Which medicine is more dangerous: beclazone or symbicort? InternetAmbulanceMedical portal

Acute respiratory diseases, the flu often causes complications. They are expressed in the inflammatory process in the bronchi and lungs. Bronchitis is manifested by the following symptoms:

• cough;
• temperature increase;
• weakness;
• difficulty breathing.

Timely treatment will prevent the development of pneumonia. Symbicort is considered a popular drug for bronchial inflammation. Instructions for use, analogues - all information will be presented below. The described medications have differences in composition. At the same time, the indications and contraindications are practically the same.

Release form

The drug has anti-inflammatory and bronchodilator effects. Available in the form of a white granular powder for inhalation. The main component of the drug is micronized budesonide in doses of 80, 160 and 320 mcg, as well as formoterol fumarate dihydrate in doses of 4.5 and 9 mcg. The auxiliary component is lactose monohydrate. The medicine is packaged in metal inhalers designed for 60 and 120 doses.

A drug of combined action to eliminate an attack. The two main substances of the drug have different effects on the bronchi, thereby reducing the frequency. The main properties of the drug allow them to be used in conjunction with other groups of drugs to relieve bronchial asthma.

Budesonide after the first inhalation for several hours reduces inflammatory process in the bronchi, reduces the frequency of attacks and exacerbations of bronchial asthma. The bronchial mucosa becomes less swollen, and secretion production decreases.

Formoterol is a selective adrenergic receptor antagonist. After inhalation, the smooth muscles of the bronchi in patients with bronchial obstruction quickly and permanently relax respiratory tract. After just 3 minutes, a bronchodilator effect occurs, and it lasts for about half a day. Tradename medical product "Symbicort Turbuhaler". Instructions for use, analogues - all information must be studied before starting therapy.

Indications and contraindications

The medication can be prescribed for the following pathologies:

• bronchial asthma of various etiologies;
• COPD

Contraindications:

• age up to 6 years;
• age up to 12 years, for a medication dosage of 320 mcg;
• hypersensitivity to individual components of the drug;
• tuberculosis;
• infectious and bacteriological pathologies of the respiratory system;
• diabetes;
• severe form of hypertension;
• heart diseases.

Before starting treatment, it is necessary to thoroughly study all contraindications to the drug Symbicort (160/4.5). Analogs should also be used after reading the instructions and consulting a doctor.

Dosage

The medicine is not intended to treat the initial signs of bronchial asthma. The selection and prescription of the dose depends on the severity of the disease and the individual characteristics of the organism. This should be taken into account before starting the treatment process with combined drugs and when changing the dosage. The main task of the drug is to reduce the number of attacks and exacerbations of bronchial asthma.

Basically, inhalations of 80, 160 and 320 mcg are prescribed twice a day, depending on age and the ongoing process. Symbicort analogues will have similar recommendations. It is necessary to use the inhaler according to the instructions and inhale correctly medicine to stop an attack.

An overdose will lead to the development of the following symptoms:

• tremor;
• tachycardia;
• headache;
• insomnia;
• decrease in pressure.

In case of overdose, the patient is prescribed symptomatic treatment and correct the daily norm. The analogs existing for the drug Symbicort will have the same recommendations. The instructions describe the maximum permissible daily intake. But you should not take the drug yourself. Only a doctor can prescribe the medicine.

Drug interactions

• "Ketoconazole";
• beta blockers;
• "Quinidine";
• "Disopyramide";
• antihistamines;
• "Levodopa";
• "Oxytocin";
• MAO inhibitors.

Pregnancy and lactation

There are no reliable studies on how the drug affects the fetus during pregnancy and lactation. The medicine is prescribed only when the benefit to the mother outweighs the risk to the fetus. Cheap analogues of Symbicort are not recommended for use in the first and third trimesters of pregnancy.

Side effects

In general, the product is well tolerated. Only in rare cases, the following adverse reactions may occur:

• tachycardia;
• tremor;
• migraine;
• dizziness;
• nausea;
• vomit;
• excitement;
• sleep disturbance;
• allergic reactions.

Symbicort analogues can also lead to the development of the described symptoms.

The drug is stored at a temperature not exceeding 30 degrees out of the reach of children. Available at the pharmacy with a prescription. It is recommended to gradually reduce the dosage of the drug so as not to cause withdrawal syndrome. The medicine is not intended for individual use for severe forms of bronchial asthma. Patients suffering from frequent attacks should always have the drug with them.

The drug should be used with caution in patients with renal and hepatic insufficiency. All these instructions must be taken into account when treating with Symbicort Turbuhaler (160/4.5, 120 doses). An analogue may be similar in composition. Therefore it will have the same recommendations.

Before using the drug, you must learn how to use an inhaler so that the dose is evenly distributed in the larynx and the drug is a short time relieved an attack of suffocation.

The analogue of "Symbicort" in Russia is the drug "Benacort"

The medicine belongs to the group of corticosteroids for inhalation. Unlike Symbicort Turbuhaler, the medication is available in the form of a fine-crystalline powder or a clear solution. The main substance in the drug is budesonide in doses of 200, 250 and 500 mcg. The auxiliary component is sodium benzoate.

Intended for use by inhalation. It has an anti-inflammatory, antiallergic, and immunosuppressive effect on the bronchi. Well tolerated with long-term use. Does not have mineralocorticoid effect. Improvement in lung function is observed within two hours after the first dose. A positive therapeutic effect occurs after seven days of treatment. The drug does not stop an attack of asthma, but is used to eliminate bronchial asthma. Symbicort has an identical effect. The Russian analogue can be purchased at a pharmacy at a reasonable price - about 400 rubles per pack. At the same time, the cost of the drug "Symbicort" is almost twice as high.

Feedback from experts shows that there is no significant difference between the two drugs when it comes to the effect on the body. Therefore, there is no point in overpaying for a more expensive drug.

Indications and contraindications

The medication is used for the following pathologies:

• bronchial asthma: as an anti-inflammatory agent in complex use;
• chronic obstructive pulmonary disease.

Contraindications:

• active form of tuberculosis;
• fungal and bacterial infections of the lungs;
• acute bronchospasm;
• age up to 16 years;
• non-asthmatic form of bronchitis;
• glaucoma.

Other analogues for the drug Symbicort have the same indications and contraindications. The inhaler is also used in the joint treatment of attacks of bronchial asthma and contains a certain number of doses.

Benacort dosage

Inhalation of the drug is carried out using a portable individual inhaler "Cyclohaler". The daily dose is set depending on the severity of bronchial asthma and taking into account the characteristics of the patient’s body. The initial dose may be slightly higher than when using Symbicort and will be 400-1600 mcg. The maximum dosage per day should not exceed 2000 mcg. It is distributed over 4 inhalations. The course of treatment is from 10 to 14 days.

Like other analogues (Symbicort, Benacap), Benacort is not compatible with all medications. It is not recommended to carry out therapy with the following medications:

• "Phenytoin."
• "Phenobarbital".
• "Rifampicin."
• "Ketonazole".
• estrogens.

Reviews from doctors show that if the drug is taken incorrectly, the following side effects may develop:

• redness of the laryngeal mucosa;
• hoarseness;
• nausea;
• migraine;
• dizziness;
• sleep disturbance.

Benacort can be an excellent substitute for Symbicort. Analogs are cheaper, but often not inferior in quality. Reviews about the drug "Benacort" are mostly positive.

In rare cases, hypersensitivity to the active ingredient may develop. It manifests itself in the form of skin rashes and itching. An allergic reaction is a serious reason to seek medical advice. The specialist will be able to select a high-quality substitute and also prescribe an antihistamine.

"Benacap"

This medicine, unlike those described above, is available in the form of drops and belongs to the group of corticosteroids. Used for inhalation, local and intranasal use. It has an anti-inflammatory, anti-allergic and anti-exudative effect, which, through inhalation, reduces the production of secretion and obstruction in the bronchi.

During the treatment, lung function improves, the frequency of shortness of breath decreases, and the attack of suffocation and spasmodic cough also disappear. The maximum therapeutic effect is observed two weeks after use. Similar action provides the drug "Symbicort Turbuhaler". Analogues are cheaper, but also perfectly reduce the number of asthma attacks.

