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Symbicort® – Inhaler-based Medication for Asthma

Symbicort® – Inhaler-based Medication for Asthma


Symbicort® Turbuhaler® (budesonide/formoterol delivered via the inhaler device, Turbuhaler®) is indicated in the regular treatment of asthma where use of a combination (inhaled corticosteroid [ICS] and long-acting β2 adrenoceptor agonist [LABA]) is appropriate:

- patients not adequately controlled with ICS and “as needed” inhaled short-acting β2 adrenoceptor agonists (SABAs).


- patients already adequately controlled on both ICS and LABAs [1,2,3].

Symbicort® is also widely used as inhaled medication for COPD (Read about Symbicort® in COPD).

Symbicort Turbuhaler SMART™

In asthma, Symbicort® is licensed for use as a regular maintenance therapy with a separate SABA as needed or as a maintenance and reliever therapy in one inhaler, Symbicort® Maintenance And Reliever Therapy (Symbicort Turbuhaler SMART™); both fixed maintenance and maintenance plus as needed doses are recommended by the GINA 2014 report [4]. Symbicort Turbuhaler SMART™ combines the anti-inflammatory corticosteroid budesonide and the rapid and long-lasting bronchodilator formoterol in one combination inhaler, to provide an effective approach to managing asthma [5–11]. This approach uses the same Symbicort® inhaler for both maintenance and relief.

Read more about the mechanism of action of budesonide and formoterol


With Symbicort Turbuhaler SMART™, patients take a maintenance dose of Symbicort® in line with normal practice to establish asthma control and take additional inhalations of Symbicort® as needed if symptoms occur, to provide rapid symptom relief and increased asthma control.

With this approach, the underlying inflammation is treated with every inhalation [12], making it a more effective treatment approach than traditional ICS and ICS/LABA maintenance therapies using a SABA as needed, improving daily symptom control and reducing asthma attacks [5–10]. Read more about clinical efficacy of Symbicort®. Symbicort Turbuhaler SMART™ is also a simpler regimen since a separate short-acting bronchodilator is no longer needed.

The concept behind Symbicort Turbuhaler SMART™ is to treat the inflammation with every inhalation, whether used for maintenance or relief [8, 13]

Symbicort Turbuhaler SMART™ for maintenance or relief

Treating inflammation

Symbicort Turbuhaler SMART™ (budesonide/formoterol maintenance and reliever therapy) is an asthma medication that combines budesonide, an ICS that provides an anti-inflammatory effect, with formoterol, a rapid LABA bronchodilator, in a single inhaler for both maintenance and reliever therapy for the treatment of asthma. Symbicort Turbuhaler SMART™ treats the inflammation associated with asthma with every inhalation and thus reduces symptoms and the risk of exacerbations [5, 6, 9, 10].

Symbicort Turbuhaler SMART™ treats inflammation and reduces symptoms and exacerbations with extra as needed doses [9]*

Symbicort SMART budesonide

*Postulated mechanism of action as suggested

Report an adverse event

AstraZeneca monitors the safety of our products by collecting, evaluating and reporting adverse events/side effects from a variety of sources. This is a critical component in the development of the prescribing information that provides healthcare professionals with the benefit/risk information they need to make appropriate prescribing decisions.

Countries worldwide may have specific processes in place to handle reports of adverse events. Please refer to the manufacturer contact information contained in the prescribing information to report any adverse events/side effects experienced by patients while taking an AstraZeneca prescription drug.


  1. SmPC 80/4.5 µg/inhalation
  2. SmPC 160/4.5 µg/inhalation
  3. SmPC 320/9 µg/inhalation
  4. Global Initiative for Asthma. Global strategy for asthma management and prevention – updated 2010. Available at: Last accessed July 2011. An update to these guidelines was released in August 2014.
  5. O'Byrne PM, Bisgaard H, Godard PP, et al. Budesonide/formoterol combination therapy as both maintenance and reliever medication in asthma. Am J Respir Crit Care Med 2005; 171: 129–136.
  6. Scicchitano R, Aalbers R, Ukena D, et al. Efficacy and safety of budesonide/formoterol single inhaler therapy versus a higher dose of budesonide in moderate to severe asthma. Curr Med Res Opin 2004; 20: 1403–1418.
  7. Kuna P, Peters MJ, Manjra AI, et al. Effect of budesonide/formoterol maintenance and reliever therapy on asthma exacerbations. Int J Clin Pract 2007; 61: 725–736.
  8. Bousquet J, Boulet LP, Peters MJ, et al. Budesonide/formoterol for maintenance and relief in uncontrolled asthma vs. high-dose salmeterol/fluticasone. Respir Med 2007; 101: 2437–2446.
  9. Rabe KF, Atienza T, Magyar P, et al. Effect of budesonide in combination with formoterol for reliever therapy in asthma exacerbations: A randomised controlled, double-blind study. Lancet 2006; 368: 744–753.
  10. Rabe KF, Pizzichini E, Stållberg B, et al. Budesonide/formoterol in a single inhaler for maintenance and relief in mild-to-moderate asthma: A randomized, double-blind trial. Chest 2006; 129: 246–256.
  11. Barnes PJ. Scientific rationale for using a single inhaler for asthma control. Eur Respir J 2007; 29: 587–595.
  12. Humbert M, Andersson TL, Buhl R. Budesonide/formoterol for maintenance and reliever therapy in the management of moderate to severe asthma. Allergy 2008; 63: 1567–1580.
  13. Vogelmeier C, Naya I, Ekelund J. Budesonide/formoterol maintenance and reliever therapy in Asian patients (aged ≥16 years) with asthma: a sub-analysis of the COSMOS study. Clin Drug Invest 2012; 32: 439–49.