Symbion 4.5/160
160mcg+4.5mcg/puffRx৳ 980/unit
Pack: ৳ 980
৳ 980/unit
Pack: ৳ 980
At a glance
Budesonide + Formoterol Fumarate is a combination inhaler used for the long-term treatment of asthma and COPD. It combines the anti-inflammatory action of budesonide and the bronchodilator action of formoterol to make breathing easier.
Indications
- Asthma - in patients 12 years and older
- Chronic Obstructive Pulmonary Disease (COPD) - maintenance treatment of airflow obstruction
Pharmacology
Budesonide is an anti-inflammatory corticosteroid with potent glucocorticoid activity and weak mineralocorticoid activity. Inflammation is an important component in asthma pathogenesis. Corticosteroids have wide-ranging inhibitory activities against multiple cell types (mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (histamine, eicosanoids, leukotrienes, cytokines). Formoterol Fumarate Dihydrate is a long-acting, selective β2-adrenergic agonist with rapid onset. Inhaled formoterol acts locally in the lungs as a bronchodilator via stimulation of intracellular adenyl cyclase, increasing cAMP levels.
Dosage
Inhaler (Asthma) - 12 years and older:
Maintenance dose: 1 puff twice daily OR 2 puffs once daily. Some patients may require 2 puffs twice daily (160/4.5 mcg/inhalation only).
Reliever dose: 1 additional puff as needed; if symptoms persist after a few minutes, another puff. Maximum 6 puffs on any single occasion.
Inhalation Capsule (Asthma) - 12 years and older:
Maintenance dose: 100 or 200 Inhalation Capsule twice daily.
Reliever dose: 1 additional capsule as needed; maximum 6 capsules on any single occasion, total daily dose normally ≤8 capsules (temporarily up to 12).
Inhalation Capsule (Asthma) - Children 4 years and older:
Maintenance dose: 100 Inhalation Capsule once daily.
Reliever dose: 1 additional capsule as needed; maximum 4 capsules on any single occasion, total daily dose normally ≤4 capsules (temporarily up to 8).
Inhalation Capsule (COPD) - 40 years and older:
200 Capsule: 2 capsules twice daily (max 4 capsules/day).
400 Capsule: 1 capsule twice daily (max 2 capsules/day).
Children (<12 years): Safety and efficacy not established for the inhaler.
Side effects
Common side effects: Cough, fungal infection of mouth, headache, hoarseness of voice, increased heart rate, musculoskeletal pain, nausea, respiratory tract infection, sore throat, vomiting.
Formoterol-related: Tremor, palpitations, headache; uncommon: cardiac arrhythmias, muscle cramps, hypersensitivity reactions (rash, edema, angioedema).
Budesonide-related: Hoarseness, oropharyngeal candidiasis, throat irritation, cutaneous hypersensitivity reactions, respiratory tract infections, immunosuppression, growth effects in children, glaucoma, cataract.
Use in pregnancy
May be unsafe during pregnancy (Category C). Limited human studies available; animal studies have shown harmful effects on the developing baby. Your doctor will weigh benefits and risks before prescribing.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Precautions & warnings
- Not for relief of acute bronchospasm; use rescue inhaler.
- Do not stop abruptly.
- Rinse mouth with water after each use (prevents oral thrush).
- If paradoxical bronchospasm occurs, discontinue immediately and consult your doctor.
- Caution in diabetes mellitus, thyrotoxicosis, hypokalemia, severe hypertension, ischemic heart disease, tachycardia, severe heart failure, glaucoma, cataract, hypercorticism.
- Regular monitoring of height in children on long-term therapy.
- Caution during pregnancy and lactation.
Overdose effects
Budesonide overdose: Acute overdose is not expected to be a clinical problem. Chronic excessive doses may cause hypercorticism and adrenal suppression.
Storage conditions
Inhalation capsules must not be swallowed. Only to be used with inhalation device. Store below 25°C, away from light and moisture. Keep out of reach of children. Remove capsule from blister pack immediately before use (moisture may prevent piercing).