Symbicort
Symbicort (budesonide / formoterol) is a combination inhaler used to treat asthma and chronic obstructive pulmonary disease (COPD). It contains two medications: budesonide, a steroid, and formoterol, a long-acting beta-agonist (LABA). Both medications work together to reduce inflammation in the lungs and open up your airways. The typical dose is two puffs by mouth twice a day, usually about 12 hours apart. Common side effects include common cold symptoms, headache, and sore throat.
What is Symbicort (budesonide / formoterol)?
What is Symbicort (budesonide / formoterol) used for?
- Asthma - in adults and children 6 years and older
- Chronic obstructive pulmonary disease (COPD) - in adults
How Symbicort (budesonide / formoterol) works
Symbicort (budesonide / formoterol) is a combination of two medications.
-
Budesonide is a corticosteroid. It works by lowering swelling and irritation in your lungs. This helps make breathing easier.
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Formoterol is a long-acting beta-agonist (LABA). It relaxes the muscles in your airways. This opens up the lungs, helping air flow more easily.
Drug facts
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Side effects of Symbicort (budesonide / formoterol)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Asthma:
- Common cold symptoms (10-11%)
- Upper respiratory tract infection (8-11%)
- Headache (7-11%)
- Sore throat (6-9%)
- Sinus infection (5-6%)
COPD:
- Common cold symptoms (7%)
- Oral thrush (6%)
- Bronchitis (5%)
Less Common Side Effects
Asthma:
- Flu symptoms
- Back pain
- Nasal congestion
- Stomach discomfort
- Vomiting
- Oral thrush
COPD:
- Sinus infection
- Upper respiratory tract infection
Symbicort (budesonide / formoterol) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Sudden narrowing of the airways: worsening trouble breathing, coughing, wheezing
- Severe allergic reaction: rash, hives, swelling of the face or tongue, breathing problems
- Overdose: chest pain, a fast or irregular heartbeat, tremor, headache, nervousness
- Pneumonia: more mucus, fever, more coughing, mucus that changes color, chills, more trouble breathing
- Other infections: fever, body aches, tiredness, vomiting, pain, chills, nausea
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The following Symbicort (budesonide / formoterol) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Body aches or pain
chills
difficulty with breathing
ear congestion
headache
loss of voice
muscle aches
pain or tenderness around the eyes and cheekbones
stuffy or runny nose
tightness of the chest
unusual tiredness or weakness
Less common
Bladder pain
bloody or cloudy urine
congestion
cough producing mucus
difficult, burning, or painful urination
dryness of the throat
fast, irregular, pounding, or racing heartbeat or pulse
frequent urge to urinate
general feeling of discomfort or illness
hoarseness
joint pain
loss of appetite
lower back or side pain
noisy breathing
shakiness in the legs, arms, hands, or feet
shivering
sore mouth or tongue
stomach pain
sweating
tender, swollen glands in the neck
trembling or shaking of the hands or feet
trouble with sleeping
trouble with swallowing
voice changes
vomiting
white patches in the mouth or on the tongue
Rare
Blurred vision
confusion
decreased urine
dizziness or lightheadedness when getting up suddenly from a lying or sitting position
enlarged pupils
fainting
flushed, dry skin
fruit-like breath odor
increased hunger
increased sensitivity of the eyes to light
increased sweating, possibly with fever or cold, clammy skin
increased thirst
increased urination
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
muscle cramps
nervousness
numbness or tingling in the hands, feet, or lips
pounding in the ears
seizures
severe chest pain
severe headache
slow, fast, pounding, or irregular heartbeat or pulse
stiff or sore neck
unexplained weight loss
Incidence not known
Blindness
decreased vision
puffiness or swelling of the eyelids or around the eyes, face, lips or tongue
tearing
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Arm, back, or jaw pain
chest pain or discomfort
darkening of the skin
drowsiness
mental depression
rapid, deep breathing
restlessness
skin rash
stomach cramps
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Stomach discomfort
Less common
Belching
difficulty with moving
indigestion
muscle spasms or stiffness
pain in the arms or legs
stomach upset
swollen joints
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Symbicort (budesonide / formoterol)
Pros
- Long-term treatment for both COPD and asthma
- Might feel relief in as soon as 15 minutes for asthma
- Safe for children 6 years and older for asthma
- Combines two medications into one inhaler for convenience
Cons
- Won't work well for asthma attacks or COPD flare ups
- Can cause thrush in mouth or throat as a side effect
- Taken 2 times a day
- Possible bone loss if used for a long time
Pharmacist tips for Symbicort (budesonide / formoterol)
- Take Symbicort (budesonide / formoterol) every day, 2 puffs in the morning and 2 puffs in the evening. Try to take the doses about 12 hours apart to keep the medication working all day.