Dosage of the drug "Benacap"

The dose depends on age, severity of the disease and individual characteristics of the body. Only the doctor determines the number of inhalations. Analogues (Symbicort, Benacort and other drugs) of Benacap are mainly used for inhalation, in the form of a powder or solution.

• "Omeprazole."
• "Cimetidine"
• "Rifampicin."

There is no data on how the drops affect during pregnancy and lactation. The medication is used only when the benefit to the mother outweighs the risk to the fetus. Other Symbicort analogues will have the same recommendations. Feedback from experts shows that in practice it was necessary to prescribe inhalers to pregnant women. Side effects was not identified. However, it is advisable to carry out therapy under supervision.

"Seretide"

A drug with bronchodilator and anti-inflammatory effects. This medicine comes in aerosol form as a white suspension. The main components of the drug are salmeterol xenofoate at a dose of 25 mcg and fluticasone propiolate 50, 125 and 250 mcg. A product of a combined composition that has different effects. The drug "Seretide" differs in composition from the drug "Symbicort Turbuhaler". Analogs, despite the difference in active ingredients, have similar effects on the body.

Indications and contraindications

The drug "Seretide" is prescribed for the following diseases:

• treatment of bronchial asthma in combination with other groups of drugs;
• obstructive pulmonary disease.

Contraindications:

• hypersensitivity to components;
• age up to 4 years;
• acute tuberculosis;
• renal and liver failure;
• pregnancy;
• lactation;
• glaucoma.

The drug Symbicort has identical contraindications to treatment. Analogues are cheaper in most cases, but do not differ in the effectiveness of therapy. However, you should not purchase a substitute at the pharmacy without the recommendation of a specialist. In rare cases, hypersensitivity to the active ingredient may develop, which manifests itself as an allergic reaction. If any unpleasant symptoms You should stop using the inhaler and consult a doctor for advice.

Dosage

The drug "Seretide" is used only for inhalation. The number of procedures per day is determined by the doctor, depending on the severity of the disease and the individual characteristics of the patient. Only regular use will help reduce the number of asthma attacks. Cheap analogues of Symbicort are used in a complex manner. Only a doctor can determine the daily dosage of the drug for a particular patient. Self-medication is not advisable.

Comparison and reviews

The drugs “Symbicort”, “Seretide”, “Benacap”, “Benacort” have different main substances in their composition, but identical indications for use and a number of contraindications. All of them belong to the group of corticosteroids, which are used in the form of inhalations and aerosols. After treatment with these drugs, many patients were able to reduce the number of attacks, relieve inflammation in the bronchi, remove allergy symptoms and swelling of the mucous membrane. Most physicians prescribe these medications for the treatment of bronchial asthma with long-term use.

Quite a lot good reviews You can hear about the drug "Symbicort". Domestic analogues are also widely used. Treatment for renal disease is prescribed with caution and the only negative is the price. The drug "Symbicort" is the most expensive of those described above (about 900 rubles per package).

If you couldn’t find the drug “Symbicort” in the pharmacy, cheaper analogues can be used after consultation with a specialist. Cheap does not mean low quality. The described drugs perfectly relieve the symptoms of bronchial asthma, despite the differences in composition.

We present to your attention a series of lectures on bronchial asthma provided to our siblings by Alena Paretskaya, pediatrician, consultant, and Natalya Krechetova, general practitioner.
In the fourth and final part, you will learn how bronchial asthma is treated.

Treatment.

In this section, we will talk about elimination (this is a complete and permanent cessation of the patient’s contact with the allergen that causes an attack), consider groups of drugs used in the treatment of bronchial asthma, the principles of their action, and clarify which methods of drug delivery are better. And what medications and their dose will be prescribed by your doctor.

When starting a conversation about reducing/eliminating the impact of an allergen on the body, we can say that the main, and probably the only, principle remove the allergen from your environment. In the early stages of the disease, when the disease progresses without complications, stopping contact can be very effective and attacks of suffocation will be very rare.

If you are allergic to house dust. It is clear that it needs to be eliminated. First of all, we remove all “dust collectors” from the apartment, and especially from the room where you sleep. This category of items includes upholstered furniture, carpets, soft toys, houseplants, feather beds, duvets and pillows, curtains made of dense heavy fabric. If you have a rich library, then you need to keep books in a cabinet with glass doors and never in the bedroom. Wash soft toys as often as possible and at a temperature of 60C. If possible, entrust the cleaning to someone in the household; if this is not possible, then the room must be ventilated during the cleaning process. First of all, wet cleaning of the apartment is necessary; If you have carpets left on the floor, they need to be vacuumed daily. But remember that vacuum cleaners, which are usually used in everyday life, do not remove dust, but rather disperse it into the air. In this case, it is better to use washing vacuum cleaners or new generation vacuum cleaners that trap even the smallest dust particles, including waste products of mites living in dust. All pillows, blankets and feather beds will have to be removed and bedding made from modern materials that do not accumulate dust, such as polyester.
If you cannot give up your favorite pillow, then buy bed linen made from special durable fabrics or 100% cotton. If you are allergic to animal epidermis(particles of skin, fur, saliva, excrement, chitinous integument, feathers) of course, it is necessary to get rid of the animal and not keep it in the future. It should be remembered that this group also includes insects that live in residential areas and in the wild. It is also worth considering that if, for example, a person is allergic to sheep’s wool, then attacks can also occur when wearing socks knitted from sheep’s wool. Or if you are allergic to dander, the horse should not be given anti-tetanus serum (since horse blood is used to make the serum). If you are allergic to mushrooms (molds, yeasts), then it is necessary to strictly monitor the microclimate in the apartment - constantly ventilate the room, establish a ventilation system, and avoid high humidity in the apartment. At food allergies You should exclude foods that cause asthma attacks, not forgetting, of course, complex foods and dishes in which our allergen may be a component. If you are allergic to pollen from flowering plants you need to know which plant is “not yours” and when it blooms. During the flowering period, it is not advisable to appear in parks, alleys, forests or fields, i.e. where the “enemy” might be. In dry, windy weather, refrain from going outside; it is best to keep the windows closed, and if necessary, ventilate the apartment at night. When planning a vacation in another region or country, ask if your plant is there and, if it is present, check its flowering period. When prescribing herbal medicine, especially complex mixtures, be sure to ask what herbs are included in the composition and take into account the possibility of cross-reactions). If you have a drug allergy you need to clearly know which medicine is causing your attacks. If the name is too difficult for you, write it on a piece of paper and carry it in your wallet or purse. And be sure, when entering the hospital for treatment or when visiting a doctor, tell the medical staff about the intolerable drug.

Treatment. The main principle of treating bronchial asthma is a stepwise approach, in which, depending on the severity of the disease, one or another intensity of treatment is used. After all, the main goal is to achieve good health by using fewer medications. The fact is that even the same patient may have a different number of attacks depending on many factors - the presence of an allergen, time of year, health status, namely the presence colds. And if the condition worsens, you need to increase the dose of the medicine or the frequency of administration (this is decided individually with each patient), change it. After improving the condition and maintaining good health for 3 months, as a rule, they begin to reduce the intensity of treatment to a minimum amount, but this minimum amount should always remain! If you completely stop taking medications, especially those prescribed for therapeutic purposes, your condition may worsen even for no apparent reason.
In the treatment of bronchial asthma, medications can be taken in different forms, for example in tablets; in severe cases, to relieve an attack - intravenously, in the form of injections, but the main form of drug delivery for bronchial disease is inhalation. By administering medications by inhalation, we deliver it to where it is needed in high concentrations, namely to the bronchi. In this case, the effect develops much faster than if we take a pill. Also, with inhalation, many side effects can be avoided, this is especially true for glucocorticosteroids.

There are several forms of inhalers and each type has its own inhalation technique.
The most common and frequently used form of inhalers is aerosol cans. When using them, you must strictly follow the sequence of actions:

Before using the inhaler, you must remove the cap and shake the can.
-Turning it upside down, you need to exhale.
-Cover the mouthpiece tightly with your lips and inhale deeply, while inhaling, press the bottom of the can.

