Symbicort is an inhalation aerosol for relieving the symptoms of asthma and chronic obstructive pulmonary disease. It is an FDA approved bronchodilator application for the maintenance treatment of obstructive airways and is not intended for acute episodes of breathing trouble.
What are asthma and COPD?
Asthma is caused by environmental factors in genetically predisposed individuals, characterized by a cough, tightness in chest, wheezing and shortness of breath. The symptoms of asthma come in episodes that may vary in their frequency; usually, the condition worsens at night. The management of asthma includes avoiding the stimulants that trigger the asthmatic attacks and medications such as corticosteroid inhalers or in the severe cases intravenous route is used. Medicines for asthma come in two categories, the controls and the rescue ones for regular and urgent situation respectively.
Chronic Obstructive Pulmonary Disease is a collective term used for progressive diseases of lungs namely chronic bronchitis and emphysema, characterized by symptoms similar to those of asthma as shortness of breath, cough, wheezing, fatigue and frequent respiratory infections.
The management of COPD involves medications, pulmonary rehabilitation and in severe of cases, surgical intervention. The medications for COPD are mainly bronchodilators and anti-inflammatory drugs that dilate the airways and reduce inflammation therein, that may aggravate the symptoms of COPD. The drugs for this purpose are given as pills, inhalers or others.
In both the cases of asthma and COPD, early diagnosis and treatment are crucial for a better quality of life.
What is Symbicort?
Symbicort is a combination of two medicines aimed at easing the breathing in patients with asthma and COPD, by
- relaxation of airway muscles (bronchodilation)
- Reduction of any inflammation in the airways (anti-inflammatory)
The two medicines are Budesonide and Formoterol that is the steroid (anti-inflammatory) and the long-acting beta-2 adrenergic agonist (bronchodilator) respectively.
Symbicort for Asthma
Symbicort acts as a CONTROL medicine for asthma, working within 15-minutes of inhalation. By using Symbicort twice daily (morning and evening), patients will require the RESCUE medication less frequently.
Symbicort is used in children above 12-years of age and in patients, whose asthma is not controlled with a long-term control medicine or their condition is severe enough to begin treatment with it.
Symbicort for COPD
As for asthma, Symbicort is indicated for the maintenance therapy of COPD in a strength of 160/4.5 and the effects can be experienced as early as five minutes.
It is important to note that Symbicort is not intended to use as a RESCUE medicine for asthma or COPD. Do not use Symbicort in case an acute attack has already begun.
Symbicort is indicated in the following doses for different age groups
- 80/4.5 for children aged 6-12 years (for asthma)
- 80/4.5 for children above 12-years (for asthma)
- 160/4.5 for adults (for asthma and COPD)
Two inhalations per day as a morning and evening dose should be taken.
Side effects of Symbicort
Some of the side effects of Symbicort as cited the official website are
- Localized infections of mouth and pharynx with Candida Albicans
- Infection of the lower respiratory tract including pneumonia
- Hypersensitivity and allergic reaction to Symbicort
- Varying degree of cardiovascular and nervous system side effects
- Long-term use may lead to decreased bone mineral density
- Retardation in growth rate of children
- Glaucoma, cataract and increased intraocular pressure
- Hypokalemia and hyperglycemia
Rests of the side effects are discussed in detail at the official web page of Symbicort. The inhaler has many drug interactions and its indication should be carefully evaluated and monitored by a physician. For asthmatic patients, once the symptoms are controlled, the further administration should be decided upon by your doctor. As with the majority of prescription drugs, the dose of Symbicort should never be terminated without the physician’s advice.
Precautions to use for Symbicort
There are some precautions for the indication of Symbicort
- Patients on long-term Ketoconazole treatment
- Patients with hypertension, cardiac arrhythmias, and coronary insufficiency
- Patients with glaucoma or cataract
- Patients with thyrotoxicosis, diabetes, convulsive disorders, and ketoacidosis
- Patients being treated with MAO inhibitors or tricyclic anti-depressants
- Patients on diuretics, specifically the non-potassium sparing ones
Contraindications to the use of Symbicort
Some conditions will not ensure the administration of Symbicort
- Not to be used in acute episodes associated with asthma
- Not to be administered in already worsening conditions of asthma or COPD
- Patients already on Formoterol or other LABA prescriptions
- Immune compromised patients
- Pregnancy, exceptions to rule is when the benefit outweighs the risk to the baby.
FDA has ranked it a C, implying that research on animals show adverse effects on the developing fetus whereas the research is lacking as regards its safety in human pregnancy.
The expected time duration for the anticipated results and projected side effects
The therapeutic effects of Symbicort start being established in the first few days and reach the maximum after about few weeks to months.
The period when the side effects start troubling you is
- From initial few hours to few days_ headache
- From first few days to first few weeks _ common cold and back pain
- From first few days to few months_ mouth infection
- Lasting from first few hours to days_ stomach problems
Source: FDA product label and Iodine Pharmacists
The Symbicort comes with a boxed warning meaning it is a pre-requisite by FDA to the use of any product with serious or life-threatening risk. In the case of Symbicort,
Long-acting beta-2 adrenergic agonists, such as Formoterol, one of the active ingredients in Symbicort, increase the risk of asthma-related deaths. (For full content, please visit the website)
User reviews and ranking of Symbicort
According to Drugs.com, the prescription for Symbicort tops the ranking as regards the indications for COPD when compared with 38 counterpart medications. As far as its role as a maintenance therapy, Symbicort stands at an average ranking of 7.9 when compared with its equivalents, both for COPD and asthma.
After analyzing some of the users’ reviews about Symbicort, it was observed that Symbicort did great as a maintenance or control therapy for the majority of the patients. The cases that reported side effects were actually the ones under the ‘contraindicated’ category of the Symbicort so obviously had severe side effects to terminate the use.
At another site (Iodine.com), based on 382 reviews, 57% of the users recommended Symbicort by calling it worth the shot, 21% did not find it useful whereas 22% were not sure about it.
The cost of Symbicort
The good thing about Symbicort is that its cost is covered by most Medicare and insurance plans. Some of the pharmacies offer coupons for its purchase and some may even put forward a lower cash price for its purchase.
You might want to take advantage of the ‘Manufacturer Coupon’ with a free program but some rules to purchase. In the case of Symbicort, the manufacturer coupon is offered by AstraZeneca that can be downloaded by registering online (mysymbicort.com/coupon-prescription-savings.html) and printing it. These coupons are free for the first month and for $25 thereafter for each prescription, limited to one individual.
The cost of Symbicort ranges from $320-$340 at various pharmacies with discounts and free coupons.
Final word on Symbicort
All the indications on Symbicort tell a fairy tale but
- being a combination of steroid and LABA
- with a boxed warning
- various side effects
- many drug interactions
There is growing skepticism on the use of asthma drugs containing LABA. These drugs have been shown to ‘mask’ the effects of asthma and in some cases have also revealed their addictive character. According to an article published in Huffington’s post, these drugs can cause ‘desensitization’ or ‘toleranc e’ to ‘changing of the lung capacity over prolongs use’.
Always consult your physician before initiating any drug, go through the drug literature meticulously, and report any side effect promptly to authorities.