- If you miss a dose of Symbicort (budesonide / formoterol), just take your next dose at your usual time. Don’t take extra puffs to make up for the missed dose.
- Symbicort (budesonide / formoterol) isn't used to treat symptoms of an asthma attack or a COPD flare up. or sudden asthma attacks or COPD flare-ups. If you have wheezing, coughing, shortness of breath, or chest tightness, tell your prescriber right away. Always keep a rescue inhaler like albuterol with you for emergencies.
- Get your routine tests done on time while you're taking Symbicort (budesonide / formoterol). These checkups help your prescriber see if the medication is working and not causing problems. Tests might include blood work, breathing tests, and eye exams.
- Talk to your prescriber or pharmacist before starting any new medications. Some medications can interact with Symbicort (budesonide / formoterol) and cause more side effects.
How to use Symbicort (budesonide / formoterol):
- Write use-by date: Once you open the foil pouch, write down the use-by date on the inhaler (3 months from the day you opened it). Throw away the inhaler when it hits 3 months or shows “0” doses, whichever comes first.
- Priming the inhaler: If you're using a new inhaler, haven't used it in over a week, or if you drop it, you'll need to "prime" it. This means shaking it and then spraying 2 puffs into the air. Priming makes sure you get the right dose when you use it.
- Taking a dose: Shake the inhaler, breathe out fully, and place the mouthpiece in your mouth. Inhale deeply while spraying 1 puff, then hold your breath for up to 10 seconds. Repeat for the second puff.
- After use: Rinse your mouth with water and spit it out. This helps prevent a yeast infection called oral thrush). Call your prescriber if you notice white patches in your mouth or throat.
- Cleaning: Wipe the mouthpiece with a dry cloth once a week so the medication doesn't build up and block the spray through the mouthpiece. Don't rinse the inhaler with water.
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Common questions about Symbicort
Symbicort is a combination inhaler containing two different medications. One of the medications is budesonide, an inhaled steroid. It reduces swelling and inflammation in your lungs, helping you breathe more easily.
No. Symbicort isn't a rescue inhaler. It's a daily long-term maintenance inhaler used to prevent asthma or COPD symptoms over time. Rescue inhalers, like albuterol, are for quick relief when you suddenly feel short of breath, wheeze, or cough. Symbicort doesn’t work fast enough for emergencies. But if you use it every day, it can help keep your symptoms under control, so you won’t need your rescue inhaler as much. If you notice you're using your rescue inhaler more often than usual, or it’s not helping like it used to, tell your prescriber.
You can keep taking Symbicort as long as your prescriber recommends it. It’s usually used twice a day, even if you feel fine. Taking it regularly helps prevent flare-ups and keeps asthma or COPD symptoms under control. But if your symptoms get worse, let your prescriber know since they might need to change your treatment.
Not exactly. Breyna (budesonide / formoterol) is a generic version of Symbicort, and contains the same active ingredients. It might look different, but both inhalers work the same. Speak to your prescriber if you have questions about how they compare.
People didn't report weight gain as a side effect of Symbicort in clinical trials. While oral steroids such as prednisone are known to cause weight gain, inhaled steroids are less likely to cause this when used as directed. If you're worried about weight changes, talk to your prescriber.
It's possible for Symbicort to raise your blood pressure, but this isn't common at recommended doses. To be safe, make sure to tell your prescriber about any history of heart conditions or high blood pressure.
Some people felt relief from asthma symptoms within 15 minutes of taking Symbicort. But to get the full benefit, you need to take it regularly for at least 2 weeks. That’s why it’s important to keep a rescue inhaler with you for sudden symptoms like shortness of breath, wheezing, or coughing.
Yes, it's common to use Symbicort and albuterol together. But they serve different purposes when managing asthma and COPD. Symbicort is a maintenance inhaler you take every day to help prevent symptoms. Albuterol is a rescue inhaler you use for quick relief when symptoms like wheezing or shortness of breath suddenly happen. Using both can raise the chance of side effects, so talk to your prescriber about how to use them safely.
