9 Symbicort Side Effects and How to Manage Them

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

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. 

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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

• Effects on growth

• Lower bone density

• Eye problems

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.

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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.

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.

If your headaches are bothersome or aren’t going away, talk to your prescriber. They may suggest trying an OTC pain reliever or have you reduce your Symbicort dosage. You can also try home remedies that may help ease your pain.

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 usually presents as painful white or yellow patches anywhere in your mouth.

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.

When should you contact your prescriber about Symbicort side effects?

Most Symbicort side effects can be treated (or prevented) at home. But contact your healthcare team if you ever experience side effects that are bothersome, persistent, or become severe.

While rare, serious side effects are possible with Symbicort. Your prescriber may monitor for some of these during your routine checkups. Let them know if you notice changes in your vision, heart rate, or blood pressure.

Don’t stop taking Symbicort without talking to your prescriber first. They can help you determine if a lower dosage or alternative medication would be better for you.

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Written by:

Brian Leonard, PharmD, BCACP, BCGP

Brian Leonard earned his doctorate in pharmacy from the University of Florida College of Pharmacy and is board certified in Ambulatory Care and Geriatric Pharmacy.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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