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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Symbicort
Generic Name
Budesonide And Formoterol Fumarate Dihydrate
Active Ingredient
BudesonideCategory
Corticosteroid [EPC]
Variants
6
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 160 ug/1 | AEROSOL | RESPIRATORY (INHALATION) | 0186-0370 |
| 160 ug/1 | AEROSOL | RESPIRATORY (INHALATION) | 50090-4509 |
| 80 ug/1 | AEROSOL | RESPIRATORY (INHALATION) |
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Symbicort, you must consult a qualified healthcare professional.
| 160 ug/1 | AEROSOL | RESPIRATORY (INHALATION) | 50090-1403 |
| 160 ug/1 | AEROSOL | RESPIRATORY (INHALATION) | 50090-4508 |
| 80 ug/1 | AEROSOL | RESPIRATORY (INHALATION) | 0186-0372 |
Detailed information about Symbicort
Budesonide is a potent corticosteroid used to manage inflammatory conditions like asthma, Crohn's disease, and allergic rhinitis. It works by reducing inflammation with high local activity and low systemic exposure.
Dosage for Budesonide varies significantly based on the condition being treated and the formulation prescribed by your doctor.
Budesonide is approved for use in children for specific conditions, but dosing must be strictly monitored by a pediatrician.
No specific dosage adjustments are typically required for patients with renal (kidney) impairment, as the drug is primarily metabolized by the liver. However, patients should be monitored for systemic corticosteroid effects.
Since Budesonide is cleared by the liver, patients with moderate to severe hepatic impairment (liver disease) may experience higher levels of the drug in their blood. Your doctor may need to monitor you more closely for signs of 'Cushingoid' symptoms (like a round face or weight gain) and may consider a lower dose.
In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your regular schedule. Do not double the dose to catch up. Consistency is key for managing chronic inflammation.
Acute overdosage with Budesonide is unlikely to be life-threatening. However, chronic overdosage (taking too much over a long period) can lead to systemic corticosteroid effects such as hypercorticism and adrenal suppression. Symptoms of chronic overdose include thinning skin, easy bruising, changes in body fat distribution (especially in the face, neck, and waist), and increased acne or facial hair. If you suspect an overdose, contact your local poison control center or seek emergency medical attention.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or stop taking Budesonide without medical guidance, as sudden discontinuation can lead to a flare-up of your symptoms or withdrawal-like effects.
Common side effects are often related to the specific method of delivery. For inhaled Budesonide, the most frequent issues include:
Budesonide is a powerful medication that requires careful management. It is essential to understand that Budesonide is not a 'rescue' medication. For asthma, it will not stop an ongoing attack; for IBD, it will not provide instant relief. It is designed for long-term control. Patients must also be aware of the 'steroid-sparing' nature of this drug, which means it has fewer side effects than prednisone but is not entirely risk-free.
As of 2026, there are no FDA black box warnings for Budesonide. However, clinical guidelines emphasize that deaths due to adrenal insufficiency have occurred in patients transferring from systemic steroids to less systemically available steroids like Budesonide.
Conditions where Budesonide must NEVER be used include:
These conditions require a careful risk-benefit analysis by your physician:
Budesonide is generally considered the preferred corticosteroid for the treatment of asthma during pregnancy. According to the FDA and various clinical guidelines, maintaining control of asthma is vital for the health of both the mother and the fetus.
Budesonide is a potent glucocorticoid with a high ratio of topical anti-inflammatory activity to systemic effects. Its molecular mechanism involves passing through the cell membrane and binding with high affinity to the Glucocorticoid Receptor (GR). This complex then translocates to the nucleus where it binds to DNA.
Specifically, it inhibits the transcription of pro-inflammatory genes that code for cytokines (IL-1, IL-2, IL-4, IL-5, IL-6, IL-8, TNF-alpha), chemokines, and adhesion molecules. It also induces the expression of anti-inflammatory genes like Annexin-1 (which inhibits phospholipase A2, reducing arachidonic acid release) and Mitogen-activated protein kinase phosphatase-1 (MKP-1). This multi-pronged approach reduces airway hyperreactivity in asthma and intestinal mucosal swelling in IBD.
Common questions about Symbicort
Budesonide is a versatile corticosteroid used primarily to reduce inflammation in various parts of the body depending on its formulation. In its inhaled form, it is used as a maintenance treatment for asthma to prevent wheezing and shortness of breath. The oral capsule and tablet forms are used to treat inflammatory bowel diseases like Crohn's disease and ulcerative colitis by targeting the digestive tract directly. Nasal sprays containing Budesonide are used to manage hay fever and other upper respiratory allergies. Additionally, a viscous oral suspension is used for eosinophilic esophagitis, an allergic condition of the esophagus. Always use the specific form prescribed for your condition.
