Symbicort Turbohaler is a combination inhaler that is used to prevent and relieve asthma symptoms, but some people use it just as a preventer inhaler alongside a separate reliever or ‘blue’ inhaler. The Symbicort Tubohaler can also be used to treat chronic obstructive pulmonary disease (COPD).

Symbicort is a type of turbohaler which means it contains dry powder that is inhaled to deliver the medication to the airways where it is needed.

Symbicort Turbohaler is available in 3 different doses:

• 100/6
• 200/6
• 400/12

Your doctor will advise which strength you will need and how often you should take it.

Symbicort contains 2 active ingredients that work to manage asthma symptoms:

• Budesonide: a type of medication called a corticosteroid that works to reduce swelling and inflammation in the lungs.
• Formoterol fumarate: a bronchodilator also known as a ‘long-acting beta2 adrenoceptor agonist’ that works by relaxing the muscles in the airways, making it easier for you to breathe.

The Symbicort Turbohaler is used to prevent and relieve asthma symptoms such as:

• coughing
• wheezing
• breathlessness
• chest tightness

As well as being used daily to prevent asthma attacks, Symbicort Turbhaler can be used during a sudden asthma attack to relieve the symptoms and help your breathing return to normal.

How long does Symbicort take to work?

When Symbicort Turbohaler is used to prevent asthma symptoms, it can take up to 2 weeks to fully notice the benefits.

Symbicort will be effective within 3 minutes when used to treat the sudden onset of asthma symptoms as formoterol fumarate acts quickly to relax the muscles in the lungs. The effects can last for up to 12 hours.

How effective is Symbicort?

Clinical studies have shown that a combination inhaler containing budesonide and formoterol was as effective at managing asthma symptoms as separate budesonide and formoterol inhalers. The combined inhaler was also more effective than a budesonide inhaler alone.

Further research shows that people who use a combined budesonide and formoterol inhaler experience:

• reduced asthma symptoms
• improved lung function
• less reliever inhalations

You should always use the Symbicort Turbohaler exactly as your doctor has prescribed.

Before you use your new Symbicort Turbohaler for the very first time, you will need to prepare it for use as follows:

1. Unscrew the cover and remove it. You may hear a rattling sound, this is normal.
2. Hold the Symbicort Turbohaler upright making sure the red grip is on the bottom.
3. Turn the red grip as far as it will go in either direction until it stops. Then, turn it as far as it will go in the other direction, you should hear a click sound. This could come from either direction
4. Now repeat by turning the red grip in both directions.
5. The Symbicort Turbohaler is now loaded and ready for you to use.

How to use the Symbicort Turbohaler

1. Unscrew the cover and lift it off - you may hear a rattling sound. This is normal.
2. Hold the Symbicort Turbohaler upright, making sure the red grip is at the bottom.
3. Make sure you do not hold the mouthpiece while you load the Symbicort Turbohaler.
4. To load, turn the red grip as far as it will go in one direction. Then turn it as far as it will go in the other direction, you should hear a click sound on the first or the second twist. The Symbicort Turbohaler is now loaded and ready to use. Only load the Turbohaler when you need to use it.

How to take an inhalation

1. When the Symbicort Turbohaler is loaded, hold it away from your mouth. Breathe out slowly and gently as far as you feel comfortable. Do not breathe out through your Symbicort Turbohaler.
2. Place the mouthpiece gently between your teeth. Close your lips, making a seal so no medication can escape.
3. Breathe in as deeply and as hard as you can through your mouth. Do not bite down or chew on the mouthpiece.
4. Remove the Symbicort Turbohaler from your mouth and then breathe out gently. The amount of medicine inhaled is so small you may not be able to taste it after inhalation. However, so long as you have followed the instructions, you can be confident that the required dose of medication is now in your lungs.
5. If you require a second dose, repeat steps 2 to 7.
6. Replace the cover tightly after use.
7. Rinse your mouth with water after each preventer dose and spit it out to reduce the risk of developing mouth thrush.

Do not try to remove or twist the mouthpiece. It is fixed to your Symbicort Turbohaler and must not be removed. Do not use your Symbicort Turbohaler if it has been damaged or if the mouthpiece has come apart from your Symbicort Turbohaler.

To clean your Symbicort Turbohaler, wipe the outside of the mouthpiece once a week with dry tissue. Do not use water or any other liquid.

When to use Symbicort Turbohaler

The Symbicort Turbohaler can be used in different ways to manage asthma symptoms. You should use Symbicort as directed by your doctor:

1. Use the Symbicort Turbohaler every day to prevent asthma symptoms and to treat an asthma attack, or
2. Use Symbicort Turbohaler every day to prevent asthma symptoms alongside a separate reliever inhaler, or
3. Use the Symbicort Turbohaler as your reliever inhaler when you need it but use a separate daily preventer inhaler

The Symbicort Turbohaler can also be prescribed to manage COPD in adults.

