Log in
Asthma UK community forum
11,290 members17,556 posts


Hi to all.

Have been backwards and forwards to the doctor for asthma reviews since April this year on my last visit the doctor said he may want to change me from seretide to symbicort at my next appointment. My asthma has been out of control for the last few years and have had several courses of pred. Peak flow has being all over the place.

I don't understand how symbicort works and what is is symbicort smart?


11 Replies


Symbicort is basically the same sort of thing as Seretide ie a combination of a steroid and a LABA, but it's different drugs: budesonide and formoterol instead of fluticasone and salmeterol. [EDIT got wrong drug - d'oh!]

I have an idea budesonide is a stronger steroid but I may be talking rubbish! For some reason though, with the components of Symbicort you can use it as a preventer - so take it twice a day all the time - but also use it when you have symptoms like Ventolin (I think up to a certain level). This is how SMART works basically - it stands for Symbicort Maintenance And Reliever Therapy.


Hope this helps - I'm on it and it seems to be doing something!



I was on Symbicort SMART for nearly 3 years. I was on the 200/6 turbohaler. The quantity of puffs are tailored for the individual. I was on 2 puffs maintenance dose am and pm and I could use a puff each time I experienced symptoms up to 6 puffs at any one time. If I had to use 8 or more puffs each day for 2 weeks I needed to see the GP or if I was needing the maximum of 12 puffs in 24 hours (incl maintenance dose)I needed to see the GP.

I really liked it but unfortunately my asthma is worse at the moment so on more meds but still on Symbicort (400/12 3 puffs twice a day) as it does work really well for me.


Hi Rachel

Symbicort is pretty much the same as Seretide(both have an LABA and a steroid), although I believe the fluticasone in seretide is more potent than the Budesonide in Symbicort. Changing from Seretide to Symbicort is a bit like trying ibuprofen instead of paracetamol for a painkiller. Some people will find one works better than the other, so it might be worth finding out which works best. Also, if you're going onto the SMART programme, then every time you need your reliever then you'll be getting an extra dose of steroid to help control things. Hope you get things sorted soon. L


I forgot to mention that lou, that's what i liked about it too, you don't need to think about increasing your steroid inhaler when you are getting worse as you are automatically doing it. I had several occasions when I was using just over 8 puffs a day for 10 days and thinking right I need to make a GP appt and then everything would calm down.


hehe Lou, now I'm confused about which steroid is more potent - so I looked it up, and seems some sources say fluticasone is the most potent but others say a direct comparison is vv hard.

I now realise that I should have checked what was in Seretide as I was absolutely convinced it was beclomethasone which I have had and didn't work. OOPS. Especially since I asked for Symbicort instead of Seretide because I was sure I'd had both components and they hadn't worked. Perhaps Seretide is an option after all?

Sorry for any idiotic leading astray that may have occurred lol, glad there are others to put me straight! Could have just looked it up so easily too.


It's all so confusing.

I found this on the sign guidelines sign.ac.uk/pdf/sign101.pdf

4.2.1 comparison of inhaled steroids

BDP and budesonide are approximately equivalent in clinical practice, although there may be

variations with different delivery devices. There is limited evidence from two open studies of less than ideal design that budesonide via the turbohaler is more clinically effective.295 However, at present a 1:1 ratio should be assumed when changing between BDP and budesonide.

Fluticasone provides equal clinical activity to BDP and budesonide at half the dosage. The

evidence that it causes fewer side effects at doses with equal clinical effect is limited. Mometasone appears to provide equal clinical activity to BDP and budesonide at half the dosage.296 The relative safety of mometasone is not fully established.

Philomela-I've also had beclometasone (as Qvar) and it didn't work for me either.


aargh v confusing!

Thing is, now I realise that I got it wrong (and possibly said something stupid to my cons, but why quibble at that amongst the many stupid things I have probably said to him), I'm wondering if the Symbicort is the right one after all! It's working, but there's room for improvement, so now wondering if after all Seretide might be better.

Guess I can give it another few months and ask next time - I don't know if after a while it 'peaks' and things are as good as they're going to get on that particular med/dose. I did ask my cons but he said he didn't know because this was me and he can't extrapolate from normal people. lol, and a fair enough response, but not helpful.


Oh god, the dreaded Symbicort or Seretide dilema, aargh. There are so many of us that have been, are going through or will go through this dilema of a decision.


I know! And I didn't think I'd have to either - though really it's a good thing as means I have more options than I thought.


On the subject of changing inhalers, roughly how long would it take to notice a change in medication? I was using Seretide for years between 500 and 1000mcg per day and changed to Qvar 400mcg per day. That was a week ago now and I haven't felt any different - my peak flow has stayed consistent too. I assume the fact I haven't got any worse is a positive thing as is taking less medication? Or is there a sting in the tail somewhere along the line !


Its a combi inhaler which you use take a couple of mandatory puffs morning and evenings, but you can also use during the day to top up if needed. When I slow down in the summer months, I reduce my mandatory puffs to one, to keep myself maintained.


You may also like...