The main disadvantage of the balloon is that many patients find it difficult to inhale and press at the same time. To overcome this obstacle, you can use a spacer, which we will discuss below. Some companies also produce aerosol inhalers that are activated by breathing. These drugs are easily recognized by their name, for example Beclazon IVF easy breathing, salamol IVF easy breathing. Shake the inhaler several times before use. Holding it vertically, open the lid, exhale and, wrapping your lips around the mouthpiece, take a deep breath. Thus, there is no need to try to coordinate breathing and pressing the can.

Aerosol preparations with dry powder in the form of capsules, disks, multi-doses are often used, but these are, as a rule, medicinal preparations.

Very often, when stopping an attack or when taking medications, spacers and nebulizers are used.

A nebulizer is a device that turns a liquid, in our case a medicine, into an aerosol and delivers it to the bronchi; even during a severe attack, the aerosol easily passes into the severely narrowed bronchi.

Spacer. This is an additional reservoir that is located between the patient’s mouth and the aerosol can. The medicine first enters the spacer and then to the patient. Who needs a spacer? This is for children and elderly people; patients who cannot fully perform the inhalation technique correctly; when taking large doses of medications; when taking inhaled glucocorticosteroids. When using a spacer, you do not need to try to press the canister and inhale; you can breathe calmly without fear of losing the medicine. In addition, large particles of matter that still settle in oral cavity, when using a spacer, settle on its walls, which is especially important when breathing inhaled steroids. The latest models of spacers are equipped with valves that prevent loss of aerosol and allow you to take several breaths.

But in order for a spacer to help, you need to know how to use it. First of all, when using a spacer, you must make sure that the protective cap is removed from the inhaler. The can must be upside down, i.e. the mouthpiece is at the bottom. Immediately before inhalation, you must take a deep breath, with your lips tightly covering the mouthpiece. Inhalation from the spacer should be done within the first 5 seconds. You need to inhale completely, but not too quickly. After inhaling, you should try to hold your breath for 5-10 seconds and only then exhale. If you are prescribed several doses, then they should not be taken simultaneously, but sequentially with an interval of about 30-40 seconds. And of course, keep the spacer in order, wash or wipe it in a timely manner, according to the care instructions.

Now let's briefly look at the groups of medications that are used to treat bronchial asthma. For what? - you ask, - after all, the doctor prescribes medications and he must understand these drugs, and I only carry out these prescriptions. The fact is that you also need to know what medicine was prescribed to you and what it is for - to stop an attack or for treatment. This is fundamentally important!

First we will talk about drugs that dilate the bronchi. Remember, in the last lecture, we examined the structure of the bronchus during an attack and that in this case the lumen of the bronchus narrows and thick, viscous sputum appears, which is difficult to cough up? It is at this moment that we need to expand the bronchus. Moreover, this needs to be done very quickly. It is precisely these properties - dilation of the bronchi and speed of action - that Short-acting β2 agonists. It is not necessary to remember this incomprehensible foreign word; the main thing is to remember the drugs belonging to this group. These include salbutamol (analogues of Ventolin, Salamol)- this is one of the first and most famous drugs for stopping an attack. During an attack of bronchial asthma, it is used in the form of inhalation. The effect of the drug begins in 4-6 minutes and lasts up to 4-5 hours. Typically, 2 breaths are used to relieve an attack. Remember! Increasing the number of breaths at one time does not lead to a faster or longer-lasting response, but it does increase the possibility of side effects (rapid heartbeat).

This group also belongs Fenoterol (Berotec). The effect of the drug also begins within 4-5 minutes, but the duration is longer than that of Salbutamol - up to 6 hours.

M - anticholinergics also dilate the bronchi (but their mechanism of action differs from the previous group) and are also used to relieve an attack. This group includes Atrovent. The effect occurs slightly later than that of salbutamol and Berotek, after 6-8 minutes and lasts up to 6 hours. But Atrovent, unlike the above drugs, does not cause an increase in heart rate, which is very important for patients who have heart disease.

There is also a drug that includes β2 agonists And M - anticholinergics- This Berodual. The two components of the drug seem to complement each other, providing a good result. The effect of the drug begins in 6-8 minutes and lasts up to 6 hours.

Remember! To relieve asthma attacks, use only Salbutomol, Berotek, Atrovent or Berodual in the form of inhalation with a metered aerosol or through a nebulizer! Long-acting drugs are not used in this case!

There are drugs that dilate the bronchi for a long time, but they are practically not used to relieve attacks, since the effect of the drugs begins within a few hours. These include the same β2 agonists And M - anticholinergics, but only long acting. This Salmeterol (Serevent), Formaterol (Oxis, Foradil) and Spiriva. The effect of these drugs lasts up to 12 - 24 hours (i.e. they are used 1-2 times a day).

When talking about what changes occur during an attack, we noted that there is inflammation in the walls of the bronchi - this is a response to the action of allergens. It follows that treatment must include medications that reduce these manifestations.

The main group used for this purpose are glucocorticosteroids. These drugs are prescribed to all patients, regardless of severity, because Only these drugs can remove inflammation in the walls of the bronchus. And with constant, long-term and correct use of these drugs, the frequency of attacks decreases, and therefore the amount of drugs used, too. Hormones, as they are most often called, can be administered in various forms - tablets, IV and inhalation. Intravenous hormones are prescribed in severe cases to stop an attack. Drugs in tablets are rarely prescribed, for severe forms of bronchial asthma, in cases where, for one reason or another, aerosol drugs do not help. But even when prescribing tablet forms of hormones, when the condition stabilizes, they try to reduce the number of tablets to a minimum, and ideally, abandon them, using only inhaled forms.
The main form of delivery of hormones to the lungs is, of course, aerosol preparations.

Many patients are afraid of the prescription of hormones and strongly resist, assuring that these drugs are very dangerous for the body and they have many systemic (manifested in other organs) side effects. Yes, they are right, glucocorticosteroids have many undesirable effects, such as osteoporosis and bone fractures, the risk of developing stomach ulcers, weight gain, diabetes, and addiction to the drug. But this applies to situations where drugs are used in tablets or injections for a long time. Let's see, are aerosol forms just as dangerous?

These forms of drugs are designed so that their effect is only at the level of the bronchi, i.e. when inhaled correctly hormones enter the bronchi in a small dose, sufficient to relieve inflammation, and the amount of medication that enters the general bloodstream is very small, which means the risk of side effects is small. But the main thing is to learn how to use these drugs correctly.

When inhaling hormones, be sure to use a spacer. Some manufacturers add an optimizer (small spacer) to the package with the can. When taking aerosolized glucocorticosteroids, you should rinse your mouth by spitting out the water rather than swallowing. And it should be noted that dependence on aerosol hormones does not develop.
Thus, systemic side effects of aerosol hormones are practically non-existent.
But they may be local (occurring at the site of administration or action of the drug) side effects. Namely, cough due to irritation of the upper respiratory tract, hoarseness of the voice, and candidiasis (thrush) of the oral cavity may develop. But they, as a rule, occur when the inhalation technique is not followed and the dose is uncontrolled.

It was also noted that the earlier treatment with inhaled steroids was started, the faster asthma control was achieved, which in turn does not require taking injectable and tablet forms of hormones.

Drugs in this group include - Pulmicort, Beclazone, Seretide, Flixotide and analogues.

What dose of the drug your doctor will prescribe depends on the severity of the condition. The more severe the attacks, the higher the daily dose of the drug. But with a decrease in the number and severity of attacks, the dose of the drug is reduced to the minimum.

It is important to know what dose of the hormone the doctor prescribed for you, because the effect of treatment depends on this. The fact is that the medicine can be produced in different dosages, which are already measured and are either in a capsule, blister or delivered by a dosing device. For example, your doctor prescribed you beclazone 250 mcg 2 times a day. You bought a drug containing 100 mcg per dose and did not pay attention to this and use one inhalation 2 times a day, i.e. The doses prescribed by the doctor and those entering the bronchi are different and, accordingly, the effect is not what the doctor expected and for him this is a signal to intensify therapy.