How often to take Symbicort

• Using Symbicort Turbohaler with a separate reliever inhaler: Take 1 or 2 puffs twice a day but this can be increased to 4 puffs twice a day if needed. You must take your prescribed dose as instructed to prevent asthma symptoms from occurring. If you experience asthma flare-up symptoms, use a separate reliever inhaler as and when they occur.
• Using Symbicort Turbohaler as your only inhaler: You’ll need to use the inhaler exactly as your doctor prescribes. To prevent asthma symptoms you will either need to take 1 inhalation in the morning and then 1 in the evening or 2 puffs in the morning and 2 in the evening. You will also use the Symbicort Turbohaler as your reliever inhaler to treat asthma symptoms when they happen. To use it as your reliever inhaler, you’ll need to take 1 inhalation and wait a few minutes, if you do not feel better, take another inhalation. You must not take more than 6 inhalations at one time.
• Using Symbicort Turbohaler as your reliever inhaler: Take 1 inhalation when you notice asthma flare-up symptoms starting and wait a few minutes, if you do not feel better, take another inhalation. You must not take more than 6 inhalations at one time. Always carry your Symbicort Turbohaler with you.
• Using Symbicort Turbohaler to treat COPD: The usual dose is 2 inhalations twice a day.

If you take Symbicort to relieve asthma symptoms during an asthma attack and notice you need it more often than usual, or it’s not remaining effective with a daily dose of more than 8 inhalations, speak with your doctor straight away. You may need to change your asthma treatment plan. Usually, more than 8 puffs a day is not needed, but in some cases, your doctor can increase this to 12 puffs for a limited time. Don’t take more than 12 puffs of Symbicort in total in any 24-hour period.

How long do you need to use Symbicort Turbohaler for?

Most people will need to use their asthma inhaler for many years. You should use Symbicort for as long as you have been directed by your doctor. If you feel you need to stop using it, you should speak to your doctor first.

How long will Symbicort last?

Each Symbicort Turbohaler contains 30, 60, or 120 doses.

If you use Symbicort daily and are required to use 2 puffs 2 times per day, your inhaler would last 15 days on a 60-dose inhaler and 30 days on a 120-dose.

If you are also using your inhaler as a reliever, this will shorten the usage on both units, depending on how often you need to use it.

The effects of Symbicort Turbohaler can remain effective for up to 12 hours.

Symbicort is a prescription-only medication, so you will need a prescription from a doctor to obtain it. It is available to request from reputable online services like Superdrug Online Doctor or it may be available on the NHS.

Can I buy Symbicort Turbohaler online?

Yes, you can request the Symbicort Turbohaler from Superdrug Online Doctor if you have already been prescribed it by a doctor.

If so, ordering is quick, easy, entirely confidential, and can be done from the comfort of your home, saving valuable time. To request a Symbicort Turbohaler, simply:

1. Fill in a brief questionnaire about your health and lifestyle.
2. Order your preferred choice of treatment and make payment.
3. One of our doctors will review your order and questionnaire answers.
4. If your order is approved, your treatment will be posted directly to your address or made available for collection at a Superdrug Pharmacy.
5. If your order is not right for you, one of our doctors will contact you via your account with other suitable options.

Can I buy Symbicort over the counter?

No, Symbicort is a prescription-only medication, meaning you would need to be assessed by your doctor in order to get it.

At Superdrug Online Doctor, our doctors use the same criteria to assess if your choice of medication is right for you.

Can I get Symbicort on the NHS?

It may be possible for you to obtain Symbicort on the NHS. You would first need to make an appointment with your GP for them to assess if it is the right treatment for you.

Like all medications, Symbicort can cause side effects, although not everybody gets them.

If you experience any of the following rare but serious side effects of an allergic reaction, stop using Symbicort Turbohaler and call 999 or get someone to take you to A&E immediately:

• swelling of your face, particularly around your mouth
• swelling of the tongue and/or throat
• difficulty swallowing
• hives together with difficulty breathing
• sudden feeling of faintness
• sudden acute wheezing or shortness of breath after using your inhaler

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

• awareness of your heart beating (palpitations)
• trembling or shaking.
• thrush (a fungal infection) in the mouth
• mild sore throat, coughing and a hoarse voice
• headache
• pneumonia in COPD patients

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

• feeling restless, nervous or agitated
• disrupted sleep
• feeling dizzy
• feeling sick (nausea)
• fast heartbeat
• bruising
• muscle cramps
• blurred vision

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

• rash, itching
• tight airway muscles
• low blood potassium levels
• irregular heartbeat

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

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

Inhaled corticosteroids can affect the normal production of steroid hormones in your body, particularly if you use high doses for a long time. The effects include:

• changes in bone mineral density (thinning of the bones)
• cataract (clouding of the lens in the eye)
• glaucoma (increased pressure in the eye)
• a slowing of the rate of growth of children and adolescents
• an effect on the adrenal gland (a small gland next to the kidney)

These effects are much less likely to happen with inhaled corticosteroids than with corticosteroid tablets. Your doctor will also make sure you’re on the lowest dose needed to keep your asthma under control.

