Available in:Powder Inhaler
Dosage:62.5+25MCG, 62.5+25+100, 6+100MCG, 6+200MCG, 25+100MCG, 25+200MCG, 400+12MCG, 50+100MCG, 50+110MCG, 50+250MCG, 50+500MCG, 150+160MCG, 50+150+160
Manufacturer:Astrazeneca
Available in:Metered Dose Inhaler
Dosage:2.5+2.5MCG, 5+50MCG, 5+100MCG, 5+200MCG, 20+100MCG, 25+125MCG, 25+250MCG
Manufacturer:Merck
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For asthma treatment, budesonide - formoterol can be used for maintenance therapy or for maintenance plus reliever therapy.
The starting dose of budesonide - formoterol is based on control of your symptoms. After asthma symptoms are controlled, your doctor will adjust your dose to the lowest regular dose that prevents asthma symptoms.
Symbicort Turbuhaler is inhaled into the lungs through the mouth, using the device that contains the medications (Turbuhaler®). Your health care professional should show you how to use the device. If you are not sure about how to use the device, contact your doctor or pharmacist for advice.
For maintenance therapy, the recommended dose for adults and adolescents over 12 years of age is 100 µg to 400 µg of budesonide, which is equivalent to 1 to 2 inhalations (or puffs) of Symbicort® 100 or Symbicort® 200, 1 or 2 times daily. If you need fast relief from asthma symptoms, use your fast-acting "reliever" (or "rescue") medication such as formoterol, terbutaline, or salbutamol. The maximum recommended daily maintenance dose is 4 inhalations. When asthma is worsening, the dose can temporarily be increased to a maximum of 4 inhalations twice daily.
With the higher-strength product, Symbicort® Forte, a 400 µg dose is achieved with 1 puff, which may be inhaled 1 or 2 times a day. The maximum daily dose of this product is 2 puffs (800 µg) inhaled twice daily.
For maintenance and reliever therapy, the recommended dose for adults and adolescents over 12 years of age is 1 to 2 inhalations 2 times daily or 2 inhalations once daily. If you need fast relief from asthma symptoms, use 1 additional inhalation as needed and repeat after a few minutes (to a maximum of 6 inhalations) if symptoms persist. The maximum recommended total daily dose is 8 inhalations. Symbicort® Forte should not be used as a reliever medication.
When used as COPD therapy, the recommended dose is 400 µg of budesonide (2 inhalations of Symbicort® 200 or 1 inhalation of Symbicort® Forte), inhaled 2 times daily. The maximum recommended daily dose is 800 µg of budesonide.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.
When used regularly, Symbicort Turbuhaler can reduce the number and severity of episodes of difficulty breathing. Regular daily use is important for its effectiveness.
Budesonide - formoterol turbuhaler should be used regularly, even when you are not experiencing any symptoms.
It is important to use Symbicort Turbuhaler exactly as prescribed by your doctor. If you miss a dose, use it as soon as possible and then continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store Symbicort Turbuhaler at room temperature with the cover on tight, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Zenhale is taken as 2 inhalations twice a day (morning and evening). It should be used regularly to receive the most benefit from the medication.
The effectiveness of the medication depends on the proper use of the inhaler. Have your doctor or pharmacist instruct you in the correct usage of the inhaler. Rinse your mouth and gargle with water after using the inhaler to help prevent thrush (yeast infection of the mouth) from developing.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to use Zenhale exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store Zenhale at room temperature, protect it from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes Symbicort Turbuhaler. If you are concerned about side effects, discuss the risks and benefits of Symbicort Turbuhaler with your doctor.
The following side effects have been reported by at least 1% of people taking Symbicort Turbuhaler. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Stop taking the medication and seek immediate medical attention if any of the following occur:
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Symbicort Turbuhaler.
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes Zenhale. If you are concerned about side effects, discuss the risks and benefits of Zenhale with your doctor.
The following side effects have been reported by at least 1% of people taking Zenhale. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Stop taking the medication and seek immediate medical attention if any of the following occur:
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Zenhale.
Symbicort 100 Turbuhaler
Each dry powder inhaler contains 100 µg of budesonide and 6 µg of formoterol fumarate dihydrate per dose. It also contains lactose, which acts as a "carrier." The amount added does not normally cause problems for lactose-intolerant people.
Symbicort 200 Turbuhaler
Each dry powder inhaler contains 200 µg of budesonide and 6 µg of formoterol fumarate dihydrate per dose. It also contains lactose, which acts as a "carrier." The amount added does not normally cause problems for lactose-intolerant people.
Symbicort Forte Turbuhaler
Each dry powder inhaler contains 400 µg of budesonide and 12 µg of formoterol fumarate dihydrate per dose. It also contains lactose, which acts as a "carrier." The amount added does not normally cause problems for lactose-intolerant people.
