Budesonide and Formoterol (Symbicort) Rapihaler

Medication Information Leaflet

What is this medication for?

Symbicort inhaler is used to help control symptoms in asthma and chronic obstructive pulmonary disease (COPD). COPD is a disease affecting the lungs which make it harder for the person to breathe as the disease gets worse.

Symbicort contains two ingredients, Formoterol and Budesonide. Formoterol helps to keep the airways open, making it easier for air to move in and out of the lungs. Budesonide is a type of steroid and helps to reduce and prevent swelling and inflammation in the airways.

Symbicort is normally referred to as a ’preventer’ or ‘controller’ inhaler as it helps to prevent symptoms such as breathlessness in asthma and COPD. It can also help to reduce the chances of having an asthma attack. In some cases, the doctor will also ask you to use Symbicort to relieve asthma attacks.

How should I use this medication?

  • Use your Symbicort inhaler regularly as directed. Do not stop using the inhaler without checking with your healthcare professional, even if you feel well or there are no symptoms.
  • Preparing the inhaler before use
​Shake the inhaler gently.  
​For a new inhaler, release
  • 3 puffs into the air, if you are using the 40mcg/2.5mcg inhalation
  • 2 puffs into the air, if you are using inhalers of other strengths
​For inhalers that have not been used for more than a week or have been dropped, release 2 puffs into the air.

  • Administering the medication 
​Shake the inhaler before use.
​Remove the mouthpiece cover. 
​Hold the inhaler upright in front of your mouth. Breathe out as far as you can and put the mouthpiece in your mouth (between your teeth) and close your lips around it.
​Start to breathe in deeply and slowly through your mouth. Press down firmly on the counter to release the medication at the same time.
​Remove the inhaler from your mouth. Hold your breath for approximately 10 seconds or for as long as comfortable.
​Shake the inhaler then repeat Steps 3 to 5 if another puff is required.
​Put the mouthpiece cover back to the original position to prevent dust and debris from accumulating.
​Rinse your mouth with water after use

  • Cleaning the inhaler
​Remove the mouthpiece cover.
​Wipe the inside and outside of the mouthpiece with a clean, dry cloth.
​Replace the mouthpiece cover.
​It is recommended to clean the inhaler at least once a week. Do not put the inhaler in water or dismantle the inhaler.

  • Reading the counter
    • The counter helps you to keep track of the number of puffs left in the inhaler.
    • Discard the inhaler when the counter reaches zero as you have used up the inhalations in the inhaler.
    • Your inhaler may not feel empty, and it may still operate but you will not get the right amount of medication if you continue to use it.

What should I do if I forget to take/use this medication?

If you forget to take a dose, take it as soon as you remember. Then take your next dose at the usual time. Do not take two doses to make up for the missed dose.

What precautions should I take?

Inform your healthcare professional if:
  • You are allergic to this medication or any of the other ingredients of this medication
  • You are pregnant, planning to become pregnant, or breastfeeding.
  • You are taking any other medications, including supplements, traditional medications and herbal remedies.
  • You are taking oral medications to treat fungal infections such as itraconazole or ketoconazole.
  • You have high blood pressure
  • You have heart, liver or thyroid problems
  • You have diabetes
  • You have low blood potassium levels
Symbicort can be used both to prevent and relieve an asthma attack. If your doctor has told you to use Symbicort to relieve your asthma attack, make sure you have it with you at all times.

However, if your doctor gave you a separate fast-acting inhaler, such as Salbutamol inhaler, make sure you have the Salbutamol inhaler with you at all times instead. A fast-acting inhaler would open up your airways quickly to relieve your breathlessness during an asthma attack. Fast-acting inhalers are normally referred to as ‘reliever’ inhalers.

Please see your healthcare professional if your asthma symptoms get worse. Signs include:
  • Having to use your ‘reliever’ inhaler more often than before
  • Your wheezing (a high-pitched whistling sound made while breathing) or chest tightness
    gets worse
  • Your ‘reliever’ inhaler doesn’t help you as well as before
These symptoms may mean that your condition could be getting worse and you may need extra treatment.

What are some common side-effects of this medication?

  • Increase chance of experiencing throat irritation, oral fungal infection (seen as white
    patches in mouth), hoarseness of voice and coughing. You can prevent these side
    effects by:
    • Rinsing your mouth with water and spitting the water out after rinsing
    • Brushing your teeth each time after you use your Symbicort inhaler
  • Dizziness
  • Headache
The dizziness and headache may happen but should get better over time. Check with your doctor if any of these symptoms are serious or do not go away.

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:
  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body
If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

What food or medication should I avoid when I take this medication?


How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children. Keep the cap on when not in use.

How should I throw away this medication safely?

Pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin.

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated on September 2022
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