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Risks and warnings for Symbicort (budesonide / formoterol)
Symbicort (budesonide / formoterol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Worsening asthma or COPD
- Risk factors: Using albuterol more often | Using too much Symbicort (budesonide / formoterol)
Symbicort (budesonide / formoterol) shouldn't be used for asthma attacks or serious breathing problems from asthma or COPD. If you suddenly have trouble breathing or start wheezing, use a rescue inhaler like albuterol instead.
If you notice you're using your rescue inhaler more often, tell your prescriber right away. This could mean your condition is getting worse and your treatment might need to change. Don't take more than 2 puffs in the morning and 2 puffs in the evening.
Overdose
- Risk factors: Using too much Symbicort (budesonide / formoterol) | Using together with other LABAs
Using Symbicort (budesonide / formoterol) more often, at a higher dose than prescribed, or with other LABAs can raise your risk of overdose. Taking too much can lead to serious side effects like heart problems, and in rare cases, even death. Get medical help right away if you have symptoms like chest pain, a fast or irregular heartbeat, tremor, headache, or nervousness.
Oral thrush
- Risk factor: Not rinsing and spitting after using Symbicort (budesonide / formoterol)
Symbicort (budesonide / formoterol) can sometimes cause a yeast infection in your mouth or throat called oral thrush. Symptoms include white patches inside of your mouth, redness, soreness, or pain while eating or swallowing. If you notice these symptoms, tell your prescriber right away since you might need an antifungal medication to treat it. To help prevent this, rinse your mouth with water after each use and spit it out — don’t swallow the water.
Pneumonia
- Risk factors: COPD
Symbicort (budesonide / formoterol) can raise your risk of certain lung infections like pneumonia, especially if you have COPD. Keep in mind that pneumonia can look a lot like a COPD flare up, so tell your prescriber if you have more mucus, a fever, more coughing, mucus that changes color, chills, or more trouble breathing. They can help figure out the cause and choose the right treatment for you.
Higher risk of infection
- Risk factors: Active, chronic (long-term), or recurrent infection | Medical conditions that weaken the immune system | Taking other medications that can weaken the immune system
Symbicort (budesonide / formoterol) can make it harder for your body to fight infections. Infections like tuberculosis, chickenpox, and measles can be more serious if you're using this medication. Don't use Symbicort (budesonide / formoterol) if you have an active or ongoing infection without talking with your prescriber first. Let them know right away if you have signs of an infection, such as a fever, body aches, tiredness, vomiting, pain, chills, or nausea.
Changes in stress hormone levels
- Risk factors: High doses of Symbicort (budesonide / formoterol) | Using Symbicort (budesonide / formoterol) for a long time | Stressful events (e.g., surgery)
Rarely, using an inhaled steroid like Symbicort (budesonide / formoterol) for a long time can lead to adrenal insufficiency, a condition where your body doesn't make enough of its own steroid hormones. To help prevent this, your prescriber will recommend the lowest dose of Symbicort (budesonide / formoterol) that works for you, for the shortest amount of time. If you need to use the medication long term, your prescriber might order some lab tests to check how well your adrenal glands are working. Let your prescriber know if you feel very tired, weak, or sick to your stomach — especially after surgery or during times of stress — as these could be signs of low steroid levels.
Sudden narrowing of the airways
Although rare, Symbicort (budesonide / formoterol) can cause paradoxical bronchospasm, which means your breathing suddenly gets worse right after using the inhaler. This can be life-threatening if not treated quickly. If you notice more wheezing, shortness of breath, or coughing after using Symbicort (budesonide / formoterol), stop using it and use a rescue inhaler (like albuterol) right away. Contact your prescriber since you might need to switch to a different treatment.
Serious allergic reaction
Some people might have an allergic reaction immediately after using Symbicort (budesonide / formoterol). This could include hives, swelling of the face or throat, rash, or trouble breathing. If you notice any of these signs, stop using the inhaler and get medical help right away.
Heart and nervous system problems
- Risk factors: History of heart problems | Using too much Symbicort (budesonide / formoterol)
Using too much Symbicort (budesonide / formoterol) can lead to serious issues like seizures, heart problems, and changes in blood pressure. To stay safe, only use it exactly as your prescriber tells you. Talk to your prescriber right away if you experience chest pain, fast heart rate, headache, tremor, nausea, dizziness, and trouble sleeping.
