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Medication for asthma & chronic obstructive pulmonary disease From Wikipedia, the free encyclopedia
Budesonide/formoterol, sold under the brand name Symbicort among others, is a fixed-dose combination medication used in the management of asthma or chronic obstructive pulmonary disease (COPD).[2] It contains budesonide, a steroid and formoterol, a long-acting β2-agonist (LABA).[2] The product monograph does not support its use for sudden worsening or treatment of active bronchospasm.[2] However, a 2020 review of the literature does support such use.[5] It is used by breathing in the medication.[2]
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Combination of | |
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Budesonide | Glucocorticoids |
Formoterol | Long-acting beta-adrenoceptor agonist |
Clinical data | |
Trade names | Symbicort, DuoResp Spiromax, BiResp Spiromax, others |
AHFS/Drugs.com | Professional Drug Facts |
License data | |
Pregnancy category |
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Routes of administration | Inhalation[2] |
ATC code | |
Legal status | |
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CAS Number | |
KEGG | |
CompTox Dashboard (EPA) | |
Chemical and physical data | |
Formula | C44H58N2O10 |
Molar mass | 774.952 g·mol−1 |
3D model (JSmol) | |
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Common (≥1/100 to <1/10) side effects include candidiasis, headache, tremor, palpitations, throat irritation, coughing, and dysphonia.[6] Pneumonia is a common side effect in people with COPD, and other, less common side effects have been documented.[2][3] There were concerns that the LABA component increases the risk of death in children with asthma, however these concerns were removed in 2017.[7] Therefore, this combination is only recommended in those who are not controlled on an inhaled steroid alone.[2] There is tentative evidence that typical doses of inhaled steroids and LABAs are safe in pregnancy.[8] Both formoterol and budesonide are excreted in breast-milk.[1]
Budesonide/formoterol was approved for medical use in the United States in 2006.[2][9] It is on the World Health Organization's List of Essential Medicines.[10][11] It is available as a generic medication.[12] In 2021, it was the 72nd most commonly prescribed medication in the United States, with more than 9 million prescriptions.[13][14]
Budesonide/formoterol has shown efficacy to prevent asthma attacks.[5] It is unclear if the efficacy of budesonide/formoterol differs from that of fluticasone and salmeterol in chronic asthma.[15]
The combination is approved in the United States only as a maintenance medication in asthma and chronic obstructive pulmonary disease (COPD).[2] However, a 2020 review of the literature does support use as needed during acute worsening in those with mild disease, and as maintenance followed by extra doses during worsening.[5]
Use for both maintenance and as-needed treatment is also known as single maintenance and reliever therapy (SMART) and is a well-established treatment.[16][17] It has been shown to, 1) reduce asthma exacerbations that require oral corticosteroids, 2) reduce hospital visits better than maintenance on inhaled corticosteroids alone at a higher dose, or 3) inhaled corticosteroid at the same or higher dose together with a long-acting bronchodilator (LABA), with a short-acting bronchodilator (SABA) as a reliever.[16][17]
Often mild, and usually disappear as the medication continues to be used:
With high doses for a long period of time.
It was approved for use in the United States in July 2006.[9][20]
Budesonide/formoterol was approved for use in the European Union in April 2014.[4][21]
There are several patents related to the drug; some of which have expired.[22] It was initially marketed by AstraZeneca.
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