Symbicort Turbuhaler 400/12

Symbicort Turbuhaler general information

What is Symbicort Turbuhaler used for?

Symbicort Turbuhaler 400/12 is a combination medication for treating obstructive airways disease, such as asthma and chronic obstructive pulmonary disease (COPD). This combination therapy is used for long-term asthma management in adults and children over 6 years, who are already using an inhaled “preventer” asthma medication (corticosteroid) to treat asthma as well as a “reliever” medication (short-acting bronchodilator) when needed, but who are not adequately controlled as they are still having symptoms. However it is not suitable for management of severe asthma. Symbicort Turbuhaler is also used for asthma management in people who are already adequately controlled by using both components of the combination (corticosteroid and long-acting bronchodilator) as separate medications. Symbicort Turbuhaler 400/12 is also used for maintenance therapy of moderate to severe COPD for people who are using a bronchodilator but are still having symptoms.

How does Symbicort Turbuhaler work?

Symbicort Turbuhaler 400/12 contains a combination of two medications that work by different mechanisms of action to control reversible obstructive airways disease in asthma and chronic obstructive pulmonary disease (COPD). Budesonide is a corticosteroid and anti-inflammatory medication that blocks Inflammation, one of the underlying causes of asthma, by inhibiting the production of inflammatory chemicals released in the airways in response to asthma trigger, such as an allergens or irritants in the air. This reduces inflammation and swelling of the airways, as well as excess mucus production, which can cause blockage of the airways. Eformoterol is a rapid and long-acting beta2-agonist and bronchodilator that relaxes the muscles of the small airways of the lungs (bronchioles) to widen the airways. This reduces bronchospasm (constriction or the airways) relieving symptoms of asthma such as tightness of the chest, wheezing and shortness of breath and provides relief for up to 12 hours. The combination of medications in Symbicort Turbuhaler 400/12 has an additive effect as they work together to provide better control of asthma to protect against symptoms, including tightness of the chest, wheezing and shortness of breath; also to prevent exacerbations of asthma or COPD and improve lung function.

What does Symbicort Turbuhaler contain?

Symbicort Turbuhaler 400/12 contain a combination of the active ingredients budesonide (100mcg) and eformoterol fumarate dehydrate (6mcg) in a dry powder, used to treat asthma and chronic obstructive pulmonary disease (COPD). It also contains lactose.

What doses of Symbicort Turbuhaler are available?

Symbicort Turbuhaler contains is available online from Inhouse pharmacy in the following doses of Budesonide/ Eformoterol:

• 100/6 for maintenance and reliever therapy
• 200/6 for maintenance and reliever therapy
• 400/12 for maintenance therapy only, using another separate inhaler for reliever therapy

Treating asthma with Symbicort Turbuhaler

Symbicort Turbuhaler 400/12 contains a combination of two medications budesonide and eformoterol that are used together for long-term asthma management therapy as well as a “reliever” for asthma attack as part of an asthma management plan. Budesonide is a corticosteroid and anti-inflammatory medication that blocks Inflammation, one of the underlying causes of asthma, by inhibiting the production of inflammatory chemicals released in the airways in response to asthma trigger, such as an allergens or irritants in the air. This reduces inflammation and swelling of the airways, as well as excess mucus production, which can cause blockage of the airways. Eformoterol is a rapid and long-acting beta2-agonist and bronchodilator that relaxes the muscles of the small airways of the lungs (bronchioles) to widen the airways. This reduces bronchospasm (constriction or the airways) relieving symptoms of asthma such as tightness of the chest, wheezing and shortness of breath and provides relief for up to 12 hours. The combination of medications in Symbicort Turbuhaler 400/12 has an additive effect as they work together to provide better control of asthma to protect against symptoms, including tightness of the chest, wheezing, cough and shortness of breath. Symbicort Turbuhaler 400/12 should only be used for maintenance therapy and not for both maintenance and therapy; you should use another reliever medication when needed.

Can Symbicort Turbuhaler be used with other asthma inhalers?

At the 2 lower doses (400/12 and 200/6), Symbicort Turbuhaler can be used as a long-term “preventer” medication to reduce inflammation and swelling of the airways of the lung, and as a “reliever” medication to reduce bronchospasm (constriction or narrowing of the bronchioles or small airways) as part of an asthma management plan to reduce symptoms and exacerbations of asthma, and to improve lung function. The higher dose of Symbicort Turbuhaler (400/12) is only for maintenance therapy and you will also be prescribed a short-acting bronchodilator for relief of bronchospasm during an asthma attack, to be used as needed. Both are intended to be taken together, only if recommended by your doctor.

Symbicort Turbuhaler for chronic obstructive pulmonary disease (COPD)

Symbicort Turbuhaler 400/12 contains a combination of two medications, budesonide and eformoterol that are used together for long-term maintenance therapy of moderate to severe obstructive pulmonary disease (COPD) for people who are using a bronchodilator but are still having frequent symptoms and a history of exacerbations. COPD is a chronic disease of the airways and includes conditions such as emphysema and chronic bronchitis, characterised by inflammation of the airways and increased mucus production which cause symptoms like cough with phlegm production and breathlessness. Budesonide is a corticosteroid and anti-inflammatory medication that reduces inflammation and swelling of the airways, as well as excess mucus production, which can cause blockage of the airways. Eformoterol is a rapid and long-acting beta2-agonist and bronchodilator that relaxes the muscles of the small airways of the lungs (bronchioles) to widen the airways. This reduces bronchospasm (constriction or the airways) making breathing easier, and provides relief for up to 12 hours. The combination of medications in Symbicort Turbuhaler 400/12 has an additive effect as they work together to provide better relief from symptoms, increased airflow, reduced exacerbations and improved quality of life.

