Symbicort Turbuhaler

Symbicort 80/4.5 mcg/dose turbuhaler Budesonide 80 mcg, formoterol 4.5 mcg. Symbicort 160/4.5 mcg/dose turbuhaler Budesonide 160 mcg, formoterol 4.5 mcg. Symbicort Forte 320/9 mcg/dose turbuhaler Budesonide 320 mcg, formoterol 9 mcg

Symbicort 80/4.5 mcg & Symbicort Forte: Regular treatment of asthma where use of combination (inhaled corticosteroid & long-acting β₂-adrenoceptor agonist) is appropriate. Symbicort 160/4.5 mcg & Symbicort Forte: Symptomatic treatment of patients w/ COPD (FEV1 <70% predicted normal) & history of exacerbation despite regular bronchodilator therapy. Symbicort 160/4.5 mcg: Asthma including symptomatic relief & to reduce risk of exacerbations in adults & adolescents ≥12 yr.

Symbicort 80/4.5 mcg Asthma Maintenance therapy Adult ≥18 yr 1-2 inhalations bid, may be increased up to max: 4 inhalations bid. Adolescent 12-17 yr 1-2 inhalations bid. Childn ≥6 yr 2 inhalations bid. Adult & adolescent ≥12 yr Maintenance therapy 2 inhalations daily either as 1 inhalation in the morning & evening, or 2 inhalations either morning or evening. Childn ≥6 yr 1 inhalation once daily. Reliever therapy Take 1 additional inhalation as needed in response to symptoms. Max: >8 inhalations daily is not normally needed, but may use up to 12 inhalations daily temporarily. Symbicort 160/4.5 mcg Asthma Anti-inflammatory reliever therapy Adult & adolescent ≥12 yr w/ mild disease 1 inhalation as needed in response to symptoms. Take additional inhalation if symptoms persist. Not >6 inhalations on any single occasion. Max: >8 inhalations daily is not normally needed, but may use up to 12 inhalations daily temporarily. Anti-inflammatory reliever + maintenance therapy Adult & adolescent ≥12 yr 2 inhalations daily (as 1 inhalation in the morning & evening, or 2 inhalations either morning or evening) or 2 inhalations bid. Max: >8 inhalations daily is not normally needed, but may use up to 12 inhalations daily temporarily. Maintenance therapy (fixed dose) 1-2 inhalations bid. Max: 4 inhalations daily. COPD Adult 2 inhalations bid. Symbicort Forte Asthma Adult ≥18 yr 1 inhalation bid, may be increased up to max: 2 inhalations bid. Adolescent 12-17 yr 1 inhalation bid. COPD Adult 1 inhalation bid.

Hypersensitivity to budesonide, formoterol or lactose.

Discontinue use if paradoxical bronchospasm occurs. Not to be initiated during exacerbation or in patients w/ significantly worsening or acutely deteriorating asthma. Active or quiescent pulmonary TB, fungal & viral airway infections. Adrenal suppression, decreased bone mineral density, cataract, glaucoma; periods of stress, elective surgery; thyrotoxicosis, phaeochromocytoma, DM, untreated hypokalaemia, hypertrophic obstructive cardiomyopathy, idiopathic subvalvular aortic stenosis, severe HTN, aneurysm or other severe CV disorders eg, ischaemic heart disease, tachyarrhythmias or severe heart failure; QTc interval prolongation; visual disturbances. Pneumonia in patients w/ COPD. Risk of oropharyngeal candida infection. May cause allergic reactions due to lactose. Monitor serum K & blood glucose levels. Transferring from previous systemic steroid therapy. Taper dose & avoid abrupt discontinuation. High-dose & prolonged treatment. Lactose intolerance. Concomitant use w/ xanthine derivatives, steroids, diuretics. Severe liver cirrhosis. Pregnancy & lactation. Growth retardation in childn & adolescents. Symbicort 80/4.5 mcg & Symbicort Forte: Not intended for initial management of asthma. Symbicort 80/4.5 mcg: Not recommended in childn <6 yr. Not appropriate in patients w/ severe asthma. Symbicort Forte: Not recommended in childn <12 yr.

Headache, tremor; palpitations; oropharynx candida infection, pneumonia (in COPD); mild throat irritation, coughing, hoarseness.

Increased budesonide systemic exposure w/ potent CYP3A4 inhibitors. Weakened or inhibited formoterol effect w/ β-adrenergic blockers including eye drops. Prolonged QTc interval & increased risk of ventricular arrhythmias w/ quinidine, disopyramide, procainamide, phenothiazines, antihistamines, MAOIs & TCAs. Impaired cardiac tolerance by l-dopa, l-thyroxine, oxytocin, alcohol. Precipitated hypertensive reactions w/ MAOIs including agents w/ similar properties eg, furazolidone, procarbazine. Elevated risk of arrhythmias w/ anaesth w/ halogenated hydrocarbons. Additive effect w/ other β-adrenergic drugs. Hypokalaemia w/ digitalis glycosides.

Antiasthmatic & COPD Preparations

R03AK07 - formoterol and budesonide ; Belongs to the class of adrenergics in combination with corticosteroids or other drugs, excluding anticholinergics. Used in the treatment of obstructive airway diseases.

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