Symbicort Turbohaler

When using your Turbohaler, you should follow the instructions on the patient information leaflet as follows:

1. Unscrew the cover and lift it off. You may hear a rattling sound.
2. Hold your Symbicort Turbohaler upright with the red grip at the bottom.
3. Do not hold the mouthpiece when you load your Symbicort Turbohaler. To load your
Symbicort Turbohaler with a dose, turn the red grip as far as it will go in one direction.
Then turn it as far as it will go in the other direction (it does not matter which way you
turn it first). You should hear a click sound. It does not matter whether the click comes on
the first or the second twist. Your Symbicort Turbohaler is now loaded and ready to use.
Only load your Turbohaler when you need to use it.
4. Hold your Symbicort Turbohaler away from your mouth. Breathe out gently (as far as is
comfortable). Do not breathe out through your Turbohaler.
5. Place the mouthpiece gently between your teeth. Close your lips. Breathe in as deeply and
as hard as you can through your mouth. Do not chew or bite on the mouthpiece.
6. Remove your Symbicort Turbohaler from your mouth. Then breathe out gently. The
amount of medicine that is inhaled is very small. This means you may not be able to taste
it after inhalation. If you have followed the instructions, you can still be confident that
you have inhaled the dose and the medicine is now in your lungs.
7. If you are to take a second inhalation, repeat steps 2 to 6.
8. Replace the cover tightly after use.
9. Rinse your mouth with water after your daily morning and/or evening
doses, and spit it out.

Depending on whether your Symbicort Turbohaler is being prescribed to you as a preventer or reliever will determine the frequency at which you can use it.

Symbicort Turbohaler as preventer:

Adults (18 years and above)
The usual starting dose is 1 or 2 inhalations, twice a day.
If your doctor or prescriber deems it necessary, this dose may increase to 4 inhalations, twice a day.
If your symptoms are well controlled, your doctor may ask you to take your medicine
once a day.

Adolescents (12 to 17 years)
The usual starting dose is 1 or 2 inhalations, twice a day.
If your symptoms are well controlled, your doctor may ask you to take your medicine
once a day.

Children (6 to 11 years)
The usual starting dose is 2 inhalations, twice a day.

Symbicort Turbohaler as Reliever/Only Inhaler:

Use your Symbicort Turbohaler every day. This helps to prevent asthma symptoms from
happening. You can take:

1 inhalation in the morning and 1 inhalation in the evening
or
2 inhalations in the morning
or
2 inhalations in the evening.

Also use Symbicort Turbohaler as a ‘reliever inhaler’ to treat asthma symptoms when
they happen.
If you get asthma symptoms, take 1 inhalation and wait a few minutes.
If your symptoms do not subside, take another inhalation.
Do not take more than 6 inhalations at a single time.

Symbicort Turbohaler is not recommended to be used in children who are younger than
6 years.

As with all medication, there is a list of side effects that could potentially happen, for a more exhaustive list, please read the patient information leaflet.

Some of the common Symbicort Turbohaler side effects are as follows:

• Palpitations (awareness of your heart beating)
• Trembling or shaking.
• Thrush (a fungal infection) in the mouth. This is less likely to happen if you rinse your mouth out
  with water after using your Symbicort Turbohaler.
• Mild sore throat,
• Coughing
• Hoarse voice.
• Headache

Uncommon side effects from the Symbicort Turbhaler:

• Feeling restless, nervous or agitated.
• Disturbed sleep.
• Feeling dizzy.
• Nausea (feeling sick).
• Fast heart beat.
• Bruising of the skin.
• Muscle cramps.
• Blurred vision.

The rare side effects from using your Symbicort Turbohaler are:

• Rash, itching.
• Bronchospasm (tightening of the muscles in the airways which causes wheezing).
• Low levels of potassium in your blood.
• Uneven heart beat.

The very rare side effects reported from Symbicort Turbohaler:

• Depression.
• Changes in behaviour, especially in children.
• Chest pain or tightness in the chest (angina pectoris).
• An increase in the amount of sugar (glucose) in your blood.
• Taste changes, such as an unpleasant taste in the mouth.
• Changes in your blood pressure

Always consult your doctor/prescribe if you experience any of these symptoms.

Some of the known food interactions with Symbicort Turbohaler is:

Grapefruit: consuming grapefruit when taking your Symbicort Turbohaler can lead to an increase in plasma in your blood.

Generally avoid Grapefruit and Grapefruit juice to avoid any unwanted effects.

