Sara is a clinical pharmacist that believes everyone should understand their medications, and aims to achieve this through her writing.

Alex Yampolsky, PharmD, is a clinical pharmacist at Elizabeth Seton Children’s Center, a pediatric long-term care facility in Yonkers, New York.

Symbicort is an inhaled treatment that contains two different medicines: budesonide and formoterol . It is used to treat asthma in people aged 6 and older and chronic obstructive pulmonary disease (COPD).

Budesonide is a corticosteroid that fights off inflammation, which can be caused by lung conditions like asthma and COPD. Many types of steroids exist. Corticosteroids are an important part of human biology that affect the body’s immune response.

Formoterol is called a long-acting beta-agonist (LABA). This medicine targets the airways in your lungs and causes them to relax and open up, making it easier to breathe.

Symbicort is a prescription drug, which means you need an order for it from your healthcare provider. You’ll pick it up from your pharmacy rather than purchasing it over-the-counter (OTC) from a drugstore or grocery store.

Generic Name: Budesonide and formoterol

Brand Name(s): Symbicort

Therapeutic Classification: Anti-asthma, anti-inflammatory/bronchodilator combination

Controlled Substance: N/A

Active Ingredient: Budesonide and formoterol fumarate dihydrate

Dosage Form(s): Aerosol liquid (for inhalation by mouth)

The Food and Drug Administration (FDA) approved Symbicort to treat asthma in people at least 6 years old, and COPD, including both chronic bronchitis and emphysema.

Symbicort comes as a type of inhaler called an MDI or metered-dose inhaler. This is one of the most common types of inhalers. It uses a chemical called a propellant to move the medicine from a canister into your lungs as you inhale.

Getting the full dose of medicine into your lungs is dependent on your inhaler technique, especially with MDIs.

First off, you'll need to prime your inhaler if:

The following steps will ensure you get the full dose:

Store your Symbicort inhaler at room temperature (68 to 77 degrees Fahrenheit) in a dry place. This usually means humid areas like the kitchen or bathroom are not the best options as they can expose the inhaler to steam. Likewise, avoid hot areas like a car trunk, glove box, or anywhere in direct sunlight.

The inhaler has a dose counter that will tell you how many inhalations are left before it’s time for a refill. The canister may not feel totally empty at that time, and the inhaler may still spray medicine. It’s best to go ahead and get your refill, as you are not guaranteed to get the full amount of medicine once the dose counter runs out.

The medicines you inhale when you take Symbicort, budesonide and formoterol, are designed to target the airways in the lungs and improve symptoms caused by asthma and COPD. For this reason, there are no common off-label uses for Symbicort.

It is worth noting that LABAs are not used to treat acute asthma attacks. They work over a longer period to prevent attacks and will not help the symptoms of an asthma attack that has already started.

You can expect to see some improvement in your asthma and COPD symptoms within about 15 and five minutes, respectively, after taking Symbicort. It might take a couple of weeks to feel the full effects. Call your healthcare provider if you don’t notice any improvement after a week or if your symptoms get worse.

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

The following are some of the more common side effects of Symbicort. Notify your healthcare provider if you notice these side effects and think they are severe or do not go away:

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you have a medical emergency.

Serious side effects can include pneumonia or lower respiratory tract infections in people with COPD. Symbicort may also cause hypokalemia, or a low potassium level, leading to irregular heart rate or rhythm.

Other serious side effects are associated with the long-term use of corticosteroids (such as budesonide) found in Symbicort.

The following are some side effects associated with using any type of corticosteroid over a long period of time. This includes the budesonide found in Symbicort.

However, since it is an inhaled medication, less budesonide will enter your blood circulation (and therefore other bodily organs). Instead, more of it will remain in the lungs compared with other medications ingested by mouth or injected into the veins .

Some long-term side effects associated with Symbicort include:

Symbicort may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

In some cases, your healthcare provider may adjust your dose or treatment with Symbicort.

