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When control has been achieved, the dose should be titrated to the lowest dose at which effective control of symptoms is maintained.
Budesonide + Formoterol fumarate dihydrate (SYMBICORT RAPIHALER) maintenance therapy: Budesonide + Formoterol fumarate dihydrate (Symbicort) taken as regular maintenance treatment, with a separate rapid-acting bronchodilator as rescue. Patients should be advised to have their separate rapid-acting bronchodilator available for rescue use at all times. (See Table 1.)
Click on icon to see table/diagram/imageIncreasing use of a separate rapid acting bronchodilator indicates a worsening of the underlying condition and warrants a reassessment of the asthma therapy. (See Table 2.)
Click on icon to see table/diagram/imageGeneral information: The patients should be instructed that Budesonide + Formoterol fumarate dihydrate (SYMBICORT RAPIHALER) must be used even when asymptomatic for optimal benefit.
There are no special dosing requirements for elderly patients.
There are no data available for use of Budesonide + Formoterol fumarate dihydrate (SYMBICORT RAPIHALER) in patients with hepatic or renal impairment. As budesonide and formoterol are primarily eliminated via hepatic metabolism, an increased exposure can be expected in patients with severe liver diseases.
Instructions for correct use of Budesonide + Formoterol fumarate dihydrate (SYMBICORT RAPIHALER): On actuation of Budesonide + Formoterol fumarate dihydrate (SYMBICORT RAPIHALER), a volume of the suspension is expelled from the canister at high velocity. When the patient inhales through the mouthpiece at the same time as actuating the inhaler, the substance will follow the inspired air into the airways.
Note: It is important to instruct the patient to: Carefully read the instructions for use, handling and disposal under Cautions for Usage.
Shake the inhaler gently prior to each use to mix its contents properly.
Prime the inhaler by actuating it twice into the air when the inhaler is new, has not been used for more than one week or if it has been dropped.
Place the mouthpiece in the mouth. While breathing in slowly and deeply, press the device firmly to release the medication. Continue to breathe in and hold the breath for approximately 10 seconds or as long as is comfortable.
Shake the inhaler again and repeat.
Rinse the mouth with water after inhaling the maintenance dose to minimise the risk of oropharyngeal thrush.
Clean the mouthpiece of the inhaler regularly, at least once a week with a clean dry cloth.
Do not put the inhaler into water.