It was noted that when hormones and long-acting beta 2 agonists (those that dilate the bronchi) are taken together, the effect of the latter is much better. Therefore, they began to produce combination drugs Symbicort And Seretide, where the dose of both drugs is indicated through a fraction, for example Symbicort 160/4.5 mcg is pulmicort 160 mcg + formoterol 4.5 mcg.

Remember! Inhaled hormones are not intended to relieve an attack!

In addition to the listed drugs, the following may be prescribed:

Cromones (Tyled, Intal), but the anti-inflammatory effectiveness of these drugs is low and is usually used for mild asthma;
- antileukotriene drugs (acolat) are prescribed for aspirin-induced asthma and asthma accompanied by allergic rhinitis;
- long-acting theophyllines (teopek, theotard, etc.) these drugs are less effective than the bronchodilators mentioned above.

Recently, data have appeared on the positive effect of treating bronchial asthma using specific immunotherapy. The essence of this therapy is as follows: under the mandatory supervision of a doctor, subcutaneous injections of allergen extracts are carried out for 2-4 months, as a result of which the body’s sensitivity to the action of the allergen decreases. As a rule, this type of treatment is prescribed when the allergen is well known and cannot be completely excluded from environment- house dust mite, plant pollen, reaction to the stings of bees and wasps; with a combination of asthma attacks and allergic rhinitis. In severe asthma and in situations where the allergen is unknown, the use of immunotherapy is dangerous.

We looked at what drugs are used in the treatment of bronchial asthma. Now let's see what to do, if you have a seizure:

The basis of treatment in this situation will be a fast-acting beta 2 agonist (salbutamol, Berotec) up to 3 times during the first hour, administered through a spacer or nebulizer.
-in case of a severe attack, you can add inhaled steroids through a nebulizer - pulmicort.
But remember that even with a positive response to treatment, a visit to the doctor is necessary. A severe attack that is not completely relieved by the drugs listed above can be life-threatening and the patient must be treated in a hospital.

Very often, patients ask questions regarding non-traditional and traditional methods treatments (breathing exercises, yoga, Buteyko and Strelniova methods, herbal medicine, acupuncture, homeopathy). It must be remembered that these methods have not yet been fully studied and for many their effectiveness in bronchial asthma has not been proven, although a positive effect is also found (but this does not exclude the possibility of proof positive action, because Research work in this direction is being carried out), in addition, this treatment is not suitable for everyone.
Breathing exercises can be used for bronchial asthma, but they are an addition to the main treatment and in no case replace it. With regular use of breathing exercises, you can improve the functionality of your lungs and breathing muscles. The simplest exercise is breathing training while creating positive pressure at the end of exhalation. To do this, you don’t even need to purchase any equipment. Simply after taking a deep breath, exhale through a straw dipped into a glass of water. This exercise can be done up to 4-5 times a day for 10 minutes.

Herbal medicine can be dangerous for patients with pollen allergies, because... There may be cross allergic reactions. In addition, for many of the herbs included in the collections, there is no clear data on how the herb works and what its side effects are.

The effectiveness of acupuncture and homeopathy has not been proven.
It should be noted that patients with bronchial asthma should engage in active physical exercise. You need to start at a time when asthma is well controlled, increasing the load gradually.

To summarize our conversation, I would like to remind you that bronchial asthma is a disease with which you can live in society, leading an active lifestyle, a disease that is well controlled with proper treatment and following the doctor's recommendations.

In this article you can read the instructions for use of the drug Symbicort. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Symbicort in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Symbicort in the presence of existing structural analogues. Use for the treatment of bronchial asthma and chronic obstructive pulmonary disease (COPD) in adults, children, as well as during pregnancy and lactation. Composition of the drug.

Symbicort- a combination drug for the treatment of bronchial asthma. Contains formoterol and budesonide, which have different mechanisms of action and exhibit an additive effect in reducing the frequency of exacerbations of bronchial asthma. The special properties of budesonide and formoterol make it possible to use their combination simultaneously as maintenance therapy and for the relief of attacks, or as maintenance therapy for bronchial asthma.

Budesonide, a glucocorticosteroid (GCS), after inhalation has a rapid (within several hours) and dose-dependent anti-inflammatory effect on the airways, reducing the severity of symptoms and the frequency of exacerbations of bronchial asthma. When budesonide is prescribed in the form of inhalations, there is a lower incidence of serious adverse effects than when using systemic GCS. Reduces the severity of edema of the bronchial mucosa, mucus production, sputum formation and airway hyperreactivity. The exact mechanism of the anti-inflammatory effect of GCS is unknown.

Formoterol is a selective beta2-adrenergic receptor agonist. After inhalation, it causes rapid and prolonged relaxation of bronchial smooth muscles in patients with reversible airway obstruction. The bronchodilator effect is dose-dependent, occurs within 1-3 minutes after inhalation and persists for at least 12 hours after taking a single dose.

Symbicort Turbuhaler: budesonide + formoterol

Bronchial asthma

Clinical efficacy of Symbicort as maintenance therapy

With the combined use of formoterol and budesonide, the severity of symptoms of bronchial asthma decreases, pulmonary function improves and the frequency of exacerbations of the disease decreases.

The effect of Symbicort Turbuhaler on lung function corresponds to the effect of the combination of budesonide and formoterol monotherapy and exceeds the effect of budesonide alone. In all cases, a short-acting beta2-agonist stimulant was used to relieve attacks. There was no decrease in the anti-asthmatic effect over time. The drug is well tolerated.

While taking Symbicort Turbuhaler as maintenance therapy for 12 weeks in children aged 6 to 11 years (two inhalations of 80/4.5 mcg/inhalation 2 times a day), pulmonary function improved and the drug was well tolerated, compared with an appropriate dose of budesonide Turbuhaler.

Clinical effectiveness of Symbicort as maintenance therapy and for the relief of attacks

During the observation of 4447 patients receiving Symbicort therapy as maintenance therapy and for the relief of attacks for 6 to 12 months, a statistically and clinically significant decrease in the number of severe exacerbations was noted, an increase in the period until the onset of the first exacerbation in comparison with the combination of Symbicort or budesonide as maintenance therapy and a beta2-agonist to relieve attacks. Effective control of disease symptoms, pulmonary function, and a decrease in the frequency of inhalation prescriptions to relieve attacks were also noted. There was no development of tolerance to the prescribed therapy. In patients who applied for medical care in connection with the development of an acute attack of bronchial asthma, after inhalation of Symbicort, relief of symptoms (relief of bronchospasm) occurred as quickly and effectively as after the administration of salbutamol and formoterol.

COPD

In patients with severe COPD (FEV1 = 36% before initiation of Symbicort therapy), a significant reduction in the frequency of exacerbations of the disease was observed while taking Symbicort Turbuhaler compared with patients receiving formoterol or placebo alone as therapy (mean exacerbation frequency 1.4 compared with 1.8- 1.9 in the placebo/formoterol group). There were no differences noted between taking Symbicort Turbuhaler and formoterol in terms of FEV1 values.

Compound

Micronized budesonide + Formoterol fumarate dihydrate + excipients.

Pharmacokinetics

Symbicort Turbuhaler is bioequivalent to the corresponding monotherapy drugs (budesonide and formoterol) in terms of their systemic action. Despite this, a slight increase in cortisol suppression was noted after taking Symbicort Turbuhaler compared to monotherapy. This difference does not affect clinical safety. There is no evidence of a pharmacokinetic interaction between budesonide and formoterol. The pharmacokinetic parameters of budesonide and formoterol were comparable after they were taken as single drugs and as part of Symbicort Turbuhaler.

When using the combination drug, the AUC of budesonide was slightly higher, the absorption of the drug was faster and the Cmax value was higher; The Cmax of formoterol coincided with that for the single drug. Inhaled budesonide is rapidly absorbed and reaches Cmax after 30 minutes. The average dose of budesonide that enters the lungs after inhalation through a turbuhaler is 32-44% of the delivered dose. Systemic bioavailability is approximately 49% of the delivered dose. In children aged 6 to 16 years, the average dose of budesonide that entered the lungs after inhalation through a turbuhaler does not differ from those in adult patients (the final concentration of the drug in the blood plasma was not determined).