The side effects of Budesonide depend largely on how it is administered. For inhaled versions, the most common side effects include sore throat, cough, and oral thrush (a yeast infection in the mouth), which can be prevented by rinsing the mouth after use. Oral Budesonide commonly causes headache, indigestion, and increased susceptibility to minor respiratory infections. Nasal sprays may cause nosebleeds or nasal irritation. Because Budesonide is designed to stay 'local,' it causes fewer systemic side effects than drugs like prednisone, but some patients may still experience mild mood changes or sleep disturbances. If side effects become severe or persistent, you should contact your healthcare provider.
There is no known direct chemical interaction between alcohol and Budesonide that makes it dangerous to consume in moderation. However, alcohol can be an irritant to the gastrointestinal tract, which may counteract the benefits of Budesonide if you are taking it for Crohn's disease or ulcerative colitis. Furthermore, chronic heavy alcohol use can affect liver function, potentially slowing down the metabolism of Budesonide and increasing the risk of steroid-related side effects. For patients using Budesonide for asthma or allergies, moderate alcohol consumption is generally considered acceptable. It is always best to discuss your alcohol intake with your doctor to ensure it does not interfere with your specific treatment goals.
Budesonide is often considered the 'gold standard' or preferred corticosteroid for treating asthma during pregnancy because it has a long history of safe use and extensive data. Large-scale studies involving thousands of pregnant women have shown no increased risk of birth defects or complications when the inhaled form is used. For oral Budesonide, doctors usually perform a risk-benefit analysis, as more of the drug enters the mother's bloodstream compared to the inhaled version. However, untreated asthma or IBD can pose a significant risk to the developing fetus, so maintaining control of these conditions is essential. Always inform your obstetrician if you are taking any form of Budesonide.
Budesonide is not a fast-acting medication and requires consistent use to reach its full therapeutic potential. For patients using it for asthma, some improvement in breathing may be noticed within 24 to 48 hours, but it typically takes 1 to 2 weeks of daily use to achieve maximum benefit. In the treatment of Crohn's disease or ulcerative colitis, it may take 2 to 4 weeks before symptoms like abdominal pain and diarrhea significantly improve. Nasal sprays for allergies usually show results within a few days, though peak effectiveness may take up to two weeks. Because it works gradually to reduce underlying inflammation, you should continue taking it even if you do not feel an immediate difference.
You should never stop taking Budesonide suddenly without first consulting your healthcare provider, especially if you have been taking the oral form for more than a few weeks. Corticosteroids can suppress the body's natural production of cortisol, and stopping the drug abruptly can lead to a condition called adrenal insufficiency. This can cause symptoms like extreme fatigue, joint pain, nausea, and dizziness. Additionally, stopping the medication suddenly can cause a rapid 'flare-up' or worsening of the condition being treated, such as an asthma attack or a return of IBD symptoms. Your doctor will typically provide a tapering schedule to gradually lower the dose and allow your body to adjust.
If you miss a dose of Budesonide, you should take it as soon as you remember. However, if it is almost time for your next scheduled dose, you should skip the missed dose and continue with your regular dosing schedule. Never take two doses at the same time to make up for a missed one, as this can increase the risk of side effects. For medications like Budesonide, maintaining a steady level of the drug in your system is important for controlling chronic inflammation. If you find yourself frequently forgetting doses, consider using a pill organizer or setting a daily alarm on your phone to help you stay on track with your treatment.
Weight gain is a well-known side effect of systemic corticosteroids like prednisone, but it is much less common with Budesonide. Because Budesonide is designed to act locally and is quickly broken down by the liver, very little of the drug circulates throughout the rest of the body. However, at higher doses or with long-term use of the oral tablets, some patients may experience 'Cushingoid' symptoms, which can include weight gain in the face (moon face) and abdomen. Inhaled and nasal forms of Budesonide are very unlikely to cause any significant weight changes. If you notice rapid or unusual weight gain while taking this medication, discuss it with your doctor to rule out systemic absorption.
Budesonide can interact with several other medications, so it is vital to provide your doctor with a complete list of everything you take. The most significant interactions occur with drugs that inhibit the CYP3A4 enzyme, such as certain antifungal medications (ketoconazole), certain antibiotics (clarithromycin), and some HIV medications (ritonavir). These can cause Budesonide levels to rise dangerously high. Additionally, you should be cautious with other steroids, as the effects can be cumulative. Most common medications for blood pressure, pain, and diabetes do not interact with Budesonide, but your pharmacist should always screen your profile for potential conflicts. Rinsing your mouth after inhalation also prevents interactions with oral health.