What are the side effects of Symbicort Turbuhaler?

The most commonly reported side effects when taking Symbicort Turbuhaler 400/12 include: a sore throat or tongue, which may be due to candida infection (thrush), hoarseness or throat irritation, headache, tachycardia (rapid heart beat), tremor (shaky or tense feeling), palpitations. Paradoxical bronchospasm is uncommon but can occur in which your inhaler worsens your breathing. Also hypokalaemia (low blood potassium) is an uncommon but serious side effect.

When should Symbicort Turbuhaler not be used?

You should not use Symbicort Turbuhaler400/12 if you:

• are allergic to budesonide or eformoterol or any ingredients in Symbicort Turbuhaler
• are pregnant or are breastfeeding, without discussion with your doctor
• cardiovascular disease, including heart failure ischaemic heart disease or tachyarrythmias (rapid heart beat)
• have diabetes, thyroid problems or problems with your potassium levels, without discussion with your doctor
• are taking medicines that interact with Symbicort Turbuhaler, including: other beta-adrenergic stimulants or sympathomimetic amines such as ephedrine; the antifungals ketoconazole and itraconazole; beta blockers, including eye drops for glaucoma, the antiarrhythmics quinidine, disopyramide and procainamide; phenothiazines in antipsychotics, the antihistamine terfenadine; monoamine oxidase inhibitors and tricyclic antidepressants, L-Dopa for Parkinson’s disease, L-thyroxine for thyroid disease, oxytocin to induce labour, alcohol, xanthines found in stimulants, mineralocorticosteroids for Addisons disease, diuretics for water retention

What medications interact with Symbicort Turbuhaler?

Several medications interact with Symbicort Turbuhaler 400/12 and should either not be taken while you are taking Symbicort Turbuhaler or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Symbicort Turbuhaler: other beta-adrenergic stimulants or sympathomimetic amines such as ephedrine, the antiarrhythmics quinidine, disopyramide and procainamide, phenothiazines in antipsychotics, the antihistamine terfenadine, monoamine oxidase inhibitors and tricyclic antidepressants; L-Dopa for Parkinson’s disease, L-thyroxine for thyroid disease, oxytocin to induce labour, alcohol, xanthines found in stimulants, mineralocorticosteroids for Addisons disease, diuretics for water retention
• Drugs that affect Symbicort Turbuhaler: beta blockers (including eye drops)
• Drugs that are affected by Symbicort Turbuhaler: the antifungals ketoconazole and itraconazole

What are the health risks of Symbicort Turbuhaler?

Long term use of Symbicort Turbuhaler may cause the adrenal glands, which produce endogenous (naturally occurring) corticosteroids, to stop working efficiently. This may slow down the growth rate in children and will need regular monitoring.

What is paradoxical bronchospasm?

All inhaled asthma medications can cause paradoxical bronchospasm, which is when the inhaled medication taken to relieve or prevent bronchospasm actually makes it worse, causing wheezing, shortness of breath and tightness of the chest. If this happens you should inform your doctor and take their advice.

How should Symbicort Turbuhaler be used?

The dose of Symbicort Turbuhaler 400/12 you use (number of inhalations) and how often you take it depends on what you are being treated for, the severity of your asthma, whether you are using it for maintenance and reliever therapy or just for maintenance therapy, and your age, and should be as recommended by your doctor. You will usually take one inhalation twice a day, morning and evening, or you can take 2 inhalations either morning or evening. If you experience asthma symptoms and you need a “reliever” inhaler your doctor may recommend that you take another inhalation as well as your usual doses, and the total number of inhalations you take per day depends on your age, condition and your doctor’s recommendation. You should continue to use your Symbicort Turbuhaler 400/12 daily for as long as recommended by your doctor and you should not stop taking your Symbicort Turbuhaler 400/12, even if you feel better.

How to use your Symbicort Turbuhaler?

Follow the instruction provided with your Symbicort Turbuhaler:

1. Remove the cover from your Symbicort Turbuhaler.
2. Breathe out as far as is comfortable and then place the mouthpiece in your mouth.
3. Breath in forcefully and deeply through the mouthpiece to ensure that you inhale the full dose into your lungs. Never breathe out through the mouthpiece.
4. Replace the cover after use.
5. Rinse your mouth out with water after inhaling to ensure that there is no powder remaining in your mouth.

How many puffs to take from your Symbicort Turbuhaler?

How many inhalations you take from your Symbicort Turbuhaler and how often depends on the severity of your condition and your age and should be as recommended by your doctor. You will usually take one or two puffs twice a day, morning and evening.

How long should you take Symbicort Turbuhaler?

You should continue to use your Symbicort Turbuhaler 400/12 daily for as long as recommended by your doctor and you should not stop taking your Symbicort Turbuhaler 400/12, even if you feel better.

Missed dose of Symbicort Turbuhaler

If you miss a dose of Symbicort Turbuhaler 400/12 you do not need to make up for the missed dose just take the next dose and skip the missed dose. Do not take a double dose.

How should Symbicort Turbuhaler be stored?

You should store your Symbicort Turbuhaler 400/12 below 25°C in a cool dry place. Keep away from direct sunlight and replace the cover when not in use