Contraindications
Patients with hypersensitivity budesonide, formoterol, or lactose
Side effects
Palpitations, candida infections, headache, tremour, coughing, throat irritation
Less common: tachycardia, nausea, diarrhoea, weight gain, muscle cramps, dizziness
Drug to drug interactions
Budesonide and formoterol have limited reports regarding interactions with other medications in the treatment of asthma.
Symbicort should be avoided when in combination with ritonavir (antiretrovial), itraconazole antifungal), ketoconazole (antifungal). Research has shown concomitant treatment with these drugs have the potential to increase systemic adverse reactions, such as Cushing's syndrome.
Pharmacokinetics
Absorption: absorption is rapid after inhalation and the maximum plasma concentration is reached within 30 minutes after inhalation.
Distribution/ Metabolism: Budesonide undergoes biotransformation on first passage through the liver
Elimination: Formoterol is eliminated by metabolism in the liver and then followed by renal excretion. 8-13% of formoteral is excreted in the urine. Budesonide is eliminated via urine.