Explanation

Symbicort® is a medicine to help control your asthma.

Symbicort® is actually made up of two different types of medicine: One is called budesonide and the other one is called formoterol fumarate dihydrate (or formoterol for short).

Both of the medicines come together in the same inhaler.

What does Symbicort® do?

The two medicines in Symbicort® help your asthma in different ways:

Budesonide prevents and reduces inflammation in your lungs. Inflammation makes your lungs swell up and stops them working properly. This can cause some of the feelings of asthma, like breathlessness and wheeziness. Budesonide is called a preventer, because it prevents or stops the feelings of asthma from happening in the first place.

Formoterol acts to open the airways in your lungs, making it easier for air to get in and out. This helps you to breathe more easily. Formoterol is called a reliever, because it reduces or relieves the feelings of asthma .

What does it look like?

Symbicort® is a very fine powder. You breathe the powder into your lungs using an inhaler.

When do I have to take it?

It is important to take Symbicort® regularly, every day, to help prevent asthma attacks. Your doctor or asthma nurse will tell you exactly how many puffs to take and how often.

Don't use your Symbicort® inhaler to treat a sudden attack of breathlessness or wheeziness. Your doctor will give you a different type of inhaler to use if you feel wheezy or out of breath. Make sure you carry this inhaler with you at all times. And make sure you don't get your inhalers mixed up!

But what if I don't feel like taking it?

If you don't take your Symbicort® regularly then it won't work properly. Your lungs will get inflammation again and you are more likely to have an asthma attack.

Even if you feel better, you still need to keep taking it! Don't stop unless your doctor tells you to.

What should I do if I forget to take it?

Try and take your Symbicort® at the times your doctor told you to. Even if the adults looking after you forget - go and remind them!

If you do forget to take your Symbicort®, then take the missed dose as soon as possible.

If it is almost time for the next dose, then don't worry. Just skip the missed dose and take the next dose at the usual time.

Don't take twice as much the next time to try and make up for your missed dose - remember the three Ds: DON"T DOUBLE DOSE!

How much do I take?

This depends on how old you are and how bad your asthma is.

You will probably need to take one or two puffs of your inhaler two times each day. Your doctor will tell you exactly how many puffs you should take.

If your asthma is well controlled, then your doctor might tell you to take it once a day.

Taking the right amount is important. It's the best way to stay well, without getting side effects.

What are the most likely side effects I might I get if I take Symbicort®?

The side effects that you are most likely to have when you take Symbicort® are:

Feeling like your heart is beating louder than usual

Feeling a bit shaky

A headache

An infection in your mouth called oral thrush (rinsing your mouth out with water or brushing your teeth after using Symbicort® can help to stop this from happening)

A sore throat, a cough, or a croaky voice

What other side effects might I get?

You could have the following side effects, but they are very rare:

Rash or itchiness

Wheezing or breathlessness. If this happens suddenly after using Symbicort®, stop using your inhaler and talk to your doctor right away.

A reduction in levels of potassium in your blood

An uneven heartbeat

Feeling very sad (depression)

Acting a bit strange

Pain or tightness in your chest

An increase in the amount of glucose in your blood

Strange or nasty tastes in your mouth

A change in your blood pressure

Symbicort® contains budesonide, which is a type of steroid. Sometimes using steroids can change how natural steroids are made in your body. This can have several effects, but you will usually only have them if you take high doses of steroids for long periods of time. These effects include:

Growing a bit slower than normal. Your doctor will want to check your height regularly, to make sure your growth is on track. Studies show that if you receive budesonide by itself, you will most likely catch up and be the same height as your friends after a while

A decrease in bone mineral density (thinning and weakening of your bones)

Eye problems, including cataract and glaucoma

An effect on your adrenal gland

Is it safe for me to be taking Symbicort®?

Before using Symbicort®, you should tell the doctor if you know that you have any other medical problems.

Especially if you:

Have diabetes

Have an infection in your lungs

Have high blood pressure

Have ever had a problem with your heart or blood vessels

Have a problem with your adrenal gland or your thyroid gland

Have low levels of potassium in your blood

Have a problem with your liver

And remember to tell your doctor if you have any allergies - to budesonide, formoterol or anything else. Symbicort® also contains lactose (a type of sugar) which can cause an allergic reaction in some people.

It is also very important to tell your doctor if you have a seizure while you are taking Symbicort®.

You should also make sure you don't have too much caffeine, chocolate and grapefruit or grapefruit juice, as it's possible that they could make you feel nervous, make you shake and give you a fast heartbeat. Your doctor will be able to tell you safe amounts of these for you to have.

Is it OK for me to take Symbicort® if I'm already taking other medicines?

Make sure you tell your doctor if you're taking any other medicines to help control your asthma.

You should also mention things you're taking for other medical problems, including drugs, special foods or herbal remedies.

It's especially important to tell your doctor if you're taking:

Beta-blocking drugs (for example, propranolol)

Medicines used to treat a problem with your heart (for example, quinidine, digoxin)

Medicines called diuretics

Steroids (for example, prednisolone)

Bronchodilators (for example, salbutamol)

Medicines from a family of drugs called methylxanthines (for example, theophylline or aminophylline)

Medicines used to treat depression

Medicines from a family of drugs called phenothiazine medicines

Medicines from a family of drugs called protease inhibitors (for example, ritonavir)

Medicines to treat fungal infections (for example, itraconazole, ketoconazole)

Medicines used to treat a thyroid gland problem (for example, levo-thyoxine)

You also need to tell your doctor if you are going to have a general anaesthetic for an operation.

Do I need to know anything else about Symbicort®?

If your breathing or wheezing suddenly gets worse after using the inhaler, stop using it and tell the adults looking after you or your doctor straight away. You might need a different type of medication. This happens only rarely, though.

You might have an allergic reaction after taking Symbicort®, although this is very rare. Tell the adults looking after you or your doctor or hospital straight away if you notice the following signs:

Swelling of your face, mouth, or throat

Hives or rash

Difficulty breathing

Feeling faint or lightheaded

Also, contact your doctor as soon as you possible if you find that:

Your breathing, wheeziness, or chest tightness is getting worse

Your asthma often wakes you up at night

You start to have chest tightness when you wake up in the morning

You need to use your reliever inhaler more often

It may be that your asthma is getting worse and you might need extra medicine to help. It is important to talk to your doctor quickly because if your medicine isn't working properly you might have an asthma attack.

You should tell the adults looking after you or your doctor if you have any signs of an infection. These are:

a high temperature

a chill

a really bad sore throat

pains in your ear or sinuses

a cough

a change in colour of your mucous when you cough it up

pain when you have a wee

an itch or pain in your bum

sores in your mouth

a cut or sore that won't heal up

There are some other very rare things that might happen if you miss a dose, and you should tell your doctor about them, too. These are:

a fast heartbeat

feeling really, really tired and weak

feeling confused

feeling dizzy

sweating

Also, if you have been around someone with chicken pox and you have not had it, or had immunisation against it, make sure you let your doctor know.

What if I have any more questions?

If you have any other questions, you can ask your doctor, or chat to other people with asthma in the Medikidz forums and virtual world, Mediland.