Inhaled formoterol is rapidly absorbed and reaches Cmax 10 minutes after inhalation. Studies have shown that the average dose of formoterol delivered to the lungs after inhalation through a turbuhaler is 28-49% of the delivered dose. Systemic bioavailability is about 61% of the delivered dose.

Plasma protein binding of budesonide is approximately 90%, formoterol - 50%.

Budesonide undergoes intense biotransformation (about 90%) during the “first pass” through the liver with the formation of metabolites with low glucocorticoid activity. Budesonide is metabolized predominantly by the enzyme CYP3A4. The glucocorticoid activity of the main metabolites - 6-beta-hydroxybudesonide and 16-alpha-hydroxyprednisolone - does not exceed 1% of the similar activity of budesonide.

Formoterol is metabolized primarily in the liver by conjugation to form active O-demethylated metabolites, mainly in the form of inactivated conjugates.

There is no evidence of metabolite interactions or substitution reactions between budesonide and formoterol.

Budesonide is excreted in the urine in the form of metabolites or in the form of conjugates and only in small quantities unchanged. Budesonide has a high systemic clearance (approximately 1.2 l/min).

After inhalation, 8-13% of the delivered dose of formoterol is excreted unchanged in the urine. Formoterol has a high systemic clearance (approximately 1.4 l/min); T1/2 averages 17 hours.

The pharmacokinetics of formoterol in children and in patients with renal failure have not been studied.

Plasma concentrations of budesonide and formoterol may be increased in patients with liver disease.

Indications

• bronchial asthma (insufficiently controlled by the use of inhaled glucocorticosteroids (GCS) and short-acting beta2-agonists as on-demand therapy, or adequately controlled by inhaled GCS and long-acting beta2-agonists). Symbicort Turbuhaler 80/4.5 mcg/dose and 160/4.5 mcg/dose can be used as maintenance therapy and to relieve attacks;
• COPD (symptomatic therapy in patients with severe COPD (FEV less than 50% of the estimated calculated level) and with a history of repeated exacerbations, in the presence of severe symptoms of the disease, despite therapy with long-acting bronchodilators).

Release forms

Powder for inhalation dosed turbuhaler 80 mcg + 4.5 mcg (60 doses and 120 doses), 160 mcg + 4.5 mcg (60 doses and 120 doses), 320 mcg + 9 mcg (60 doses).

There are no other dosage forms, be it tablets, drops or solution.

Instructions for use and dosage

Symbicort Turbuhaler is not intended for the initial treatment of intermittent and mild persistent bronchial asthma.

The dose selection of the drugs included in Symbicort Turbuhaler is carried out individually and depending on the severity of the disease. This must be taken into account not only when starting treatment combination drugs, but also when changing the dose of the drug.

In case if individual patients a different combination of doses of active substances is required than in the drug Symbicort Turbuhaler; beta2-adrenergic agonists and/or corticosteroids should be prescribed separately in separate inhalers.

Bronchial asthma

Symbicort Turbuhaler 80/4.5 mcg/dose and 160/4.5 mcg/dose

Patients should be under constant medical supervision to ensure adequate dosage adjustment of Symbicort Turbuhaler. The dose should be reduced to the lowest dose that maintains optimal control of asthma symptoms. Once complete control over the symptoms of bronchial asthma is achieved against the background of the minimum recommended dose of the drug, at the next stage you can try prescribing monotherapy with inhaled corticosteroids.

There are two approaches to prescribing therapy with Symbicort Turbuhaler:

• as maintenance therapy, Symbicort Turbuhaler is prescribed for continuous maintenance therapy in combination with a separate short-acting beta2-adrenergic agonist to relieve attacks;
• as maintenance therapy and for the relief of attacks, Symbicort Turbuhaler is prescribed both for continuous maintenance therapy and on demand when symptoms appear.

As maintenance therapy

The patient must always have with him a separate inhaler with a short-acting beta2-adrenergic agonist to relieve attacks.

Adults (18 years and older) are prescribed Symbicort Turbuhaler 80/4.5 mcg/dose and 160/4.5 mcg/dose, 1-2 inhalations 2 times a day. If necessary, the dose can be increased to 4 inhalations 2 times a day.

Adolescents (12-17 years old) are prescribed Symbicort Turbuhaler 80/4.5 mcg/dose and 160/4.5 mcg/dose, 1-2 inhalations 2 times a day.

Children over 6 years of age are prescribed Symbicort Turbuhaler 80/4.5 mcg/dose, 1-2 inhalations 2 times a day.

After achieving optimal control of symptoms of bronchial asthma while taking the drug 2 times a day, it is recommended to titrate the dose to the lowest effective dose, up to once a day, in cases where, in the opinion of the doctor, the patient requires maintenance therapy in combination with long-acting bronchodilators.

An increase in the frequency of use of short-acting beta2-agonists is an indicator of deterioration in overall disease control and requires a review of anti-asthma therapy.

As maintenance therapy and to relieve attacks

The patient must always have Symbicort Turbuhaler with him to relieve attacks.

In this case, the drug is especially indicated for patients with insufficient control of bronchial asthma and the need for frequent use drugs to relieve seizures; if there is a history of exacerbations of bronchial asthma that required medical intervention.

It is necessary to carefully monitor the occurrence of dose-dependent side effects in patients using a large number of inhalations to relieve attacks.

Adults (18 years and older) are prescribed Symbicort Turbuhaler 80/4.5 mcg/dose and 160/4.5 mcg/dose; The recommended dose is 2 inhalations per day: 1 inhalation in the morning and evening, or 2 inhalations 1 time per day only in the morning or only in the evening. Some patients may be prescribed a maintenance dose of Symbicort Turbuhaler 160/4.5 mcg/dose 2 inhalations 2 times a day. If symptoms occur, 1 additional inhalation is necessary. With a further increase in symptoms within a few minutes, 1 additional inhalation is prescribed, but no more than 6 inhalations to relieve 1 attack.

Usually it is not necessary to prescribe more than 8 inhalations per day, but you can increase the number of inhalations to 12 per day for a short time. In patients who use more than 8 inhalations per day, a review of therapy is recommended.

Symbicort Turbuhaler 80/4.5 mcg/dose and 160/4.5 mcg/dose as maintenance therapy and for the relief of attacks is not recommended for children and adolescents under the age of 18 years.

Symbicort Turbuhaler 320/9 mcg/dose

For adults (18 years and older), the drug is prescribed 1 inhalation 2 times a day. If necessary, the dose can be increased to 2 inhalations 2 times a day. After achieving optimal control of asthma symptoms while taking the drug 2 times a day, it is recommended to titrate the dose to the lowest effective dose, up to once a day.

Adolescents aged 12-17 years are prescribed 1 inhalation 2 times a day.

Patients should visit their doctor regularly to monitor the optimal dose of the drug. The dose should be reduced to the lowest dose that maintains optimal control of asthma symptoms. After achieving optimal control of symptoms of bronchial asthma while taking the drug 2 times a day, it is recommended to titrate the dose to the lowest effective dose, up to once a day, in cases where, in the opinion of the doctor, the patient requires maintenance therapy in combination with long-acting bronchodilators.

COPD

Adults are prescribed Symbicort Turbuhaler 160/4.5 mcg/dose, 2 inhalations 2 times a day or Symbicort Turbuhaler 320/9 mcg/dose, 1 inhalation 2 times a day.

There is no need for special selection of the drug dose for elderly patients.

There is no data on the use of Symbicort Turbuhaler in patients with renal or hepatic impairment. Because As budesonide and formoterol are eliminated primarily through hepatic metabolism, a slower rate of elimination of the drug can be expected in patients with severe cirrhosis.

Rules for using the turbohaler

The mechanism of action of the turbuhaler is such that when the patient inhales through the mouthpiece, air flows are carried along with them medicinal substance into the respiratory tract.

The patient must be instructed:

• carefully study the “Instructions for Use” of the turbuhaler;
• inhale forcefully and deeply through the mouthpiece to ensure that the optimal dose of the drug reaches the lungs;
• never exhale through the mouthpiece;
• in order to minimize the possibility of developing fungal infections of the oropharynx, rinse your mouth with water after each inhalation. It is also necessary to rinse your mouth with water after inhalation to relieve symptoms and in case of development of candidiasis of the oral mucosa and pharynx.

