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Budesonide/Formoterol (By breathing)

Treats asthma and chronic obstructive pulmonary disease (COPD). Also reduces the worsening attacks of COPD. This medicine contains a corticosteroid.

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

Budesonide and formoterol is a combination of two medicines that are used to help control the symptoms of asthma and improve lung function. It is used when a patient's asthma has not been controlled sufficiently on other asthma medicines, or when a patient's condition is so severe that more than one medicine is needed every day. This medicine will not relieve an asthma attack that has already… Read more
Brand names include
Symbicort, Symbicort 100 Turbuhaler, Symbicort 160/4.5, Symbicort 200 Turbuhaler, Symbicort 80/4.5
Drug classes About this
Antiasthma, Antiasthma, Anti-Inflammatory/Bronchodilator Combination, Respiratory Agent

What works? Research summarized

Evidence reviews

Formoterol and budesonide for the relief of asthma symptoms in adults and children

Combined formoterol and budesonide inhalers can be used for maintenance treatment of asthma and relief of symptoms. Three trials involving 5905 participants were included. We found very little evidence in relation to the use of formoterol and budesonide for relief of symptoms in people with mild asthma, but in people with more severe asthma who had suffered exacerbations in spite of regular treatment with inhaled corticosteroids, we found that reliever formoterol and budesonide compared favourably with terbutaline in reducing asthma exacerbations that required a course of oral corticosteroids. However only a small proportion of the 'severe asthma exacerbations' as defined in the trials led to hospital admissions, and no significant overall benefit has yet been shown for this outcome. In children with asthma that was not controlled with regular inhaled corticosteroids, there were fewer serious adverse events when formoterol and budesonide were used to relieve symptoms as well as for maintenance treatment.

Different combinations of inhaled steroids and long‐acting beta‐agonists for chronic asthma (fluticasone/salmeterol versus budesonide/formoterol)

People with persistent asthma often require an additional treatment to regular inhaled steroids. Some preparations of long‐acting beta‐agonists are delivered in the same inhaler device as the inhaled corticosteroids. Inhaled steroids help to treat inflammation of the airway and long‐acting beta‐agonists help the airway to relax, improving symptoms and lung function. This systematic review examined randomised controlled trials comparing two commonly available combinations administered at a fixed dose through a single inhaler, fluticasone/salmeterol and budesonide/formoterol. We included five studies which recruited 5537 people. The trials were generally well designed but only recruited adults and adolescents and not children. Participants were already taking regular inhaled steroids before the studies commenced and had mild or moderate asthma based on tests of their airway. We found that the number of people who required treatment with oral steroids and admission to hospital was similar between the treatments, but due to the statistical uncertainty of this result we could not rule out important differences in favour of either drug combination. Additional trials would enable us to draw more reliable conclusions about how well these drugs work compared with each other. We also looked at serious adverse events. Again, the results did not indicate that one combination was clearly better than the other, but again these results were imprecise so we cannot be certain. However, lung function and rescue medication use were similar between the treatments. We could not assess the relative effects of these drugs on mortality because there were so few deaths which leads to statistical uncertainty; out of the five studies, one person died. Quality of life was measured in different ways in two studies and we could not determine how the treatments compared in this respect. Further studies are needed to strengthen and better explain these findings. In particular studies which assess the effects of these therapies in children and studies which measure quality of life are a priority.

In people with asthma are single inhalers that contain both formoterol and budesonide better than current best practice?

‘Single inhaler therapy’ means that a single inhaler containing two drugs is used. One of these drugs acts quickly and is called the "reliever". The other works much more slowly and is called the "preventer". The reliever is a beta‐agonist bronchodilator, which help to open the airways and help people breathe more easily. The preventer is a steroid that controls the underlying inflammation in the lungs, which is caused by the asthma. People on 'single inhaler therapy' (SiT) have one inhaler for use every day to control their underlying inflammation and also for symptom relief. The idea behind SiT is that when people take their inhalers to reduce their shortness of breath or wheezing they will also be getting an increased dose of the steroid preventer.

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Summaries for consumers

Formoterol and budesonide for the relief of asthma symptoms in adults and children

Combined formoterol and budesonide inhalers can be used for maintenance treatment of asthma and relief of symptoms. Three trials involving 5905 participants were included. We found very little evidence in relation to the use of formoterol and budesonide for relief of symptoms in people with mild asthma, but in people with more severe asthma who had suffered exacerbations in spite of regular treatment with inhaled corticosteroids, we found that reliever formoterol and budesonide compared favourably with terbutaline in reducing asthma exacerbations that required a course of oral corticosteroids. However only a small proportion of the 'severe asthma exacerbations' as defined in the trials led to hospital admissions, and no significant overall benefit has yet been shown for this outcome. In children with asthma that was not controlled with regular inhaled corticosteroids, there were fewer serious adverse events when formoterol and budesonide were used to relieve symptoms as well as for maintenance treatment.

Different combinations of inhaled steroids and long‐acting beta‐agonists for chronic asthma (fluticasone/salmeterol versus budesonide/formoterol)

People with persistent asthma often require an additional treatment to regular inhaled steroids. Some preparations of long‐acting beta‐agonists are delivered in the same inhaler device as the inhaled corticosteroids. Inhaled steroids help to treat inflammation of the airway and long‐acting beta‐agonists help the airway to relax, improving symptoms and lung function. This systematic review examined randomised controlled trials comparing two commonly available combinations administered at a fixed dose through a single inhaler, fluticasone/salmeterol and budesonide/formoterol. We included five studies which recruited 5537 people. The trials were generally well designed but only recruited adults and adolescents and not children. Participants were already taking regular inhaled steroids before the studies commenced and had mild or moderate asthma based on tests of their airway. We found that the number of people who required treatment with oral steroids and admission to hospital was similar between the treatments, but due to the statistical uncertainty of this result we could not rule out important differences in favour of either drug combination. Additional trials would enable us to draw more reliable conclusions about how well these drugs work compared with each other. We also looked at serious adverse events. Again, the results did not indicate that one combination was clearly better than the other, but again these results were imprecise so we cannot be certain. However, lung function and rescue medication use were similar between the treatments. We could not assess the relative effects of these drugs on mortality because there were so few deaths which leads to statistical uncertainty; out of the five studies, one person died. Quality of life was measured in different ways in two studies and we could not determine how the treatments compared in this respect. Further studies are needed to strengthen and better explain these findings. In particular studies which assess the effects of these therapies in children and studies which measure quality of life are a priority.

In people with asthma are single inhalers that contain both formoterol and budesonide better than current best practice?

‘Single inhaler therapy’ means that a single inhaler containing two drugs is used. One of these drugs acts quickly and is called the "reliever". The other works much more slowly and is called the "preventer". The reliever is a beta‐agonist bronchodilator, which help to open the airways and help people breathe more easily. The preventer is a steroid that controls the underlying inflammation in the lungs, which is caused by the asthma. People on 'single inhaler therapy' (SiT) have one inhaler for use every day to control their underlying inflammation and also for symptom relief. The idea behind SiT is that when people take their inhalers to reduce their shortness of breath or wheezing they will also be getting an increased dose of the steroid preventer.

See all (14)

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