Alcohol: Alcohol is not considered to have an effect on your Symbicort Turbohaler.

If you have any concerns regarding food or alcohol, consult your doctor or prescriber.

With all medication, there are a list of interactions between Symbicort Turbohaler and other drugs,

For a more exhaustive list, please check the patient information leaflet

• Beta-blocker medicines (such as atenolol or propranolol for high blood pressure), including eyedrops (such as timolol for glaucoma).
• Medicines for a fast or uneven heart beat (such as quinidine).
• Medicines like digoxin, often used to treat heart failure.
• Diuretics, also known as ‘water tablets’ (such as furosemide). These are used to treat high blood pressure.
• Steroid medicines that you take by mouth (such as prednisolone).
• Xanthine medicines (such as theophylline or aminophylline). These are often used to treat asthma.
• Other bronchodilators (such as salbutamol).
• Tricyclic anti-depressants (such as amitriptyline) and the anti-depressant nefazodone.
• Phenothiazine medicines (such as chlorpromazine and prochlorperazine).
• Medicines called ‘HIV-protease inhibitors’ (such as ritonavir) to treat HIV infection.
• Medicines to treat infections (such as ketoconazole, itraconazole, voriconazole, posaconazole, clarithromycin and telithromycin).
• Medicines for Parkinson’s disease (such as leva-dopa).
• Medicines for thyroid problems (such as levo-thyroxine).

If any of the above applies to you, or if you are not sure, talk to your doctor or pharmacist before using Symbicort Turbohaler.

Also tell your doctor or pharmacist if you are going to have a general anesthetic for an operation or for dental work.

You would not be able to take Symbicort Turbohaler if any of the following apply to you:

• Allergic to budesonide, formoterol or the other ingredient of this medicine
  (listed in section 6), which is lactose (which contains small amounts of milk protein).
• Take any of the other drugs that interact with Symbicort Turbohaler

You should speak to your doctor/prescriber if any of the following apply to you:

• You are diabetic.
• You have a lung infection.
• You have high blood pressure or you have ever had a heart problem (including an uneven
  heart beat, a very fast pulse, narrowing of the arteries or heart failure).
• You have problems with your thyroid or adrenal glands.
• You have low levels of potassium in your blood.
• You have severe liver problems.

You should also contact your doctor if you experience blurred vision or other visual disturbances.

Pregnancy, breast-feeding and fertility

If you are pregnant, or planning to get pregnant, talk to your doctor before using
Symbicort Turbohaler – do not use Symbicort Turbohaler unless your doctor tells you to.
If you get pregnant while using Symbicort Turbohaler, do not stop using Symbicort
Turbohaler but talk to your doctor immediately.
If you are breast-feeding, talk to your doctor before using Symbicort Turbohaler.

Yes, you can legally buy inhalers online from registered prescribers such as e-Surgery. Always make sure you check for the green GPhC logo anytime you buy Soprobec inhalers online or other medicines. You can use the GPhC website to check if a pharmacy is registered. This ensures that when you buy the Symbicort Turbohaler online it is genuine.

If you have any questions regarding the Symbicort Turbohaler, and the Patient information leaflet does not answer your question, you can use our completely free Ask-A-Pharmacist service. Alternatively you can speak to your doctor or prescriber.

If you choose to buy your Symbicort Turbohaler online with e-Surgery prices start from £49.95. This includes the cost of a private prescription.

e-Surgery uses Royal Mail delivery with choices starting from Royal Mail 48 tracked delivery, Royal Mail tracked 24 and Royal Mail 1pm special delivery (discover more about e-Surgery delivery).When you buy inhalers online they will arrive in discreet, recyclable packaging at a delivery address of your choice. Find out to recycle packaging from e-Surgery.

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When your Symbicort Turbohaler arrives, you would need to store it with the following in mind:

• Keep this medicine out of the sight and reach of children.
• Do not use this medicine after the expiry date which is stated on the carton or on the label
  of your inhaler after EXP. The expiry date refers to the last day of that month.
• This medicine does not require any special storage conditions.
• Do not throw away any medicines via wastewater or household waste.
  You can take medicine you no longer use to your local pharmacy for correct disposal

The Symbicort inhaler is a prescription only medication, therefore it is not available over the counter.

You doctor may prescribe you different inhalers for different reasons depending on your individual case of asthma, these types are:

Preventers and Relievers,

Preventers are taken daily to treat asthma itself, whilst Relievers are to be taken whilst you are struggling with your asthma,

See a list below of the different inhalers in each category