The patient may not taste or feel the drug after using Turbuhaler, due to the small amount of the substance delivered.

Instructions for use of turbuhaler

Turbuhaler is a multi-dose inhaler that allows you to dose and inhale the drug in very small doses. When inhaled, the powder from the turbuhaler is delivered to the lungs, so it is important that the patient inhales forcefully and deeply through the mouthpiece.

Before using the turbohaler for the first time, you must prepare it for use:

1. Unscrew and remove the cap.
2. Hold the inhaler vertically with the red dispenser facing down. Do not hold the inhaler by the mouthpiece while turning the dispenser. Turn the dispenser all the way in one direction, and then also all the way in the opposite direction. Perform the described procedure twice.

The inhaler is now ready to use, repeat this procedure There is no need to prepare the turbohaler for operation before each use.

To take one dose, the patient must complete the following procedure:

1. Unscrew and remove the cap.
2. Hold the inhaler vertically with the red dispenser facing down. Do not hold the inhaler by the mouthpiece while turning the dispenser. In order to measure the dose, turn the dispenser all the way in one direction, and then also all the way in the opposite direction. A clicking sound will be heard during this procedure.
3. Exhale. Do not exhale through the mouthpiece.
4. Gently place the mouthpiece between your teeth, purse your lips and inhale forcefully and deeply through your mouth. Do not chew or squeeze the mouthpiece with your teeth.
5. Remove the inhaler from your mouth before exhaling.
6. If inhalation of more than one dose is required, steps 2-5 should be repeated.
7. Close the inhaler with the cap and check that the inhaler cap is screwed on tightly.
8. Rinse your mouth with water without swallowing.

You cannot remove the mouthpiece, because it is attached to the inhaler and cannot be removed. The turbhaler mouthpiece rotates, but should not be turned unless necessary.

Because the amount of powder inhaled is very small, you may not be able to taste the powder after inhalation.

However, absolutely strict adherence to the instructions ensures inhalation (inhalation) of the required dose of the drug.

If the procedure for loading the inhaler was mistakenly repeated more than once before taking the drug, patients will still receive one dose of the drug when inhaled. In this case, the dose indicator will show the total number of measured doses.

The sound heard when the inhaler is shaken is produced by the drying agent, not the drug substance.

The need to replace the inhaler

The dose indicator shows the approximate number of doses remaining in the inhaler; dose counting upon filling the turbohaler begins with the 60th or 120th dose (depending on the total number of doses of the purchased turbohaler). The indicator shows an interval of 10 doses, so it does not show every dispensed (loaded) dose.

Turbuhaler delivers the required dose of the drug, even if no changes are noticeable in the dose indicator window.

The appearance of a red background in the dose indicator window means that there are 10 doses of the drug left in the turbuhaler. When the number 0 appears on a red background in the middle of the dose window, the inhaler should be thrown away.

Please note that even when the indicator window shows the number 0, the dispenser continues to rotate. However, the dose indicator stops recording the number of doses (stops moving) and the number 0 remains in the dose window of the inhaler.

Cleaning

Regularly (once a week) you should clean the outside of the mouthpiece with a dry cloth. Do not use water or other liquids to clean the mouthpiece.

Disposal

You should be careful when handling a used inhaler and be aware that some medication may remain inside the inhaler.

Side effect

• headache;
• psychomotor agitation;
• anxiety;
• nausea;
• dizziness;
• sleep disorders;
• depression;
• behavioral disorders (mainly in children);
• taste disturbances;
• feeling of heartbeat;
• tachycardia;
• atrial fibrillation;
• supraventricular tachycardia;
• extrasystole;
• angina pectoris;
• blood pressure fluctuations;
• tremor;
• candidiasis of the oral mucosa and pharynx;
• mild irritation in the throat;
• cough;
• hoarseness;
• bronchospasm
• bruising;
• dermatitis;
• hives;
• angioedema;
• anaphylactic reactions;
• hypokalemia;
• symptoms of systemic action of GCS (including adrenal hypofunction).

The systemic effect of inhaled corticosteroids can be observed when taking the drug in high doses for a long time.

Contraindications

• children under 6 years of age (for all dosage forms);
• children under 12 years of age (for dosage form, containing budesonide 320 mcg + formoterol 9 mcg);
• hypersensitivity to budesonide, formoterol or inhaled lactose.

Use during pregnancy and breastfeeding

There are no clinical data on the use of Symbicort Turbuhaler or the combined use of budesonide and formoterol during pregnancy.

During pregnancy, Symbicort should be prescribed only in cases where the expected benefit of therapy for the mother outweighs the potential risk to the fetus. Budesonide should be used at the lowest effective dose necessary to maintain adequate control of asthma symptoms.

It is unknown whether budesonide and formoterol are excreted in human breast milk. Symbicort Turbuhaler can be prescribed to nursing women if the expected benefit of therapy for the mother outweighs the potential risk for the child.

Use in children

Contraindicated in childhood up to 6 years (for all dosage forms); in children under 12 years of age (for a dosage form containing budesonide 320 mcg + formoterol 9 mcg).

Symbicort Turbuhaler 80/4.5 mcg/dose and 320/9 mcg/dose is not intended for the treatment of patients with severe bronchial asthma.

Symbicort Turbuhaler is not intended for initial selection of therapy in the first stages of treatment of bronchial asthma.

If therapy is insufficiently effective or the maximum recommended doses of Symbicort are exceeded, it is necessary to reconsider treatment tactics. Sudden and progressive deterioration in control of symptoms of asthma or COPD is a potentially life-threatening condition and requires urgent medical attention. In this situation, the possibility of increasing the dose of GCS should be considered, i.e. prescribing a course of oral corticosteroids or antibiotic treatment in case of infection.

Patients are advised to carry medications with them at all times. emergency care, or Symbicort Turbuhaler (for patients with bronchial asthma using Symbicort Turbuhaler for maintenance therapy and to relieve attacks), short-acting beta2-agonists (for all patients using Symbicort Turbuhaler only for maintenance therapy).

The patient's attention should be drawn to the need to regularly take a maintenance dose of Symbicort in accordance with the selected therapy, even in cases where there are no symptoms of the disease. Inhalation of Symbicort Turbuhaler to relieve attacks should be carried out only when symptoms occur, but the use of the drug is not indicated for regular preventive use, i.e. before physical activity. In such cases, the use of a separate short-acting bronchodilator is indicated.

If the symptoms of bronchial asthma are controllable, the dose of Symbicort Turbuhaler can be gradually reduced, and it is important to constantly monitor the patient's condition. Symbicort Turbuhaler should be prescribed in the minimum effective dose.

Treatment with Symbicort should not be started during periods of exacerbation or significant worsening of bronchial asthma.

During therapy with Symbicort Turbuhaler, exacerbations and the development of serious adverse reactions associated with bronchial asthma may be observed. Patients should continue treatment but seek medical attention if asthma symptoms are not controlled or if symptoms worsen after starting therapy.

As with any other inhalation therapy, paradoxical bronchospasm may occur with an immediate increase in wheezing after taking a dose of the drug. In this regard, treatment with Symbicort Turbuhaler should be discontinued, treatment tactics should be reconsidered and, if necessary, alternative therapy should be prescribed.

Systemic effects may occur when taking any inhaled corticosteroids, especially when taking high doses of drugs over a long period of time. Systemic effects are less likely to occur with inhalation therapy than with oral corticosteroids. Possible systemic effects include adrenal suppression, growth retardation in children and adolescents, decreased bone mineral density, cataracts, and glaucoma.

It is recommended to regularly monitor the growth of children receiving inhaled corticosteroids for a long time. In case of established growth retardation, therapy should be reconsidered in order to reduce the dose of inhaled GCS. It is necessary to carefully evaluate the ratio of the benefits of GCS therapy to possible risk growth retardation. When choosing therapy, consultation with a pediatric pulmonologist is recommended.

