Symbicort side effects: what to expect and how to handle them

Symbicort combines a steroid (budesonide) and a long-acting bronchodilator (formoterol). That mix helps many people breathe easier, but it can cause side effects. Some are mild and easy to manage. Others need prompt medical attention. Here’s a plain, practical guide to what can happen and what you can do about it.

Common, usually mild side effects

These happen most often and don’t always mean you must stop the medicine. Watch for:

- Oral thrush (white patches or soreness in the mouth). Rinse and spit with water after each use and consider a spacer to reduce this risk.

- Hoarseness or sore throat. Good inhaler technique and rinsing your mouth help here too.

- Cough or throat irritation right after inhaling. Try breathing slowly when you use the inhaler and check your technique with your pharmacist.

- Tremor, nervousness, or a fast heartbeat. These come from the formoterol part. They often get better with time or dose adjustment.

- Headache or muscle cramps. Usually short-lived but mention them at your follow-up visit.

Less common but important risks

- Pneumonia: People with COPD using inhaled steroids may have a slightly higher risk. If you get fever, increased sputum, or worse breathing, see your doctor.

- Adrenal suppression, bone thinning, cataracts, or slower growth in children — these are rare with usual doses but can occur with long-term high-dose steroid use. Your doctor may check bones, vision, or growth if you’re on Symbicort for a long time.

- Serious allergic reactions (rash, swelling, trouble breathing) are uncommon but need emergency care.

Here are practical steps to reduce side effects:

- Use the lowest effective dose. Ask your prescriber about stepping down when your symptoms are controlled.

- Rinse your mouth and spit after every dose. Use a spacer if recommended.

- Learn and practice the inhaler technique. A pharmacist can watch you and give tips.

- Keep a symptom diary: note palpitations, tremors, infections, or mood changes and share them at visits.

When to call your doctor right away:

- New or worsening shortness of breath, faster wheeze, or chest tightness.

- Fast, irregular heartbeats, fainting, or severe tremor.

- High fever, productive cough with colored sputum, or sudden worsening of breathing.

- Signs of severe allergic reaction — swelling of face, lips, tongue, or throat.

Don’t stop Symbicort suddenly without talking to your prescriber. If side effects bother you, your doctor can adjust the dose, switch treatments, or suggest ways to manage symptoms. Your pharmacist is a great resource for inhaler technique and short-term tips. If you’re unsure, ask — it’s better to check than to guess.