How to Use a Symbicort Inhaler in 7 Easy Steps

If you have asthma or chronic obstructive pulmonary disease (COPD), your prescriber may recommend Symbicort (budesonide / formoterol). Symbicort is a combination inhaler that’s used every day to open your airways and reduce inflammation. This can make it easier to breathe and lowers the chance of symptom flare-ups.

Using your Symbicort inhaler correctly is essential to getting the full benefit of the medication.  Your prescriber or pharmacist will show you how to do this. But we’ve got you covered with the basics. In this guide, we’ll walk you through how to use a Symbicort inhaler in seven easy steps.

1. If new, remove the inhaler from the foil pouch

If your Symbicort inhaler is brand new, it will come in a sealed foil pouch. Before using it, carefully tear open the pouch and remove the inhaler. Check the expiration date on the pouch to make sure the medication is still able to be used.

EXPERT PICKS: WHAT TO READ NEXT

• Symbicort side effects: Do you get headaches after using Symbicort? Learn more about potential Symbicort side effects and tips for managing them. 

• Save on your inhaler: Asthma inhalers don’t need to break the bank. Here’s how you can save on asthma inhalers like Symbicort, albuterol, and more.

• Symbicort dosages: Pharmacists review typical Symbicort dosages, plus what to do if you miss your dose or take too much.

Once the inhaler is out of the pouch, inspect it to ensure there’s no visible damage. If the inhaler looks broken or cracked, don’t use it. Contact your pharmacy about getting a replacement.

Pharmacist tip: Write the date that you open the pouch on the medication box. This will help you remember how long you’ve been using the inhaler.

2. If needed, prime the inhaler

Priming your inhaler is necessary if you’re using it for the first time, if it hasn’t been used for over 7 days, or if it has been dropped. Priming ensures that the inhaler is ready to deliver the correct dose.

To prime your Symbicort inhaler you should:

• Hold the inhaler in the upright position.

• Remove the mouthpiece cover.

• Shake the inhaler for 5 seconds.

• Point the inhaler away from you.

• Press down on the top of the canister to release a puff of medication into the air.

• Repeat the process of shaking, pointing the inhaler away from you, and releasing a dose one more time (for a total of 2 puffs).

Once the inhaler is primed, it’s ready to use.

Good to know: You’re not “wasting” doses by priming your Symbicort inhaler for the first time. It’s made with extra doses to account for priming. After you prime your Symbicort inhaler the first time, the dose counter will read either 120 or 60, depending on the container size.

3. Shake the inhaler

Right before each use, shake your Symbicort inhaler well for about 5 seconds (even if you’ve primed it). Shaking it ensures that the medication is evenly mixed, which helps deliver the correct dose. Skipping this step can result in an uneven dose, reducing the medication’s effectiveness. Make sure the mouthpiece cover has been removed before you use it.

4. Exhale fully before use

Before taking your dose of Symbicort, exhale fully to clear your lungs and create space for the medication to reach deep into your airways.

It’s best to stand or sit up straight, then take a deep breath in. Next, slowly exhale all the air from your lungs. Your dose should be inhaled immediately after you finish exhaling fully.

5. Inhale the medication

With the inhaler prepared, follow these steps to inhale your medication:

• Hold the inhaler upright with the mouthpiece at the bottom.

• Place the white mouthpiece in your mouth and close your lips around it to create a tight seal. Ensure that the inhaler remains upright and that the opening of the mouthpiece points toward the back of your throat.

• Begin to inhale slowly and deeply through your mouth.

• As you start to inhale, press down on the canister to release a dose of medication.

• Continue to inhale deeply until your lungs are full.

Inhaling slowly helps ensure the medication reaches your lungs instead of hitting the back of your throat.

6. Hold your breath and exhale slowly

After inhaling the medication, hold your breath for at least 10 seconds, or for as long as you comfortably can. Holding your breath gives the medication time to settle in your lungs. If you exhale too quickly, the medication might not reach deep into your airways, reducing its effectiveness.

When ready, exhale slowly through your mouth. Avoid exhaling out into the inhaler, as this can cause moisture to build up in the device and affect its performance.

7. Rinse your mouth with water

Symbicort contains budesonide, a steroid that can increase the risk of oral thrush (a fungal infection in the mouth). To prevent oral thrush and lessen throat irritation, rinse your mouth with water after each use. Take a sip of water, swish it around your mouth for about 15 to 30 seconds, then spit the water out.

Don’t swallow the water, since it may contain residual medication. Swallowing it can cause side effects such as stomach discomfort.

Common mistakes to avoid when using Symbicort

Using your Symbicort inhaler correctly is essential for getting its full effects. Here are some common mistakes and how to avoid them:

• Forgetting to shake the inhaler: Always shake the inhaler before use to ensure the medication is properly mixed.

• Skipping priming: Prime the inhaler if it’s new, hasn’t been used for over 7 days, or has been dropped.

• Inhaling too quickly or shallowly: Inhale slowly and deeply to ensure the medication reaches your lungs.

• Not holding your breath: After inhaling the medication, hold your breath for at least 10 seconds (or as long as is comfortable) to allow the medicine to settle in your lungs.

• Exhaling into the inhaler: Never exhale into the inhaler. Moisture can build up and affect its performance.

• Not cleaning the inhaler: Wipe the inside and outside of the white mouthpiece opening with a dry cloth every 7 days to ensure optimal performance of your inhaler.

When to replace your Symbicort inhaler

Your Symbicort inhaler comes with a built-in dose counter to help you track how many doses are left. Replacing your inhaler on time ensures you always receive an accurate and effective dose of medication. Here’s when you should replace it:

• The dose counter shows zero. Once the dose counter reaches zero, it’s time to replace it. The inhaler may still seem to spray, but the medication being delivered may not be sufficient. So, it’s best to not use the inhaler past this point.

• The inhaler has been removed from the foil pouch for over 90 days. Symbicort inhalers are designed to be used for up to 90 days after opening the foil pouch. After this period, the medication may lose potency, even if the dose counter hasn’t reached zero. Write the date you opened the inhaler on the box or label to keep track of how long you’ve been using it.

• You notice changes in the spray, smell, or taste. If you observe any changes in how the medication sprays, smells, or tastes, it could indicate the inhaler is no longer working as intended. This can happen due to moisture buildup, mechanical issues, or damage to the inhaler.

If you’re unsure whether your inhaler can still be used, check with your pharmacist or prescriber.

Why trust our experts?

Written 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.

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:

Kristianne Hannemann, PharmD

Kristianne Hannemann, PharmD, is a licensed pharmacist in California. She has been a retail pharmacy manager and staff pharmacist for over 7 years and has contributed drug information content to different health companies.

Our editorial standards

Meet our experts