Key takeaways:
Symbicort (budesonide / formoterol) is a prescription combination inhaler. It’s approved to treat asthma and chronic obstructive pulmonary disease (COPD).
Common Symbicort side effects include upper respiratory tract infections (URTIs), headache, and throat pain. More serious side effects include adrenal suppression, fast heartbeat, lower bone density, and eye problems.
Rinse your mouth with water and spit after each Symbicort dose. This can help prevent a fungal infection called thrush and lessen throat irritation.
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Symbicort (budesonide / formoterol) is a prescription combination inhaler used to treat asthma and chronic obstructive pulmonary disease (COPD). It contains two medications, budesonide and formoterol, to help you breathe easier.
Symbicort is an orally inhaled medication that works in your lungs. While less common, it can also cause unwanted side effects in other parts of your body, including your heart, bones, and eyes. So, it’s good to know what Symbicort side effects are possible and what to do if they happen to you.
Symbicort side effects at a glance
Symbicort contains an inhaled corticosteroid (budesonide) and a long-acting beta agonist (formoterol). Each of these ingredients has the potential to cause side effects. Most are mild and can be managed at home. While less common, other side effects can be more serious and may require help from your healthcare team.
If you’re experiencing bothersome side effects, don’t stop taking Symbicort without talking to your healthcare team first. They can help you determine if a lower dosage or alternative medication would be better for you.
Common Symbicort side effects
Examples of common Symbicort side effects include:
Upper respiratory tract infection (URTI)
Headache
Throat pain
Back pain
Sinus infection
Vomiting
Nasal congestion
Stomach discomfort
Thrush
Rare Symbicort side effects
Examples of less common, but potentially serious Symbicort side effects include:
Adrenal suppression
Increased risk of pneumonia
Worsening of certain infections
Fast heart rate
Raised blood pressure
Effects on growth
Lower bone density
Eye problems
High blood sugar (hyperglycemia)
Low blood potassium levels (hypokalemia)
Narrowing of the airway in the lungs (bronchospasms)
Whether you’re new to Symbicort or have been taking it for a while, it’s good to know what to expect and how to manage potential side effects. Below, we look more closely at nine of them.
1. Upper respiratory tract infection
Symbicort may increase the risk of developing URTIs, such as the common cold and sinus infections. Common URTI symptoms can include cough, nasal congestion, and sore throat.
URTIs usually go away on their own without treatment. But if any symptoms become bothersome, you can manage them with home remedies and over-the-counter (OTC) medications. Your pharmacist can help recommend products that are safe for you to take.
If your symptoms feel severe, are getting worse, or aren’t going away, speak with your prescriber. It’s possible that your infection was caused by bacteria and requires an antibiotic.
How to save: Symbicort (budesonide / formoterol) is one of many inhalers available for asthma. Here’s how to save on asthma inhalers such as Symbicort and more.
Symbicort dosage: Learn more about typical Symbicort dosages, including steps to take if you miss your dose.
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2. Headache
Headaches are a common Symbicort side effect, especially with higher dosages. They’re also a possible side effect of taking too much Symbicort. Keep in mind that headaches can have several different causes, including other medications.
There are several tips you can try at home that may help manage headaches, such as:
Drinking more water
Getting more rest
Following a consistent bedtime routine to help improve sleep quality
Exercising regularly or adding more movement to your routine
Limiting or avoiding alcohol and caffeine
Asking your healthcare team if you can safely take an OTC pain reliever, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)
If your headaches are bothersome or aren’t going away despite trying these tips, talk to your prescriber. They may want to check for other causes of your headaches.
3. Throat pain
Inhaled steroids, such as budesonide in Symbicort, can irritate your throat and cause pain. This is sometimes called steroid inhaler laryngitis. You may also notice hoarseness or changes in your voice because of how budesonide affects your vocal cords.
To help prevent or lessen throat pain, it’s important to use your Symbicort inhaler correctly and rinse your mouth with water after each use. This minimizes the amount of time budesonide stays in your mouth and irritates the tissues.
If throat pain or irritation from Symbicort becomes bothersome or severe, reach out to your prescriber.
4. Stomach discomfort
Symbicort may cause you to feel stomach discomfort, especially with higher dosages. This may be due to budesonide, which may cause irritation in your stomach.
If you have stomach discomfort, talk to your prescriber. They may suggest OTC treatments or other tips to manage your symptoms. If needed, they may adjust your treatment regimen.
5. Thrush
Thrush, a type of fungal infection, is a common side effect of Symbicort and any other inhaler that contains a corticosteroid. It typically causes painful white or yellow patches to appear in your mouth or throat.