Risk of bone loss
- Risk factors: Using Symbicort (budesonide / formoterol) long term | Older adult | Unable to move for a long period of time | Family history of osteoporosis | Poor diet | Postmenopausal | Smoking | Using medications that can cause bone loss
People taking Symbicort (budesonide / formoterol) for a long time might be at risk for bone loss. It's not clear if this leads to broken bones, but the risk is higher if you're an older adult, postmenopausal, have a poor diet, smoke, or take certain medications. Your prescriber might check your bone density regularly to make sure your bones stay healthy. If you've had broken bones or have a history of osteoporosis, talk to your prescriber before starting this medication.
Poor growth
- Risk factors: Children
Inhaled corticosteroids like Symbicort (budesonide / formoterol) can slow down growth in children. If your child is using this medication, their height should be checked regularly to make sure they're growing normally. To lower the risk of side effects, your child's prescriber will try to use the lowest dose of Symbicort (budesonide / formoterol) that still works well to control symptoms.
Eye problems
- Risk factors: Long-term use of Symbicort (budesonide / formoterol) | History of eye problems like glaucoma or cataracts | Higher dose of Symbicort (budesonide / formoterol)
Using Symbicort (budesonide / formoterol) for a long time can raise eye pressure, worsen glaucoma, or lead to cataracts. Talk to your prescriber right away if you experience blurry vision, eye discomfort, or other changes in your vision. You might need an eye exam to check for these problems.
Low potassium and high blood sugar
Symbicort (budesonide / formoterol) can sometimes cause low potassium levels, which can affect your heart rhythm. This is usually temporary and doesn’t need treatment. Let your care team know if you have muscle pain or weakness, muscle cramps, or abnormal heartbeat as these can be signs of low potassium.
In rare cases, Symbicort (budesonide / formoterol) can also raise blood sugar levels. Let your prescriber know if you're feeling more thirsty or hungry than usual, confused, or urinating more often. These can be signs of high blood sugar.
Symbicort (budesonide / formoterol) dosage
Inhaler| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 120 doses of 80mcg/4.5mcg | 1 inhaler | $86.08 | $86.08 |
| 120 doses of 160mcg/4.5mcg | 1 inhaler | $97.09 | $97.09 |
Typical dosage for Symbicort (budesonide / formoterol)
Symbicort (budesonide / formoterol) comes in two different strengths:
- Symbicort 80/4.5 - each puff has 80 mcg of budesonide and 4.5 mcg of formoterol
- Symbicort 160/4.5 - each puff has 160 mcg of budesonide and 4.5 mcg of formoterol.
Asthma
- Adults and children 12 years and older: The typical dose is two puffs of Symbicort 80/4.5 OR Symbicort 160/4.5 by mouth twice a day, 12 hours apart.
- Children 6 to 11 years old: The typical dose is two puffs of Symbicort 80/4.5 by mouth twice a day, 12 hours apart.
COPD
- Adults: The typical dose is two puffs of Symbicort 160/4.5 by mouth twice a day, 12 hours apart.
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Interactions between Symbicort (budesonide / formoterol) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Bepridil
- Cisapride
- Desmopressin
- Dronedarone
- Mesoridazine
- Pimozide
- Piperaquine
- Saquinavir
- Sparfloxacin
- Terfenadine
- Thioridazine
- Ziprasidone
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acebutolol
- Aceclofenac
- Acemetacin
- Alfuzosin
- Amiodarone
- Amisulpride
- Amtolmetin Guacil
- Anagrelide
- Apomorphine
- Aripiprazole
- Aripiprazole Lauroxil
- Arotinolol
- Arsenic Trioxide
- Asenapine
- Astemizole
- Atazanavir
- Atenolol
- Azithromycin
- Balofloxacin
- Bedaquiline
- Befunolol
- Bemiparin
- Besifloxacin
- Betaxolol
- Bevantolol
- Bisoprolol
- Boceprevir
- Bopindolol
- Bromfenac
- Bucindolol
- Bufexamac