Based on the limited data from studies of long-term corticosteroid use, it can be assumed that most children and adolescents receiving inhaled budesonide therapy will eventually achieve normal adult growth rates. However, slight (about 1 cm), short-term growth retardation has been reported, mainly in the first year of treatment.

Due to potentially possible action inhaled corticosteroids on bone mineral density should be given Special attention patients taking the drug in high doses for a long time with risk factors for osteoporosis. Studies of long-term use of inhaled budesonide in middle-aged children daily dose 400 mcg (metered dose) or in adults an average daily dose of 800 mcg (metered dose) showed no significant effect on bone mineral density. There is no data regarding the effect of the drug in high doses on bone mineral density.

If there is reason to believe that adrenal function has been impaired due to previous systemic GCS therapy, precautions should be taken when transferring patients to treatment with Symbicort Turbuhaler.

The benefits of inhaled budesonide therapy generally minimize the need for oral corticosteroids, but patients who discontinue oral corticosteroids may experience long-term adrenal insufficiency. Patients who in the past required urgent use of high doses of corticosteroids or received long-term treatment with high-dose inhaled corticosteroids may also be at risk. It is necessary to provide additional administration of GCS during periods of stress or surgical intervention. It is recommended to instruct the patient to rinse the mouth with water after inhalation in order to prevent the development of candidiasis of the oral mucosa. It is also necessary to rinse your mouth with water after inhalation to relieve symptoms in case of candidiasis of the oral mucosa and pharynx.

Formoterol may cause QT prolongation, so the drug should be used with caution in patients with a prolonged QT interval.

The need for the use and dose of inhaled GCS should be reconsidered in patients with active or inactive forms of pulmonary tuberculosis, fungal, viral or bacterial infections of the respiratory system.

Should be observed special measures precautions in patients with unstable bronchial asthma using short-acting bronchodilators to relieve attacks during exacerbation of severe bronchial asthma, because the risk of developing hypokalemia increases against the background of hypoxia and in other conditions when the likelihood of developing symptoms of hypokalemic action increases. In such cases, it is recommended to monitor serum potassium levels.

Formoterol at a dose of 90 mcg over 3 hours is safe for patients with acute bronchial obstruction.

During treatment, blood glucose concentrations should be monitored in patients with diabetes mellitus.

Symbicort Turbuhaler contains lactose (less than 1 mg/dose). Typically, this amount does not cause adverse reactions in patients with lactose intolerance.

Impact on the ability to drive vehicles and operate machinery

Symbicort Turbuhaler does not affect the ability to drive vehicles or operate machinery. May affect the ability to drive vehicles and operate machinery with the development of side effects.

Drug interactions

With simultaneous oral administration of ketoconazole at a dose of 200 mg 1 time per day and budesonide at a dose of 3 mg, the concentration of budesonide in plasma increases on average 6 times. When taking ketoconazole 12 hours after taking budesonide, the concentration of the latter in plasma increases on average by 3 times. There is no information on such an interaction with budesonide during inhalation administration, however, a noticeable increase in the concentration of the drug in the blood plasma should be expected. Since there are currently no data to make dosage recommendations, this combination of drugs should be avoided. If this is not possible, then the intervals between doses of ketoconazole and budesonide should be increased as much as possible. A dose reduction of budesonide should also be considered. Other strong CYP3A4 inhibitors are also likely to significantly increase budesonide plasma levels. It is not recommended to prescribe Symbicort Turbuhaler as maintenance therapy and for the relief of attacks in patients receiving potent CYP3A4 inhibitors.

Beta-adrenergic blockers may weaken or inhibit the effect of formoterol. Symbicort Turbuhaler should not be co-administered with beta-blockers (including eye drops), except in cases of emergency.

With the simultaneous use of Symbicort Turbuhaler and quinidine, disopyramide, procainamide, phenothiazines, antihistamines (terfenadine), MAO inhibitors and tricyclic antidepressants, the QTc interval may be prolonged and the risk of ventricular arrhythmias may increase.

In addition, levodopa, levothyroxine, oxytocin and ethanol (alcohol) may reduce the tolerance of the heart muscle to beta2-agonists.

With the simultaneous administration of MAO inhibitors, as well as drugs with similar properties (furazolidone, procarbazine), an increase in blood pressure is possible.

Exists increased risk the development of arrhythmias in patients undergoing general anesthesia with halogenated hydrocarbon preparations while using Symbicort Turbuhaler.

When taking Symbicort Turbuhaler and other beta-adrenergic agonists simultaneously, the side effects of formoterol may increase.

The hypokalemic effect of beta2-adrenergic agonists can be enhanced by the simultaneous administration of xanthine derivatives, mineral derivatives of corticosteroids and diuretics. Hypokalemia increases the susceptibility to the development of arrhythmias in patients taking cardiac glycosides.

There has been no interaction of budesonide with other drugs used to treat bronchial asthma.

Analogues of the drug Symbicort

Structural analogues according to active substance:

• Symbicort Turbuhaler.

Analogs for therapeutic effect (medicines for the treatment of asthma):

• Astmopent;
• Atrovent;
• Afonilum;
• Beclazon;
• Beklomet Easyhaler;
• Benacort;
• Berlicourt;
• Berodual;
• Berotek;
• Bricanil;
• Bronchosan;
• Budesonide;
• Ventolin;
• Hydrocortisone;
• Dexamethasone;
• Diprospan;
• Intal;
• Ifiral;
• Clenbuterol;
• Cortisone;
• Cromogen;
• Cromoghlin;
• Xidifon;
• Metipred;
• Montelar;
• Oxis Turbuhaler;
• Pentamin;
• Platyfillin;
• Plibekot;
• Polyoxidonium;
• Polcortolon;
• Prednisolone;
• Pulmicort;
• Pulmicort Turbuhaler;
• Retafil;
• Salamol;
• Salbuvent;
• Salbutamol;
• Salgim;
• Salmecort;
• Salmeter;
• Serevent;
• Seretide;
• Seretide Multidisc;
• Singulex;
• Spophylline retard;
• Theotard;
• Theophylline;
• Triamsinolone;
• Flixotide;
• Celeston;
• Erespal;
• Eufillin;
• Euphylong.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Today, dozens of different diseases are widespread throughout the world. Some of them require immediate treatment.

In such cases, there is no choice left and you have to use similar drugs. Today's article describes the drug Symbicort. It intended for the treatment of bronchial asthma. Read the instructions for use, prices, reviews of cheap analogues of Symbicort below.

Composition, release form

Symbicort is a combination drug necessary for the treatment of asthmatic diseases.

The main active ingredients are budesonide and formoterol. They have fundamental differences in effect.

They have an additive effect in reducing the manifestation of bronchial asthma attacks.

They are characterized by specific properties that allow this combination to be used in a supporting format therapeutic treatment and to reduce the likelihood of active phases of the disease.

Symbicort does not contain substances that have a large number of side effects. The components contained in the composition act moderately, which makes the medicine the best option for maintenance therapy.

Supplied in powder form. Packages are designed for ninety doses on average.

Properties

Budesonide is characterized by an anti-inflammatory effect that appears several hours after use.

Positively affects the entire respiratory system, reducing the intensity of the manifestation of the main symptoms. It also eliminates the likelihood of exacerbation of asthmatic diseases.

There are medications that have negative effects when used together.

You should not use Phenytoin, Ketonazole and all kinds of estrogens together with Symbicort.

Budesonide has more positive feedback, rather than GCS. This is due to the lower likelihood of unwanted effects that have a significant impact on the body.

Swelling of the mucous membrane of the bronchial system is reduced. Mucus is removed better. Sputum is produced in smaller quantities. The activity of the respiratory tract is maintained at a natural level.

Formoterol is a selective androceptor agonist. Sprayed into the respiratory tract.

After entering the body for a long period, it relaxes smooth bronchial muscles. The effect lasts long enough if the patient has obstruction respiratory organs, which can actually be reversed.

To maintain the bronchodilator effect over several days, it is necessary to gradually increase the dosage of the drug. It lasts for twelve hours. Occurs with sufficient dosage in two minutes.