You can find a full list of side effects in the patient information leaflet supplied with your inhaler.

How long do Symbicort side effects last?

Most Symbicort Turbohaler side effects are mild and temporary. Therefore, they should go away on their own within the first few months of taking the medication or you may get them for a short time after taking a dose as this is when the medicine is at its highest level in your body.

What to do if you get Symbicort side effects

If you experience any side effects while using a Symbicort Turbohaler listed or not listed, you should contact your doctor, nurse, or pharmacist for advice.

If you experience any serious side effects, tell your doctor immediately or call 111 if out of surgery hours. In an emergency, call 999 or get someone to take you to A&E.

The active ingredients in a Symbicort Turbohaler may not be suitable for everyone.

Do not use Symbicort if you:

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

Tell your doctor, nurse, or pharmacist before using a Symbicort Turbohaler if you:

• have a lung infection
• are diabetic
• have ever had any heart problems
• have high blood pressure
• have an irregular or uneven heartbeat
• have narrowing of arteries or heart failure
• have low blood potassium levels
• have severe liver problems
• experience blurred vision or visual disturbances
• have a thyroid or adrenal gland issue
• take any prescribed, over-the-counter-or herbal medications

Symbicort Turbohaler and pregnancy

You should consult your doctor before taking Symbicort if:

• you are pregnant
• want to become pregnant
• think you may be pregnant

Do not use Symbicort Turbohaler in these circumstances unless your doctor tells you to.

If you are already using Symbicort and become pregnant, do not stop taking it but speak to your doctor immediately.

Symbicort Turbohaler and breastfeeding

If you are breastfeeding, talk to your doctor before using Symbicort.

Symbicort may not be suitable for everyone. It’s important that you choose a treatment for your asthma that sounds right for you and your circumstances. At Superdrug Online Doctor, we offer a range of alternative asthma treatments, such as:

Combined Inhalers

Combined asthma inhalers contain 2 active ingredients that work to both prevent and relieve asthma symptoms. Usually, they contain a corticosteroid which helps to reduce the inflammation and irritation in the airways and a bronchodilator to relax the muscles in the airways, making it easier to breathe. The alternative combination inhalers we offer are:

• Fostair
• Seretide

Preventer inhalers

Preventer inhalers, also sometimes known as brown inhalers or puffers, are used daily to limit inflammation in the airways and prevent asthma symptoms from occurring. They are usually used alongside a separate reliever inhaler which is used when asthma flare-up symptoms occur. The preventer inhalers offered by Superdrug Online Doctor are:

• Clenil-Modulite
• Pulmicort
• Qvar Easi-Breathe

Reliever inhalers

Also known as blue inhalers, reliever inhalers are carried with you at all times and are only used when asthma symptoms occur. They work quickly to relax the airways, making it easier to breathe. At Superdrug Online Doctor, we offer the following reliever inhalers:

• Ventolin
• Salbutamol

Is Symbicort the same as Pulmicort?

No, Symbicort and Pulmicort are not the same. Pulmicort is a preventer inhaler which means you will need a separate reliever inhaler to treat an asthma attack. Symbicort is a combination inhaler which can be used to prevent and relieve asthma symptoms. Whilst both Symbicort and Pulmicort contain the active ingredient budesonide, only Symbicort contains formoterol which is a bronchodilator that opens up the air passages.

Do I need a reliever inhaler still?

If Symbicort has been prescribed as a combination inhaler, you don’t need a separate reliever inhaler. That’s because it is prescribed as maintenance and reliever therapy so you can use it for both. This will be detailed in your prescription but you can check with your doctor if you’re not sure.

Sometimes Symbicort is prescribed just as a preventative inhaler. If it has been prescribed to you as your preventer inhaler, you will need a separate reliever inhaler such as Ventolin.

Can you overdose on Symbicort?

Yes, you can take too much Symbicort. The most common symptoms of using more Symbicort Turbohaler than you should are trembling, headache, or a fast heartbeat.

You should not need to use more than 8 inhalations in a day, but sometimes your doctor may allow up to 12. If you regularly need more than 8 inhalations a day, speak to your doctor as you may need a different treatment to manage your asthma.

Does Symbicort cause weight gain?

Weight gain is not listed as a side effect of Symbicort. However, there is some evidence that oral corticosteroids used to treat asthma can lead to weight gain because of increases in appetite and metabolic changes.

Inhaled corticosteroids, like budesonide, rarely cause weight gain because there is very little absorption into the rest of the body outside of the lungs. If you are concerned about weight gain while using Symbicort, speak to your doctor.