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Symbicort Powder (Budesonide Formoterol Fumarate Dihydrate) Buyer and Patient Handbook - Singapore

What is Symbicort Powder?

Symbicort Powder is a combination inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) indicated for the maintenance treatment of Asthma and chronic obstructive pulmonary disease (COPD). It belongs to the Allergy & Asthma therapeutic class and is supplied as an inhaler. The product is approved by the Health Sciences Authority (HSA) and conforms to Singapore’s regulatory standards.

Who Should Use Symbicort Powder?

• Adults ≥ 18 years with persistent asthma requiring regular controller therapy.
• Patients with COPD who need both anti-inflammatory and bronchodilator effects.
• Individuals who can correctly operate a dry-powder inhaler.

How Does It Work?

Symbicort Powder delivers two active agents in each inhalation: budesonide, which reduces airway inflammation, and formoterol, which relaxes airway smooth muscle for up to 12 hours. Think of Budesonide as a fire-extinguisher that puts out the inflammatory “flames” in the lungs, while formoterol acts like a gentle “fan” that keeps the airways open during daily activities, exercise, or work. Do not exceed the prescribed dose because formoterol, like other LABAs, can cause tachycardia if misused.

Why Choose Symbicort Powder?

• Convenient dual therapy in a single inhaler eliminates the need for multiple devices.
• Rapid onset of bronchodilation (within minutes) combined with long-lasting anti-inflammatory protection.
• Generic equivalents containing the same ingredients are available, offering comparable efficacy at lower cost.
• Off-label uses (e.g., seasonal Allergic Rhinitis) may be considered only after professional consultation.

Dosage, Administration, Lifestyle and Dietary Recommendations

Recommended Dosage

• 160 µg budesonide / 4.5 µg formoterol per inhalation (commonly written as 160/4.5 mcg).
• Typical regimen: 2 inhalations twice daily (total daily dose 320 µg/9 µg). Adjustments should follow a clinician’s advice.

How to Take

1. Prime the inhaler if it’s the first use or after a period of non-use (follow device instructions).
2. Exhale fully, place the mouthpiece in your mouth, and seal your lips.
3. Inhale rapidly and deeply through the device, then hold your breath for 5-10 seconds.
4. Repeat for the second inhalation, waiting about 30 seconds between breaths.

Missed Dose

• If you remember within 30 minutes, take the missed inhalation.
• If more than 30 minutes have passed, skip the missed dose and resume your regular schedule. Do not double-dose.

Overdose

• Symptoms: rapid heartbeat, shakiness, severe Cough, or wheezing.
• Action: Seek immediate medical attention or call Singapore’s emergency services (995).

Special Populations

• Elderly: May require slower inhalation technique; monitor for oral thrush.
• Children (< 12 years): Not approved for use in this age group in Singapore.
• Renal/hepatic impairment: No dose adjustment needed, but monitor clinical response.

Lifestyle & Diet

• Avoid grapefruit juice in large amounts as it can increase systemic exposure.
• Rinse your mouth with water (do not swallow) after each use to reduce risk of oral candidiasis.
• Alcohol in moderation does not affect efficacy, but excessive intake may worsen tachycardia.

Precautions and Warnings

• Do not use as a rescue inhaler for sudden asthma attacks; keep a short-acting bronchodilator on hand.
• Contraindicated in patients with known hypersensitivity to budesonide, formoterol, or any excipients.
• Monitor for signs of paradoxical bronchospasm (increased wheezing) and seek help promptly.
• Pregnancy & breastfeeding: Use only if the benefit outweighs the risk; discuss with a healthcare professional.

Drug Interactions

Potential Side Effects

Common Side Effects

• Oral thrush (candidiasis)
• Hoarseness
• Cough

Less Common Side Effects

• Headache
• Sore throat
• Upper Respiratory Tract Infection

Serious Side Effects

• Severe allergic reaction (rash, swelling, difficulty breathing) - seek immediate care
• Paradoxical bronchospasm (worsening wheeze) - stop use and obtain urgent assessment
• Rapid heart rate or palpitations - consult a clinician

Who Should Avoid This Medication?

• Individuals with a known allergy to budesonide, formoterol, or inhaler excipients.
• Patients experiencing unstable cardiovascular disease (e.g., uncontrolled arrhythmias).
• Those who have had a recent severe asthma exacerbation requiring mechanical ventilation.

Storage Instructions

• Keep the inhaler below 30 °C; avoid exposure to direct sunlight.
• Store in a dry place, away from humidity and heat sources.
• Keep out of reach of children; do not share the device.

Symbicort Powder Alternatives

Frequently Asked Questions

How soon after the first inhalation can I feel relief?

You may notice bronchodilation within minutes, but full anti-inflammatory benefit develops over several days.

Can I use Symbicort Powder during pregnancy?

It is category B in Singapore; only use if the clinical benefit justifies potential risk and after discussing with a healthcare professional.

Is it safe to exercise after taking Symbicort Powder?

Yes, the medication is designed to support exercise-induced bronchoconstriction, but carry a rescue inhaler for unexpected symptoms.

What should I do if I forget to take my evening dose?

If it’s within 30 minutes, take it; otherwise, skip and continue with the next scheduled dose.

Will smoking affect my treatment?

Smoking can reduce the drug’s effectiveness and worsen lung function; cessation is strongly encouraged.

Can I replace Symbicort Powder with a metered-dose inhaler?

Only if a clinician determines an equivalent device provides comparable drug delivery; the inhaler type influences dose consistency.

Are there any foods that interfere with Symbicort Powder?

Large amounts of grapefruit juice may increase budesonide exposure; moderate consumption is generally acceptable.

How long can I stay on Symbicort Powder?

It is intended for long-term maintenance; periodic review by a healthcare professional is recommended.

What is the correct way to clean the inhaler?

Wipe the mouthpiece with a clean, dry tissue after each use; do not wash or submerge the device.

Can children use this inhaler if they are older than 12?

The product is not approved for individuals under 12 years in Singapore; consult a clinician for age-appropriate options.

Glossary

• ICS (Inhaled Corticosteroid): Medication that reduces airway inflammation when inhaled.
• LABA (Long-Acting β2-Agonist): A bronchodilator that relaxes airway muscles for up to 12 hours.
• Paradoxical bronchospasm: Worsening of airway constriction after inhaler use, a rare but serious reaction.

Disclaimer

The information provided here is for general education only and does not replace professional medical advice. All off-label uses must be discussed with a qualified healthcare practitioner. Our service offers medication information and ordering assistance; the responsibility for proper use lies with the patient. Always consult a healthcare professional before starting, stopping, or changing any treatment.