50/5
Each inhalation delivers 50 µg of mometasone furoate and 5 µg of formoterol fumarate dihydrate. Nonmedicinal ingredients: ethanol anhydrous, oleic acid, and HFA-227 (propellant).
100/5
Each inhalation delivers 100 µg of mometasone furoate and 5 µg of formoterol fumarate dihydrate. Nonmedicinal ingredients: ethanol anhydrous, oleic acid, and HFA-227 (propellant).
200/5
Each inhalation delivers 200 µg of mometasone furoate and 5 µg of formoterol fumarate dihydrate. Nonmedicinal ingredients: ethanol anhydrous, oleic acid, and HFA-227 (propellant).
Do not use Symbicort Turbuhaler if you are allergic to budesonide, formoterol, or inhaled lactose.
Do not take Zenhale if you:
There may be an interaction between budesonide - formoterol turbuhaler and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with Symbicort Turbuhaler. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
There may be an interaction between formoterol - mometasone and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with Zenhale. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Symbicort Turbuhaler.
Asthma attacks: Symbicort Turbuhaler works by decreasing the frequency and severity of asthma attacks, and it can be used as a "reliever" medication. If you start developing asthma symptoms, be sure to use your "reliever" medication or an additional inhalation (or puff) of Symbicort Turbuhaler for rapid relief of your asthma symptoms. It is very important that you have your "reliever" medication available with you at all times, whether you're using Symbicort Turbuhaler or another rescue medication. If you persistently use more of your "reliever" medication, contact your doctor.
Budesonide - formoterol is not intended to be used before exercise to prevent difficulty breathing as a result of exercise.
Asthma-related deaths: Formoterol, as with other long-acting bronchodilators, may increase the risk of asthma-related deaths. It is not clear whether using corticosteroids, such as budesonide, reduces this risk. If you have concerns, speak with your doctor.
Bone health: Long-term use of inhaled corticosteroids has been associated with a decrease in bone density. This may lead to brittle bones or Osteoporosis. If you have risk factors for thinning or brittle bones, such as a slight build; long-term, regular alcohol use; poor nutrition; or a family history of osteoporosis, you may be at a greater risk of thinning bones. Discuss with your doctor how Symbicort Turbuhaler may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Symbicort Turbuhaler, and whether any special monitoring is needed.
Diabetes: Budesonide - formoterol may cause changes in blood sugar levels (may cause a loss of blood glucose control) and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using Symbicort Turbuhaler.
If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Symbicort Turbuhaler may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Symbicort Turbuhaler, and whether any special monitoring is needed.
Eye problems: Budesonide may increase the risk of developing cataracts or Glaucoma. If you are at risk of developing either of these conditions, have your eyes checked by your doctor before starting long-term treatment with Symbicort Turbuhaler. You should have your eyes monitored at regular intervals while using Symbicort Turbuhaler. Report any changes in vision to your doctor as soon as possible while you are taking Symbicort Turbuhaler.
Heart disease: If you have heart disease or high blood pressure, discuss with your doctor how Symbicort Turbuhaler may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Symbicort Turbuhaler, and whether any special monitoring is needed.
Infections: Thrush infections of the inside of the mouth and throat may occur with use of Symbicort Turbuhaler. If an infection develops, call your doctor. You can reduce the risk of infection by rinsing your mouth out with water after each dose and by practicing good oral hygiene. Also, tell your doctor if you are exposed to Chickenpox or Measles while using Symbicort Turbuhaler, as you may be more prone to infection.
People using budesonide - formoterol to treat COPD may be more likely to develop lung infections, such as pneumonia. If you experience new or worsening shortness of breath or cough, fever, or other symptoms of infection at any time while you are taking Symbicort Turbuhaler, contact your doctor as soon as possible.
Liver function: Liver disease or reduced liver function may cause Symbicort Turbuhaler to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Symbicort Turbuhaler may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Symbicort Turbuhaler, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Symbicort Turbuhaler.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Medical conditions: If you have Epilepsy or low blood potassium, discuss with your doctor how Symbicort Turbuhaler may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Symbicort Turbuhaler, and whether any special monitoring is needed.
Steroid medication use: If you have taken or are still taking steroid medication over the last several months, talk to your doctor before using Symbicort Turbuhaler. In times of stress or during a severe asthma attack, your doctor may want you to start your steroid medication again.
Stopping medication: Do not stop Symbicort Turbuhaler abruptly, as this may cause your condition to get worse. When Symbicort Turbuhaler is stopped, it should be stopped gradually as directed by your doctor.
