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Budesonide/formoterol is a combination formulation containing budesonide and formoterol used in the management of asthma and chronic obstructive pulmonary disease (COPD) in the EU. It is marketed by AstraZeneca under the trade name Symbicort. Symbicort in the United States is a metered-dose inhaler while in the EU, Australia, Canada, Israel, and elsewhere Symbicort is available as a dry powder inhaler.

Symbicort contains two active ingredients which are delivered via a single inhaler:

Doses

In Europe, Symbicort is available in doses of 100/6, 200/6 (160/4.5) and 400/12 (320/4.5), where the larger number is the dose per actuation of budesonide (in micrograms) and the lower number the dose of formoterol.

In March 2009, the FDA approved the use of Symbicort pMDI to treat chronic obstructive pulmonary disease ( COPD).

In the United States, Symbicort is available in 160/4.5mcg and 80/4.5mcg per actuation.

Use as-needed for asthma attack

Symbicort is the first combination inhaled corticosteroid/long-acting beta agonist (ICS/LABA) that has shown some efficacy as a medicine not only used to prevent asthma attacks, but also provide quick relief of an asthma attack., although the role of budesonide in these cases is questionable.The use for quick relief has been approved by the GINA guidelines 2006 (Evidence A) however Symbicort is indicated in the United States only as a maintenance medication.In patients with asthma, Symbicort for both maintenance and as-needed treatment reduces exacerbations better than as-needed formoterol or as-needed terbutaline. Nevertheless, it is unclear whether this strategy is better than increasing a maintenance dose of Symbicort or similar combined inhaler.

Market

Symbicort was introduced in Swedenmarker in 2000. It was not approved for use in the United States until July 2006.It is now approved for use in at least 70 countries, yielding global sales in excess of $1 billion in 2005, and now approx $3.7bn pa. The patent expires 2012.

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