There are things you can do to prevent thrush from Symbicort. Simply rinse your mouth with water and spit after every time you inhale a dose. This helps remove medication residue from your mouth.
But if you notice white patches in your mouth, talk to your prescriber. They may need to prescribe an antifungal medication to treat it.
6. Adrenal suppression
Corticosteroids can cause adrenal suppression — when your adrenal glands make a lower amount of natural cortisol — which can result in adrenal insufficiency. This is more common with higher doses and longer-term use of oral corticosteroids. While rare, adrenal suppression is also possible with inhaled corticosteroids, such as budesonide in Symbicort.
Symptoms of adrenal insufficiency can include fatigue and weakness, abdominal pain, and weight loss. You may also notice that you’re craving salty foods. Your healthcare team may monitor your adrenal health during treatment. But you should let them know if any of these symptoms develop.
7. Fast heart rate and increased blood pressure
The formoterol in Symbicort can speed up your heart rate, especially with higher doses. And mild increases in heart rate are also possible when you first start taking it. An increase in blood pressure can also happen.
It’s not clear how Symbicort may affect your heart health long term. So it’s important to tell your prescriber if you have a history of high blood pressure or other heart conditions before starting Symbicort.
Tell your prescriber if you notice a faster heart rate after starting Symbicort. And if you’re measuring your blood pressure at home, tell them if your readings are higher than usual. But if you develop a fast heart rate with chest pain or shortness of breath, go to the nearest ER.
8. Lower bone density
Lower bone density is a potential Symbicort side effect, especially with long-term use and higher doses. This can increase the risk of osteoporosis, which can put you at higher risk of bone fractures (breaks).
If you have osteoporosis risk factors, such as a family history of osteoporosis or older age, your healthcare team may want to monitor your bone health more closely during treatment. And if your bone density is significantly affected by Symbicort, they may switch you to a different medication.
9. Eye problems
The budesonide in Symbicort can also affect your eyes. While they’re not very common, potential eye problems from Symbicort can include glaucoma and cataracts.
Contact your healthcare team if you notice any changes in your vision after starting Symbicort. It’s also important to keep up with regular eye exams to help catch any eye problems early.
Frequently asked questions
Weight gain wasn’t seen during initial Symbicort clinical trials. But long-term use (and high doses) of other corticosteroids has been associated with weight gain. While weight gain isn’t expected with Symbicort, you should talk to your prescriber if it’s a concern for you.
It’s not clear why some people experience back pain while using Symbicort, although it may be from budesonide. During budesonide inhaler clinical trials, back pain was a commonly reported side effect, especially with higher doses.
Symbicort isn’t expected to cause you to cough up phlegm. However, coughing up phlegm could be a sign of an asthma or COPD flare-up, pneumonia, or other lung infection. Call your prescriber if you notice more phlegm (or if it changes color), fever, or worsening breathing.
Weight gain wasn’t seen during initial Symbicort clinical trials. But long-term use (and high doses) of other corticosteroids has been associated with weight gain. While weight gain isn’t expected with Symbicort, you should talk to your prescriber if it’s a concern for you.
It’s not clear why some people experience back pain while using Symbicort, although it may be from budesonide. During budesonide inhaler clinical trials, back pain was a commonly reported side effect, especially with higher doses.
Symbicort isn’t expected to cause you to cough up phlegm. However, coughing up phlegm could be a sign of an asthma or COPD flare-up, pneumonia, or other lung infection. Call your prescriber if you notice more phlegm (or if it changes color), fever, or worsening breathing.
The bottom line
Symbicort (budesonide / formoterol) is a combination inhaler used in asthma and chronic obstructive pulmonary disease (COPD). Common Symbicort side effects include upper respiratory tract infections (URTIs), headache, and throat pain. Stomach discomfort and thrush are also possible. While less common, Symbicort can affect your bones, heart, and eyes.
Contact your healthcare team if you experience any unusual or bothersome Symbicort side effects. They may be able to lower your dosage or discuss treatment alternatives.
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References
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A-S Medication Solutions. (2025). Pulmicort flexhaler- budesonide aerosol, powder [package insert]. DailyMed.
DelGaudio, J. M. (2002). Steroid inhaler laryngitis: Dysphonia caused by inhaled fluticasone therapy. Archives of Otolaryngology—Head and Neck Surgery.
Hansen, R. A., et al. (2008). Risk of adverse gastrointestinal events from inhaled corticosteroids. Pharmacotherapy.
Sannarangappa, V., et al. (2014). Inhaled corticosteroids and secondary adrenal insufficiency. The Open Respiratory Medicine Journal.
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