Symbicort Turbuhaler 60MD is a combination maintenance inhaler designed for the long-term management of asthma and chronic obstructive pulmonary disease (COPD). It integrates an inhaled corticosteroid (budesonide) and a long-acting beta2-agonist (formoterol) in a single, easy-to-use dry powder device. This formulation provides both anti-inflammatory and bronchodilatory effects, offering comprehensive airway control, reduced exacerbation frequency, and improved quality of life for appropriate patients. The Turbuhaler device ensures consistent, breath-actuated delivery, minimizing coordination issues associated with press-and-breathe metered-dose inhalers.

Features

• Contains budesonide 160 mcg and formoterol fumarate dihydrate 4.5 mcg per inhalation
• Delivered via a multidose, dry powder Turbuhaler device
• Provides 60 metered doses per inhaler
• Breath-actuated mechanism requires no propellant
• Dose counter displays remaining inhalations
• Does not require shaking before use
• Storage at room temperature (below 30°C/86°F)

Benefits

• Dual-action therapy addresses both inflammation and bronchoconstriction
• Reduces frequency and severity of asthma exacerbations
• Improves lung function (FEV1) and symptom control in COPD
• Enables some patients to reduce or eliminate oral corticosteroid use
• Convenient twice-daily dosing supports adherence
• Turbuhaler design facilitates effective drug delivery with proper technique

Common use

Symbicort Turbuhaler 60MD is indicated for the regular treatment of asthma where a combination of inhaled corticosteroid and long-acting beta2-agonist is appropriate, typically in patients inadequately controlled on inhaled corticosteroids and “as-needed” short-acting beta2-agonists, or in those already controlled on both inhaled corticosteroids and long-acting beta2-agonists. It is also indicated for symptomatic treatment of patients with severe COPD (FEV1 < 50% predicted normal) and a history of repeated exacerbations, who have significant symptoms despite regular bronchodilator therapy.

Dosage and direction

For asthma: The recommended dose is 1-2 inhalations twice daily. The maximum recommended dose is 4 inhalations twice daily. For COPD: The recommended dose is 2 inhalations twice daily. Patients should rinse their mouth with water after inhalation to reduce the risk of oropharyngeal candidiasis. The Turbuhaler should be held upright during loading and inhalation. The dose counter will show red when fewer than 20 doses remain.

Precautions

Not for relief of acute bronchospasm. Patients should have a separate short-acting beta2-agonist for rescue therapy. Systemic effects of corticosteroids may occur, particularly at high doses over prolonged periods (e.g., adrenal suppression, growth retardation in children and adolescents, decrease in bone mineral density, cataracts, glaucoma). Paradoxical bronchospasm may occur—discontinue immediately if experienced. May cause cardiovascular effects (e.g., increased blood pressure, tachycardia, arrhythmias). Use with caution in patients with thyrotoxicosis, phaeochromocytoma, diabetes mellitus, untreated hypokalaemia, severe cardiovascular disorders, or convulsive disorders. Monitor patients for signs of systemic corticosteroid effects during periods of stress or severe asthma attacks.

Contraindications

Hypersensitivity to budesonide, formoterol, or any excipient. Not indicated for the initial treatment of asthma. Should not be used to treat acute symptoms, for which a short-acting bronchodilator is required. Not recommended in children under 6 years. Contraindicated in patients with known or suspected quinidine hypersensitivity (due to cross-reactivity with formoterol).

Possible side effects

Common (≥1/100): Oropharyngeal candidiasis, hoarseness/dysphonia, headache, tremor, palpitations. Uncommon (≥1/1000): Tachycardia, muscle cramps, agitation, restlessness, nausea, dizziness, sleep disturbances, cough, skin rash. Rare: Angioedema, anaphylactic reactions, psychiatric symptoms (e.g., depression, behavioural disturbances), bronchospasm, hyperglycaemia, hypokalaemia, atrial fibrillation, supraventricular tachycardia, vision disturbances, growth suppression in children. Very rare: Glaucoma, increased intraocular pressure.

Drug interaction

Concomitant use with other beta-adrenergic drugs may potentiate sympathetic effects. Use with MAOIs and tricyclic antidepressants may potentiate cardiovascular effects. Concomitant treatment with quinidine, disopyramide, procainamide, phenothiazines, antihistamines, or other drugs that prolong QT interval may increase risk of ventricular arrhythmias. Beta-blockers (including eye drops) may antagonise bronchodilating effect and induce bronchospasm in asthmatic patients. Diuretics and xanthine derivatives may enhance hypokalaemic effect. Ketoconazole and other potent CYP3A4 inhibitors may increase budesonide plasma levels.

Missed dose

Patients should take the next dose at the usual time. Do not double the dose to make up for a missed inhalation. Maintain the regular dosing schedule without interruption.

Overdose

Overdose may lead to exaggeration of known pharmacological effects: tachycardia, tremor, headache, muscle cramps, nausea, vomiting, hyperglycaemia, hypokalaemia. Cardiac arrest may occur. Supportive and symptomatic treatment is indicated. Consider cardiac monitoring and serum potassium measurement. Dialysis is not appropriate due to high protein binding.

Storage

Store in a dry place at room temperature (below 30°C/86°F). Keep in the original container with the lid tightly closed to protect from moisture. Do not expose to temperatures above 50°C. Discard when the dose counter shows zero, or 3 months after removal from the foil pouch, whichever comes first. Keep out of sight and reach of children.

Disclaimer

This information is for educational purposes only and does not replace professional medical advice. Always consult a healthcare provider for diagnosis and treatment decisions. Dosage and suitability should be determined by a qualified physician based on individual patient assessment. Do not initiate or discontinue medication without medical supervision.

Reviews

Clinical studies demonstrate Symbicort Turbuhaler 60MD significantly improves lung function, reduces exacerbation rates, and enhances quality of life compared to monocomponent therapies. In asthma, it shows superior symptom control versus budesonide alone. In COPD, it reduces moderate-to-severe exacerbations by approximately 24% compared to formoterol alone. Patient satisfaction surveys indicate high acceptance of the Turbuhaler device, with most users reporting ease of use and reliable dosing. Real-world evidence supports maintained efficacy and safety profile with long-term use.