Thyroid disease: If you have thyroid disease, discuss with your doctor how Symbicort Turbuhaler may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Symbicort Turbuhaler, and whether any special monitoring is needed.
Pregnancy: Symbicort Turbuhaler should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Symbicort Turbuhaler, contact your doctor immediately.
Breast-feeding: Budesonide passes into breast milk. It is not known if formoterol passes into breast milk. If you are a breast-feeding mother and are using Symbicort Turbuhaler, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of Symbicort Turbuhaler for the treatment of asthma have not been established for children younger than 12 years of age. Adolescents may experience slowing of growth while using Symbicort Turbuhaler. Your doctor will monitor for this. Talk to your doctor if you have any concerns.
Symbicort Turbuhaler should not be used to treat chronic bronchitis or emphysema for anyone younger than 18 years of age.
Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Zenhale.
Asthma attacks: Zenhale is not a "reliever" medication. If you start developing asthma symptoms, be sure to use your reliever medication for rapid relief of your asthma symptoms. It is very important that you have your reliever medication with you at all times. If you persistently use more of your reliever medication, contact your doctor.
Diabetes: Both formoterol and mometasone may cause an increase in blood sugar levels. If you have diabetes, you may find it necessary to monitor your blood sugar more frequently while using Zenhale. If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Zenhale may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zenhale, and whether any special monitoring is needed.
Eye problems: If you are at risk of developing glaucoma or cataracts, have your eyes checked by your doctor before starting long-term treatment with Zenhale. You should have your eyes monitored at regular intervals while using Zenhale.
Heart rhythm: Beta-agonists such as formoterol can cause changes to the normal rhythm of the heart, including an irregular heartbeat called QT prolongation. QT prolongation is a serious life-threatening condition that can cause fainting, seizures, and sudden death.
Formoterol may cause a fluttering of the heartbeat (atrial fibrillation) or rapid heartbeat, increased blood pressure, chest pain, and decreased oxygen reaching the heart muscle.
If you are at risk for heart rhythm problems (e.g., people with heart failure, Angina, low potassium or magnesium levels), discuss with your doctor how Zenhale may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zenhale, and whether any special monitoring is needed.
Infections: Corticosteroids, such as mometasone, can reduce your body’s ability to fight infections and may hide signs of infection that is developing. Infections such as Chickenpox and Measles can be more serious for people taking medications such as fluticasone. If you are exposed to someone with chickenpox or measles, contact your doctor.
Inhalation-induced bronchospasm: Inhaled forms of medications may cause spasms of the airways, which make breathing difficult. If you experience this problem when using formoterol - mometasone, stop using Zenhale immediately. Speak to your doctor if you experience any problems with breathing while taking this or other inhaled medication.
Medical conditions: Discuss with your doctor how Zenhale may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zenhale, and whether any special monitoring is needed, if you have any of the following conditions:
Oral hygiene: Adequate oral hygiene, such as rinsing your mouth with water after using Zenhale, helps reduce the chances of developing a yeast infection of the mouth or throat (thrush). If you develop symptoms of thrush, such as white patches in your mouth, contact your doctor.
Osteoporosis: Long-term use of corticosteroids, including inhaled corticosteroids such as mometasone, may increase the risk of bone loss and osteoporosis. If your doctor recommends that you use Zenhale for a lengthy period of time, talk to your doctor about supplements and strategies to slow down and reduce bone loss.
Risks of similar medications: The results of a large clinical trial showed an increased risk of asthma-related death for patients who used another long-acting bronchodilator (salmeterol) in addition to their usual asthma therapy when compared to patients who used placebo (an inactive medication) in addition to their usual asthma therapy. Formoterol fumarate dihydrate (one of the active ingredients is Zenhale) is also a long-acting bronchodilator. It is unknown whether this product would have similar results.
Steroid medication use: If you have taken oral steroid medications over the last several months or are still taking oral corticosteroids, consult with your doctor before using Zenhale. In times of stress or during a severe asthma attack, your doctor may want you to start your oral steroid medication again.
Stopping the medication: Zenhale contains an inhaled corticosteroid, mometasone furoate. Abruptly stopping inhaled corticosteroids can make asthma worse. Do not stop Zenhale suddenly. Instead, speak to your doctor about how to stop the medication safely by gradually reducing the dose.
Worsening symptoms: If you find you need to use your short-acting ("rescue") inhaler more often or if your condition seems to worsen, call your doctor. If you have not been given instructions beforehand, contact your doctor immediately about what to do if any of the following situations occur (they may be signs of seriously worsening asthma):
Pregnancy: Zenhale should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Zenhale, contact your doctor immediately.
Breast-feeding: It is not known if Zenhale passes into breast milk. If you are a breast-feeding mother and are taking Zenhale, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children less than 12 years of age.
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