Yes, Budesonide is available as a generic medication in several of its forms, which can significantly reduce the cost for patients. Generic versions are available for the inhalation suspension (Respules), the nasal spray, and the 3 mg delayed-release oral capsules (generic for Entocort EC). Some newer formulations, such as the MMX extended-release tablets (Uceris) or specific dry-powder inhalers, may still be under patent or have limited generic availability depending on your region. Generic medications are required by the FDA to have the same active ingredient, strength, and effectiveness as the brand-name versions. Check with your pharmacist to see if a cost-effective generic version is available for your specific prescription.
Other drugs with the same active ingredient (Budesonide)
> Warning: Stop taking Budesonide and call your doctor immediately if you experience any of these serious symptoms.
Prolonged use of Budesonide, particularly the oral forms, can lead to systemic effects despite its design for local action:
No FDA black box warnings exist for Budesonide. However, there are significant warnings regarding the transfer of patients from systemic corticosteroid therapy (like oral prednisone) to Budesonide. Because Budesonide has lower systemic activity, it may not provide enough steroid to a body that has become dependent on prednisone, potentially leading to a life-threatening adrenal crisis.
Report any unusual symptoms to your healthcare provider. Your doctor will weigh the benefits of controlling your inflammation against the risks of these side effects.
Your healthcare provider will likely require the following tests while you are taking Budesonide:
Budesonide generally does not affect the ability to drive or operate machinery. However, if you experience dizziness or blurred vision as a side effect, you should avoid these activities until you know how the medication affects you.
There is no direct contraindication between Budesonide and alcohol. However, alcohol can irritate the lining of the stomach and intestines. If you are taking oral Budesonide for Crohn's or Ulcerative Colitis, alcohol may worsen your underlying condition or increase the risk of GI side effects.
Do not stop taking Budesonide suddenly, especially if you have been taking it for a long time. Sudden discontinuation can cause a 'rebound' of your inflammatory symptoms or signs of steroid withdrawal (joint pain, fatigue, nausea). Your doctor will provide a tapering schedule to slowly reduce your dose.
> Important: Discuss all your medical conditions, especially any history of tuberculosis, infections, or liver disease, with your healthcare provider before starting Budesonide.
Budesonide may interfere with the results of certain diagnostic tests:
For each major interaction, the mechanism usually involves the CYP3A4 enzyme system. Inhibition leads to toxicity (too much drug), while induction leads to reduced efficacy (not enough drug). Management usually involves choosing an alternative medication or performing frequent clinical monitoring for steroid side effects.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, including over-the-counter drugs.
Patients who have had allergic reactions to other corticosteroids (such as triamcinolone, fluticasone, or hydrocortisone) may also be sensitive to Budesonide. While not always the case, your doctor should be informed of any previous 'steroid allergies.' Some inhaler formulations contain lactose; patients with severe milk protein allergies (not just lactose intolerance) should avoid these specific brands as they may contain trace amounts of milk proteins that can trigger a reaction.
> Important: Your healthcare provider will evaluate your complete medical history, including any past infections or allergic reactions, before prescribing Budesonide.
Budesonide is widely used in children, but with specific precautions:
Clinical studies of Budesonide did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.
The pharmacokinetics of Budesonide are not significantly altered by kidney disease. No dose adjustment is typically needed for patients with renal failure or those on dialysis. However, since metabolites are excreted renally, monitoring for general steroid side effects is still wise.
Liver function is the most critical factor in Budesonide clearance.
> Important: Special populations require individualized medical assessment to ensure the safest possible treatment plan.
| Parameter | Value |
|---|---|
| Bioavailability | ~10% (Oral), ~20-30% (Inhaled) |
| Protein Binding | 85% to 90% |
| Half-life | 2.0 to 3.6 hours |
| Tmax | 1-2 hours (Inhaled), 3-5 hours (Oral) |
| Metabolism | Hepatic (CYP3A4) |
| Excretion | Renal (60%), Fecal (40%) |
Budesonide is classified as a Corticosteroid [EPC]. Within this, it is a glucocorticoid. It is related to other medications like fluticasone, mometasone, and beclomethasone, but it is unique due to its exceptionally high first-pass metabolism, making it ideal for targeted local therapy with minimal systemic impact.