Cost in pharmacies

Russian pharmacies provide the described drug at affordable prices. They vary in the segment from one thousand to one and a half thousand rubles. The cost depends on the territorial location of the city and the pharmacy.

Comparison of generic Symbicort

Often recommended medicinal product contains a component that causes the patient. In this case, you need to contact your doctor to choose a more suitable drug that does not have negative side effects. Let's consider foreign and domestic analogs of Symbicort, available in Russia.

Duoresp Spiromax

Among the most effective analogues that have a lower price, Duoresp Spiromax should be noted. It is in a lower price segment but maintains the same quality. Most of the reviews about it are positive.

In some cases, excessive sensitivity to the main active ingredient develops. It is accompanied by skin rashes and itching. Formisonide-Nativ, as an analogue of Symbicort, is close to Duoresp-Spiromax in cost.

The price of DuoResp Spiromax starts from 1655 rubles. for 120 doses, compared to the price of Symbicort 1400 rubles. for 60 doses.

Foradil Combi

This generic Symbicort has identical indications for treatment and a more affordable price. It is recommended to purchase it with a doctor's prescription, otherwise an allergic reaction may develop.

Many people have chronic intolerance to the main component.

Here is one of the reviews about the Symbicort analogue - Foradil Combi.

Formoterol-Nativ

Contains similar components, but is more expensive. The manufacturer does not provide information about contraindications.

Pregnant and lactating women use the drug if without it the likelihood of death increases significantly.

Maximum changes are noticeable after a few weeks. The components have a prolonged effect, so they do not have a significant effect immediately after use.

More analogues

Among the most similar Symbicort substitutes It is worth highlighting Astmopent, Benacort and Intap. They have identical composition. Their main purpose is to eliminate asthma by constructively influencing the source of the disease.

They should not be used as an additional drug. They may increase or decrease the effect of the main drug. They are also able to increase resistance to adrenergic agonists. If it is not possible to purchase Symbicort Turbuhaler, then it is recommended that you first take a closer look at these drugs.

Among the least effective analogues of Symbicort for asthmatics are Theotard, Celeston and Pulmicord. They are not able to completely eliminate asthmatic diseases.

Their main goal is to suppress symptoms and reduce the frequency of attacks. They have a lower price.

It should also be noted that the most effective drugs at affordable prices. They are presented below.

Article rating

The drug Symbicort has anti-inflammatory and bronchodilator properties. It is used by patients to combat bronchial asthma. It contains 2 active substances - budesonide and formoterol. Each of them has its own mechanism of action on the human body, which manifests itself as an additive effect in suppressing the frequency of exacerbations of bronchial asthma (BA).

But sometimes it happens that the drug Symbicort is not suitable for the patient, and then the question arises, which analogue can be used to replace this remedy? Today, Russian pharmacies sell at least 5 medications that will cost less, but will be no less active than Symbicort.

Seretide

The first cheap analogue that can replace the drug Symbicort is Seretide. It is produced in the form of an aerosol with certain dosages for inhalation. Fluticasone and salmeterol are used as active substances; both components give the drug Seretide glucocorticoid, anti-asthmatic and bronchodilator properties.

For what diseases should Seretide be used?

Like Symbicort, the cheap analogue Seretide helps patients cope with diseases such as:

1. Insufficient control of pathology during constant monotherapy with inhaled GCS (glucocorticosteroids).
2. As a support in the initial treatment of patients with persistent asthma (bronchial asthma) to control the pathology before GCS is prescribed.
3. It is used by patients who have adequate control of the pathology.

The drug Seretide is also used to maintain a stable course of the disease in chronic obstructive pulmonary disease.

Contraindications for use

The drug Seretide is prohibited for children under 4 years of age and for patients with individual intolerance to the components of the drug. Like Symbicort, the analogue cannot be prescribed to yourself, as it can provoke a number of complex side effects.

Note! The medicine should be taken with extreme caution by patients suffering from glaucoma, acute pulmonary tuberculosis, osteoporosis and cataracts.

Pulmicort

Judging by the reviews of patients, Pulmicort is another effective and at the same time cheap analogue that replaces the drug Symbicort. The price of the medicine in Russian pharmacies will be 740-770 rubles. At first glance, it is difficult to determine which is better - Pulmicort or Symbicort. Most people prefer the first option as it is cheaper. It is also worth considering that the drug is available in the form of a suspension, which may not be suitable for every patient.

Who should not take Pulmicort?

Like Symbicort, cheap Pulmicort has its contraindications. The drug is not used for mothers under 7 months of age, as well as for patients with individual intolerance to the active substances of the drug.

If the patient has fungal or bacterial diseases of the respiratory tract (upper), an active form of tuberculosis or cirrhosis of the liver, the analogue is taken only under the strict supervision of a doctor.

Are there any side effects?

Under certain circumstances, cheap drug Pulmicort can cause the following side effects:

1. Headache.
2. Irritation of the mucous membrane of the throat.
3. Cough.
4. Oropharyngeal candidiasis.
5. Contact dermatitis, rash, urticaria.
6. Bronchospasm.
7. Angioedema.

Berodual

Berodual is practically the cheapest analogue that can replace Symbicort. The drug is available in the form of a solution and is used to expand the bronchial lumen, narrowed due to muscle spasms. The price of the medicine is only 265 rubles, but despite its cheapness, this analogue of Symbicort is the best preventive remedy for bronchial asthma or emphysematous bronchitis.

Who is Berodual contraindicated for?

The cheap analogue is not taken by patients who may suffer from hypersensitivity to fenoterol or bromide. It is also strictly forbidden to use the drug if a person has tachycardia or obstructive cardiomyopathy.

What side effects might there be?

Like Symbicort, the cheap analog Berodual can cause a number of side effects, such as:

• deviation from normal eye pressure;
• hives;
• nausea;
• rash on the body;
• vomit;
• tachycardia or arrhythmia;
• general weakness and convulsions;
• dizziness and headaches.

The likelihood of side effects will directly depend on the patient who neglects the observations of the doctor.

Foster

Analogue Foster is one of the most worthy medicines that Russian patients can use to replace the drug Symbicort. This is not the cheapest analogue, its price is 2000-2100 rubles. The manufacturer produces it in the form of an inhalation aerosol with 120 and 180 doses. For asthmatics, this is one of the best substitutes for Symbicort.

Indications for use

This price of the medicine is due to the strong active substances, beclomethasone and formoterol. The main pathology that the Foster analogue fights is bronchial asthma, which is accompanied by the use of a glucocorticoid and a long-acting B2-adrenergic agonist as part of a combined agent.

Who should not take Foster?

Since this analog contains the same active component as Symbicort, namely formoterol, they have similar contraindications. Doctors do not prescribe this medicine, no matter what good properties it did not apply to patients with the following diseases:

1. Tuberculosis.
2. Aneurysm.
3. Pheochromocytoma.
4. Serious diseases associated with the cardiovascular system.
5. Severe form of arterial hypertension.
6. Thyrotoxicosis.
7. Diabetes.

Important! The analogue is strictly contraindicated for breastfeeding mothers and women during pregnancy.

Salbutamol

Salbutamol is the last and cheapest drug that can replace Symbicort. The price of the medicine barely reaches 100 rubles, since it was created by domestic specialists. Despite its low cost, the drug exhibits sufficient activity in the fight against asthmatic attacks and bronchospasms.

Are there any side effects?

Each analogue, including Symbicort, can cause some side effects if used incorrectly, in this case these could be:

• cough;
• tachycardia;
• pain in the chest;
• nausea;
• constant dry mouth;
• irritation of the pharyngeal mucosa;
• dermatitis;
• headache;
• general weakness and drowsiness.

Contraindications for use

If a patient decides to replace Symbicort and use the cheap drug Salbutamol, he should consider the following contraindications:

1. Hypersensitivity to active substances.
2. Diabetes.
3. Glaucoma.
4. Children under two years of age.
5. Pregnant and breastfeeding women.
6. Hypertension.

Conclusion

Before using any analogues of Symbicort, you should definitely see a doctor. Any cheap or expensive drug (price does not matter in this case) if used incorrectly will cause similar effects, which are not always easy to get rid of.