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ICS + LABA combination inhaler

Budesonide with formoterol

Brand names: Symbicort, DuoResp Spiromax, Fobumix

Adult dose

Dose: Asthma maintenance & reliever (MART): 1 inhalation BD + PRN; max 12 inhalations/day
Route: Inhaled
Frequency: BD ± PRN

Clinical pearls

  • GINA / NICE NG80 / BTS-SIGN: MART regimen with formoterol-containing ICS-LABA preferred for adults & adolescents
  • BTS / SIGN asthma
  • Counsel re inhaler technique and rinsing mouth

Contraindications

  • Untreated severe asthma exacerbation
  • Hypersensitivity

Side effects

  • Tremor
  • Tachycardia
  • Oral candidiasis
  • Hypokalaemia
  • Pneumonia (COPD)
  • Adrenal suppression (high-dose)

Interactions

  • Beta-blockers
  • QT-prolonging drugs
  • Strong CYP3A4 inhibitors
  • Diuretics (hypokalaemia)

Monitoring

  • Asthma control (RCP-3, ACQ)
  • PEFR
  • Inhaler technique
  • Oral candidiasis

Reference: BNF; NICE NG80; BTS/SIGN; GINA; https://bnf.nice.org.uk/drugs/budesonide-with-formoterol/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.