, such as amitriptyline or nefazodone
• phenothiazine medications, such as chlorpromazine and prochlorperazine
• medications to treat HIV called HIV-protease inhibitors, such as ritonavir
• medications for Parkinson’s disease, such as leva-dopa
• medications for thyroid problems, such as levo-thyroxine

Also speak to your doctor if you are due to have a general anaesthetic for a day surgery or dental work.

You can get Symbicort Turbohaler with a prescription from a doctor, either online or through your GP.

Can I buy Symbicort Turbohaler online?

Yes, you can request Symbicort Turbohaler from Asda Online Doctor if you have been prescribed it before. To order:

1. Complete a short medical questionnaire.
2. A doctor reviews your answers and approves your treatment if suitable.
3. Receive fast, free delivery or collect in-store from an Asda Pharmacy.
4. Get ongoing support and repeat prescriptions through your secure online account. Message a doctor for free if you have a medical question about your treatment.

Can I buy Symbicort Turbohaler over the counter?

No, Symbicort is a prescription-only medication and cannot be bought over the counter.

Can I get Symbicort Turbohaler on the NHS?

Yes, Symbicort is available on the NHS with a prescription from your GP. You might get Symbicort Turbohaler or another generic equivalent containing the same medications.

There are several alternative asthma inhalers if Symbicort Turbohaler is not right for you that work in the same way. However, we cannot start a new treatment, and you must be reviewed in person instead. We can prescribe repeat prescriptions if you have already been prescribed an inhaler by your GP or asthma specialist.

If you are using Symbicort Turbohaler as part of AIR therapy, alternatives include:

• Duoresp Spiromax
• Fobumix Easyhaler
• WockAIR

AIR therapy inhalers can also be used as part of a MART asthma plan. If you are using Symbicort Turbohaler as part of a MART plan, other MART inhalers include:

• Fostair
• Luforbec
• Proxor
• Vivaire
• Bibecfo

Symbicort Turbohaler vs Fostair

Symbicort Turbohaler and Fostair are both combination inhalers used in MART therapy. They contain the same bronchodilator (formoterol) and work in a similar way to reduce inflammation and open the airways.

The main differences are:

• corticosteroid type – Symbicort contains budesonide, while Fostair contains beclometasone
• inhaler type – Symbicort Turbohaler is a dry powder inhaler (DPI), while Fostair is a pressurised metered-dose inhaler (pMDI)

Symbicort Turbohaler is taken by twisting the bottom to release a dose, then breathing it in. Fostair needs to be shaken before use and is taken by pressing down to release the medication at the same time as breathing in. Some people may find using one type of inhaler easier than the other.

Symbicort Turbohaler vs Seretide

Symbicort Turbohaler and Seretide are both combination inhalers, but have a few differences, such as:

• active ingredients – Symbicort contains budesonide and formoterol, while Seretide contains the corticosteroid fluticasone and a bronchodilator called salmeterol
• use – Seretide cannot be used as part of a MART asthma plan because it’s not suitable as a reliever, while Symbicort can be used as both a preventer and a reliever
• inhaler type – Symbicort is a dry powder inhaler, while Seretide comes as a dry powder inhaler called Seretide Accuhaler or a pressurised metered-dose inhaler called Seretide Evohaler

Seretide contains salmeterol, which is a slower-acting bronchodilator, so it does not work quickly enough to be used during an asthma attack. This means you will need to take Seretide with a blue reliever inhaler like salbutamol. Symbicort Turbohaler may be preferred if you would like to have 1 inhaler, rather than 2.

Is Symbicort a steroid?

Yes, Symbicort is a combination of a corticosteroid called budesonide and a long-acting bronchodilator.

How can I tell if my Symbicort inhaler is empty?

The Symbicort Turbohaler has a dose counter that shows how many doses are left. When there are 20 doses left in the inhaler, a red mark will appear at the edge of the dose counter window. For the final 10 doses, the background of the dose counter is red. When it reaches 0, you should replace it.

How many doses are in a Symbicort inhaler?

Most Symbicort Turbohalers contain 30, 60, or 120 doses, depending on the strength and pack size.

How often can I use Symbicort inhaler?

Your Symbicort inhaler dose is set by your doctor, which is usually 1 inhalation morning and evening, or 2 inhalations once a day. This may be increased to 2 inhalations twice a day if necessary.

When using Symbicort as a reliever, take 1 inhalation at a time and wait a few minutes to see if it helps before taking another. Do not take more than 6 inhalations at once or more than 12 inhalations in 24 hours. If you regularly need 8 or more inhalations a day, speak to your GP or nurse.