While Symbicort is approved to treat children 6 years and older, long-term use of corticosteroids like budesonide may slow their growth. If your child is taking Symbicort, the healthcare provider may need to monitor their growth. They may prescribe the lowest dose possible, to be safe.

Not enough adults aged 65 years and older were included in initial clinical studies of Symbicort, so it is unknown if they will respond differently to the medication. Since older individuals are more likely to have impaired wound healing or altered mental status, the benefits of using corticosteroids should outweigh the risks of potential side effects.

There have not been any adequate studies of formoterol use in pregnant people. However, studies involving budesonide use in pregnancy have not shown an increased risk of abnormalities or toxicity to the developing fetus.

As for nursing, one study showed that the dose of budesonide in the breast milk consumed by the infant is about 0.3% to 1% of the dose inhaled by the user from a dry powder inhaler. The dose from an MDI would be expected to be similar. Talk to your healthcare provider if you are breastfeeding or planning to breastfeed.

If you forget a dose of Symbicort, you can take it as soon as you remember. If you are closer to your next dose than the dose you missed, go ahead and skip the missed dose and wait for your next scheduled one.

If you only take Symbicort as directed, you shouldn’t be too concerned about using too much or overdosing. If you accidentally double up doses, continue your schedule as usual. Since Symbicort consists of two different medicines, the effects of taking too much of either of these can be considered separately.

Taking too much budesonide would be unlikely to have immediate effects. If you take too much over a long time, your chances of experiencing long-term side effects of corticosteroids would most likely be increased.

Taking too much formoterol would be more likely to cause acute or exaggerated symptoms, such as:

These effects were rare, even in studies where twice the dose was administered.

If you think you or someone else may have overdosed on Symbicort, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Symbicort, call 911 immediately.

It is very important that your doctor check the progress of you or your child at regular visits to make sure that this medicine is working properly and to check for any unwanted effects. You may need to have your eyes checked at regular visits. Be sure to keep all appointments.

Although this medicine decreases the number of asthma episodes, it may increase the chances of a severe asthma attack when they do occur. Be sure to read about these risks in the patient information leaflet and talk to your doctor about any questions or concerns that you have.

This should not be the first and only medicine you use for asthma or COPD. It will not stop an asthma attack that has already started. Your doctor may prescribe another medicine for you to use in case of an acute asthma attack or an acute COPD flare-up. If the other medicine does not work as well, tell your doctor right away.

Take all of your COPD medicines as your doctor ordered. If you use any type of corticosteroid medicine to control your breathing, keep using it as ordered by your doctor. Do not change your doses or stop using your medicines without first asking your doctor.

You or your child should not use this medicine if your asthma attack has already started or if you already have a severe asthma attack. Your doctor may prescribe another medicine (eg, a short-acting inhaler) for you to use in case of an acute asthma attack. Call your doctor immediately for instructions.

Do not use any other asthma medicine or medicine for breathing problems without talking to your doctor. This medicine should not be used with salmeterol (Serevent®), formoterol (Perforomist™), or arformoterol (Brovana®) inhalers.

Talk to your doctor or get medical care right away if:

Do not change your dose or stop using your medicine without first asking your doctor.

You may get infections more easily while using this medicine. Tell your doctor right away if you or your child have been exposed to someone with chickenpox or measles.

This medicine may cause fungus infection of the mouth or throat (thrush). Tell your doctor right away if you or your child have white patches in the mouth or throat, or pain when eating or swallowing.

Patients with COPD may be more likely to have pneumonia when taking this medicine. Check with your doctor if you start having increased sputum (spit) production, change in sputum color, fever, chills, increased cough, or an increase in breathing problems.

Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems. Talk to your doctor if you or your child have more than one of these symptoms while you are using this medicine: darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.

This medicine may cause paradoxical bronchospasm, which may be life-threatening. Check with your doctor right away if you or your child are having a cough, difficulty with breathing, or wheezing.

If you or your child develop a skin rash, hives, or any allergic reaction to this medicine, check with your doctor right away.

This medicine may decrease bone mineral density when used for a long time. A low bone mineral density can cause weak bones or osteoporosis. If you have any questions about this, ask your doctor.

