How to deal with side effects from Symbicort

I consulted an allergist, ENT guy, and finally a gastroenterologist.

Just an FYI for all: Right now, the manufacturer's on-label, approved use for Symbicort (budesonide/formoterol) says, "Symbicort will not replace a rescue inhaler for sudden symptoms." As the research study underlines, the use of budesonide/formoterol as a rescue inhaler is currently off-label and not yet FDA-approved.

@lluth412 - What a great thing that your pulmonary function improved with changing your rescue inhaler. What types of symptoms usually prompt you to use the rescue inhaler?

@jackiet, it sounds like you are looking for a new pulmonologist, which makes it tough to ask a specialist about the side effects you've noted on budesonide/formoterol. I have also found that asthma medications take time for your body to adjust and to know if they will work for you.

One thing I've done before that's been helpful is calling and talking to the pharmacist who filled the prescription. I have found them willing to talk to me about medication side effects and how long I should take a new medication to give it a true test.

Have you by chance spoken to the pharmacist? If so, what did they say?

Lisa...If you check lluth's previous posts I think you will see that she/he was told to use Symbicort as a rescue inhaler by a Mayo Clinic pulmonologist. Sue the volunteer mentor confirmed this. Then lluth pointed us to the scientific article that uncovers the latest findings on use of Symbicort. It appears to me that the treatment of asthma and COPD is very complex, and that we have to keep up with new findings as they come along.

As for me, I do talk to pharmacists often. But I have to confess that my original post, which started all this, stated that Symbicort was causing me side effects in the sinus area. Actually, that was not true and I apologize if I have misled anyone. The next day I realized that what I thought were side effects were in fact the beginnings of a common cold. Mea culpa.

So I was not experiencing side effects from Symbicort. And since I had been on it once before for 10 months, I have no reason to think the Symbicort was causing me to sneeze, cough, etc.

Anyway, this has been useful to me to learn that Symbicort is now okay to use as a rescue inhaler. A little knowledge is a good thing.

@jackiet, you're right that asthma and COPD treatment is complex and that we and our doctors have to keep up with new research and informed off-label usage. @lluth412, thanks for sharing the journal article:

- A Call for the United States to Accelerate the Implementation of Reliever Combination Inhaled Corticosteroid–Formoterol Inhalers in Asthma https://pmc.ncbi.nlm.nih.gov/articles/PMC9940146/

Jackie, sorry to hear you've caught a cold. I'm also glad there's a simple solution to the symptoms you were having. Please keep us updated about how things go for you on Symbicort.

Thank you. I appreciate your interest.

I don’t know if I should get another topic started, or if this is the place to do it, but I have one.

Have done a little research on long-term use of steroids in the elderly. I know that Symbicort is a corticosteroid and that albuterol is not. Think I’ve also read that Spiriva is a non-steroid maintenance inhaler.

Which raises the question of what might be the safer/safest inhaler for people of an advanced age.

I could mention that I am 88 and just trying to stay alive for a few more years.

You’ll probably tell me to speak to my pulmonologist, but at the moment I don’t have one because the previous doctor refused to monitor and deal with the side effects I was having with Wixela. And it may take awhile to find another.

My PCP, on the other hand, is on board with the research I am into with the help of Mayo Clinic Connect. And I can get my Symbicort refilled for the next year.

I’m lucky that my asthma is mild to moderate, and seemingly intermittent.

Best wishes to all for a happy holiday……

H

I am glad the Symbicort is working well for you.
The good news for me is that:
Breyna (generic Symbicort) keeps my asthma well-controlled - no ER visits for 2 years for breathing/lung issues, improved Pulmo Function Test (PFT) and able to stop another long-term controller med.
All of my docs (PCP, Ortho, Pulmo & Cardio) tell me the risks of a daily low-dose inhaled steroid are less risky than a steroid blast 3 or more times a year for an exacerbation of my asthma or bronchiectasis.
The generic versions of Symbicort are now covered by my Medicare drug plan, which means that it must be "inching" closer to full approval for use in long-term asthma.
I am fortunate to have an awesome pulmonologist (took me 5 years to get on her patient list) backed by a superb team of other specialists.

Thanks again, Sue. You’re lucky to have a good pulmonologist. I plan to continue with the Symbicort, monitoring my dosage, until such time as I have a lung doctor I can trust.

Yes, please stay on Symbicort. A. Its not rec to stop without md ok and B. you dont want end up with a flare. @jackiet and will need burst of steroids.

Take care,
Lena

You have asthma, allergic rhinitis, and Gerd. I have all of that too. My asthma has been under control for the pass 20 years using Flovent. However, you can no longer get it in USA as of October 2023. I get it from Canada but it ships from New Zealand. Takes a month to get it. Almost the same price as I was paying in the US with insurance. I rarely have to take an emergency inhaler and then only when I pick up a bacteria. I have severe asthma since birth. Keep your asthma in control and that should help. Allergic Rhinitis, been taking allergy shots for the past 55 years, they work plus I take a Clartin D everyday. I pretty much only have allergies during April, when mold is at its peak and a little during the fall. Gerd, stop eating carbs and it might disappear. I try not to eat a lot of sugar but the bread, pasta, rice and potatoes cause severe heartburn with me. I use to take a Nexium everyday for it but when I went on the keto diet I lost 17 pounds and severe (going to the hospital severe thinking I am having a heart attack severe) heartburn disappeared. It reappears during the holidays a little bit when I don't watch my eating. I get my carbs from red bell peppers, onions, and other veggies. Pre- diabetes when away and cholesterol went from 232 to 180 . My body quit having aches and pains so much and I felt fantastic. This might not work for everyone but sure has worked for me. My entire family has been plagued by bad heartburn and stomach acid forever. Son also went paleo and his disappeared as well. Find what your body can do and try changing your diet . .. . could help.

You are taking very good care of your body. Kudos.