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I saw the asthma nurse today who was telling me about the symbicort smart where it is just on inhalor and it is used as the preventer and reliever so no need for another one. Has anyone else heard about this?

I was in such a panic till she assured me i don't need to give up my easi-breathe - i find symbicort fine to use morning and night but i know that i can not use it during an attack - its a bit to fussy etc to use when i'm in a state etc.

6 Replies

Hi Laurenjayne and everyone else,

I’ve been taking symbicort for over two years. Initially started on 200/6 dose and currently taking 400/12.

This combined formoterol/budesonide drug has literally been a lifesaver for me concerning daytime control of asthma symptoms. Other similar combined ‘reliever type’ or preventer type’ inhalers either didn’t work or made me worse. Always had big problems with atrovent or similar drugs for example.

One of the main advantages concerning the use of a combined long acting reliever and preventer or ‘maintenance’ med from the medics point of view is that patients get a dose of the drug, in the case of symbicort – budesonide – which should help to relieve the inflammatory process that is going on in the lungs and which can be caused by triggers such as cigarette smoke, viruses, pollen, dust etc.

Many people, especially those who don’t want to be bothered with a complicated drugs regime will often only use their short acting reliever inhalers such as ventolin to control immediate and noticeable symptoms e.g. wheezing and breathlessness. As we all know short acting relievers only open up the airways and do nothing to control inflammatory problems which, left untreated, can result in the development of even more serious disease in susceptible individuals.

The concept of symbicort SMART - Symbicort Maintenance and Reliever Therapy - has been targeted at exactly that group of people who, for whatever reason, prefer a simple quick-fix treatment regime.

As far as the medics and regulatory bodies are concerned the results that have been published re the use of symbicort SMART have been impressive enough to allow this inhaler to be licensed for use as a short acting reliever inhaler. Reasons for this include the evidence to show that symbicort SMART consistently reduces the rate of severe exacerbations – attacks –in asthma, and that the variability of asthma symptoms can be better controlled by a long acting but with rapid onset of relief reliever such as formoterol. The inclusion of budesonide ensures the patient is getting ‘as and when’ necessary anti –inflammatory treatment the cumulative effects of which should also result in the rapid relief of asthma exacerbations. A sort of continuous cycle of improvement or Kaizen for short!

Which brings me back to answering your question Laurenjayne. Yes I had problems at first using symbicort but it was because my day time symptoms were completely out of control. Intensive treatment including the long term use of the dreaded pred and other drugs eventually resulted in my being able to use symbicort ‘as and when’ and to reduce overall pred and nebs to far more acceptable levels. Still have a problem with early morning symptoms which symbicort SMART doesn’t seem to help, but overall I’m in better control than I was almost two years ago especially concerning the sort of acute exacerbations which resulted in frequent visits to the place I’m most allergic to!

I’ve included a web ref that gives more detailed info about symbicort Smart - 55k –

Hope you manage to get better control soon.




THanks so much for the long and detailed reply Mia, it was much appreciated. Do you still have another inhalor as well then?

Thats what worry's may is if i am having a bad attack i o not want to use a turbohalor if that makes sense etc? Know what i mean? I am just scared incase they take my other relievers form me.


Hi Laurenjayne,

I also use bricanyl 0.5mg for early morning relief as well as ventolin nebs if symptoms are acute.

Nobody should take your easi-breathe inhaler away from you Laurenjayne, especially if you experience an acute exacerbation. Don’t think any doc or nurse would disagree. Perhaps your asthma nurse meant that you might need to use your easi-breathe less if you get on with symbicort? This has happened to me re daytime asthma control.

I’ve said it before, but it is worth repeating that we are all so different in the way our bodies react to the same or other drugs. You need to stick with what works best. Any suggested add on med or inhaler merits a trial, but not at the expense of what helps most.

Take care,





Hi Laurenjayne

I take symbicort and have done for three years and have never heard that. I take mine in a morning and night but still need my easi-breathe they would have a fight on there hands if they tried. I never go anywhere without it.



I think what she might have meant was that one of the ideas when developing symbicourt was that it could be used as a reliever and preventer. ie your asthma is worse so you take more symbicourt therefore upping your steroids. However, this only works with more mild asthma, as people like me would be inhaling obscenely large steroid doses! Some consultants also think too much long acting beta-agonists can be a bad thing, as they decrease your awareness of your symptoms. I imagine there is limit to how much you can absorb anyway. This is what the asthma nurse specialist at my old hospital told me ( if I remember correctly!).

I personally have bricanyl and salbutamol (through a spacer) to take as a reliever.

Hope this helps! If you are in any doubt go back and ask her again- she obviously did not explain herself well enough.



I've been on it for about 6 months now, and it has worked just as well as seretide for me. What I really like about it is that some times of the year (winter and spring) makes my asthma a lot worse than late summer and fall, and it lets me increase the dose, whereas the time of the year where my asthma is not as bad, i can lower it. It is not directly a reliever though, because you dont take it when you have an attack, you just increase the dose at morning and night when you take it when there are symptoms present.


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