This medicine may cause children to grow more slowly than usual. Talk to your child's doctor if you have any concerns.

This medicine may affect blood sugar and potassium levels. If you notice a change in the results of your blood or urine sugar or potassium tests or if you have any questions, check with your doctor.

Your doctor may want you to carry a medical identification (ID) card stating that you or your child are using this medicine and that you may need additional medicine during times of emergency, a severe asthma attack or other illness, or unusual stress.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Before starting Symbicort, tell your healthcare provider if any of the following applies to you:

Your healthcare provider will determine whether it is safe for you to take Symbicort and if any dosage adjustments or extra monitoring are needed.

Drug interactions can occur with Symbicort.

Watch for the following medications:

These are medicines often used for heart failure or high blood pressure. Since beta-blockers have the opposite effect as beta-agonists, they can block the effect of formoterol. Beta-blockers are not the best choice for people with asthma or COPD.

These drugs can interrupt how your body processes Symbicort and may make it stay in your system a little longer.

These are medicines that also commonly treat high blood pressure or heart failure. They have the potential to cause hypokalemia (low potassium level), which Symbicort may also do. Used together, the risk of hypokalemia is increased slightly.

Use extreme caution with these medications if you are also taking Symbicort. MAOIs and tricyclic antidepressants may increase the effects of formoterol on the vascular system.

Always tell your healthcare provider about all medications, prescription or OTC, and supplements you take.

Other inhalers that contain both an inhaled corticosteroid and an LABA include:

This list is a list of drugs also prescribed for asthma or COPD. It is NOT a list of drugs recommended to take with Symbicort. In fact, you should not take these drugs together. Ask your pharmacist or a healthcare provider if you have questions.

Symbicort is a long-term inhaler used to reduce asthma attacks in people 6 years and older and to control COPD symptoms, such as chronic bronchitis and emphysema.

Symbicort contains two different medicines: budesonide and formoterol. Budesonide is a corticosteroid that fights inflammation in the lungs. Formoterol is a LABA (long-acting beta-agonist) that opens up the airways in the lungs, making breathing easier.

Once you start taking Symbicort, don’t stop taking it before talking to your healthcare provider. They may want you to taper (gradually lower your dose) the medication, so that your body has time to increase its natural production of corticosteroids.

Dealing with lung conditions like asthma and COPD can be downright debilitating. If you or your child has asthma or COPD, it’s understandable to feel frustrated, sad, or angry about not being able to do things you would typically do or watch your child miss out on certain activities.

In addition to taking your medications as prescribed, there are many ways you can improve your quality of life with these conditions, such as:

You can also check out support groups, online or in-person, that may help you cope with your diagnosis. It can be helpful to meet other people who are dealing with similar challenges.

Understanding your or your child’s medications, how they work, and how best to take them will provide the best chance of improving overall symptoms. Remember that your healthcare team is there to help you with any questions or concerns.

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

Food and Drug Administration. Symbicort label.

Noonan M, Rosenwasser L, Martin P, et al. Efficacy and safety of budesonide and formoterol in one pressurised metered-dose inhaler in adults and adolescents with moderate to severe asthma: a randomised clinical trial. Drugs. 2006;66(17):2235-2254. doi:10.2165/00003495-200666170-00006

Rennard SI, Tashkin DP, McElhattan J, et al. Efficacy and tolerability of budesonide/formoterol in one hydrofluoroalkane pressurized metered-dose inhaler in patients with chronic obstructive pulmonary disease: results from a 1-year randomized controlled clinical trial. Drugs. 2009;69(5):549-565. doi:10.2165/00003495-200969050-00004

Ajimura CM, Jagan N, Morrow LE, et al. Drug interactions with oral inhaled medications. J Pharm Technol. 2018;34(6):273-280. doi:10.1177/8755122518788809

By Sara Hoffman, PharmD Sara is a clinical pharmacist that believes everyone should understand their medications, and aims to achieve this through her writing.

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