- Bupranolol
- Buprenorphine
- Bupropion
- Buserelin
- Carteolol
- Carvedilol
- Celecoxib
- Celiprolol
- Ceritinib
- Chloroquine
- Chlorpromazine
- Choline Salicylate
- Ciprofloxacin
- Citalopram
- Clarithromycin
- Clofazimine
- Clonixin
- Clozapine
- Cobicistat
- Conivaptan
- Crizotinib
- Cyclobenzaprine
- Dabrafenib
- Darunavir
- Dasatinib
- Degarelix
- Delamanid
- Deslorelin
- Deutetrabenazine
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Dilevalol
- Dipyrone
- Disopyramide
- Dofetilide
- Dolasetron
- Domperidone
- Donepezil
- Droperidol
- Droxicam
- Duvelisib
- Ebastine
- Efavirenz
- Encorafenib
- Enoxacin
- Entrectinib
- Eribulin
- Erythromycin
- Escitalopram
- Esmolol
- Etodolac
- Etofenamate
- Etoricoxib
- Famotidine
- Felbamate
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Fingolimod
- Flecainide
- Fleroxacin
- Floctafenine
- Fluconazole
- Flufenamic Acid
- Flumequine
- Fluoxetine
- Flurbiprofen
- Foscarnet
- Fosnetupitant
- Fosphenytoin
- Fostemsavir
- Galantamine
- Gatifloxacin
- Gemifloxacin
- Glasdegib
- Gonadorelin
- Goserelin
- Granisetron
- Halofantrine
- Haloperidol
- Histrelin
- Hydroquinidine
- Hydroxychloroquine
- Hydroxyzine
- Ibuprofen
- Ibutilide
- Idelalisib
- Iloperidone
- Indomethacin
- Inotuzumab Ozogamicin
- Itraconazole
- Ivabradine
- Ivosidenib
- Ketoconazole
- Ketoprofen
- Ketorolac
- Labetalol
- Landiolol
- Lapatinib
- Larotrectinib
- Lefamulin
- Lenvatinib
- Leuprolide
- Levobunolol
- Levofloxacin
- Lofexidine
- Lomefloxacin
- Lorlatinib
- Lornoxicam
- Loxoprofen
- Lumacaftor
- Lumefantrine
- Lumiracoxib
- Lutetium Lu 177 Dotatate
- Macimorelin
- Meclofenamate
- Mefenamic Acid
- Mefloquine
- Meloxicam
- Mepindolol
- Methacholine
- Methadone
- Methotrimeprazine
- Metipranolol
- Metoprolol
- Metronidazole
- Mifepristone
- Mirtazapine
- Mizolastine
- Moricizine
- Morniflumate
- Moxifloxacin
- Nabumetone
- Nadifloxacin
- Nadolol
- Nadroparin
- Nafarelin
- Naproxen
- Nebivolol
- Nelfinavir
- Nepafenac
- Netupitant
- Niflumic Acid
- Nilotinib
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Norfloxacin
- Octreotide
- Ofloxacin
- Olanzapine
- Ondansetron
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Oxaprozin
- Oxprenolol
- Oxyphenbutazone
- Ozanimod
- Paliperidone
- Panobinostat
- Papaverine
- Parecoxib
- Paroxetine
- Pasireotide
- Pazopanib
- Pazufloxacin
- Pefloxacin
- Penbutolol
- Pentamidine
- Perphenazine
- Phenylbutazone
- Piketoprofen
- Pimavanserin
- Pindolol
- Pipamperone
- Piroxicam
- Pitolisant
- Ponesimod
- Posaconazole
- Practolol
- Pranoprofen
- Probucol
- Procainamide
- Prochlorperazine
- Proglumetacin
- Promethazine
- Propafenone
- Propranolol
- Propyphenazone
- Proquazone
- Prulifloxacin
- Quetiapine
- Quinidine
- Quinine
- Ranolazine
- Ribociclib
- Risperidone
- Ritonavir
- Rofecoxib
- Rufloxacin
- Salicylic Acid
- Salsalate
- Sargramostim
- Selpercatinib
- Sertindole
- Sertraline
- Siponimod
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
- Sodium Salicylate
- Solifenacin
- Sorafenib
- Sotalol
- Sparfloxacin
- Sulindac
- Sulpiride
- Sultopride
- Sunitinib
- Tacrolimus
- Talinolol
- Tamoxifen
- Telaprevir
- Telavancin
- Telithromycin
- Tenoxicam
- Tertatolol
- Tetrabenazine
- Tiaprofenic Acid
- Timolol
- Tolfenamic Acid
- Tolmetin
- Tolterodine
- Toremifene
- Tosufloxacin
- Trazodone
- Triclabendazole
- Triptorelin
- Valdecoxib
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Vilanterol
- Vinflunine
- Voclosporin
- Voriconazole
- Vorinostat
- Zotepine
- Zuclopenthixol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Auranofin
- Erythromycin
- Ketoconazole
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Symbicort (budesonide / formoterol) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Symbicort (budesonide / formoterol) will not be safe for you to take.
- Asthma attacks
- Severe episodes of asthma or COPD
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