Key Points

• Yes, your doctor may prescribe you a short course of oral prednisone to use with your Symbicort (generic name: budesonide and formoterol) if you have a severe flare-up of your asthma or COPD symptoms and you need emergency treatment. If you are in the hospital and cannot take oral medications, an intravenous (IV) corticosteroid may be used.
• Adding oral prednisone from the class of drugs known as glucocorticoids can help to lessen inflammation in your airways after an asthma attack or COPD exacerbation.
• However, prednisone can be associated with greater side effects than an inhaled corticosteroid, so a shorter course, for example 5 to 10 days, is typically used.

What can trigger my symptoms?

An asthma attack or COPD worsening often starts due to a trigger - an allergen, food, substance, environmental pollutant or medical condition that initiates your symptoms. You should learn to recognize your triggers and try to avoid them. Asthma triggers may include:

• animal dander
• mold
• trees, grass weeds and pollen
• dust mites
• cigarette smoke
• strong chemicals or odors
• a cold, flu or sinus infection
• heartburn, acid reflux
• sulfites found in certain foods
• extreme hot or cold temperatures
• intense exercise
• certain medications: aspirin, NSAIDs (example: ibuprofen, naproxen) or beta-blockers

In COPD, triggers most often include:

• bacterial or viral infections, such as colds, pneumonia, and the flu
• smoking or secondhand tobacco smoke
• chemical irritants, household cleaning products, strong odors
• air pollution, exhaust, fumes
• dust
• pet dander
• extreme cold or hot weather
• high pollen counts

What are severe asthma or COPD symptoms?

A flare-up of your asthma or COPD symptoms can lead to severe trouble catching your breath, coughing, wheezing, chest pain, chest tightness, increased mucus or other symptoms of a lung infection.

Severe symptoms might also include chest pain, agitation, confusion and drowsiness.

If you use a peak flow meter for your asthma, your readings may be low.

If your symptoms don't improve or get worse after you use your rescue medications, seek immediate medical care or call 911.

Ask your doctor to outline a treatment plan for when your symptoms worsen and how to recognize symptoms that may need emergency care.

With both asthma or COPD, it’s also important that you get an annual flu shot and other needed vaccines, practice good hygiene like hand washing, and avoid people who are sick whenever possible.

What are prednisone side effects?

Short-term use of prednisone for asthma or COPD is associated with fewer side effects than high-dose or longer-term therapy. Common side effects associated with short-term use may include:

• fluid retention
• headaches
• elevations in glucose (blood sugar)
• increased blood pressure
• behavioral and mood changes
• upset stomach
• trouble sleeping
• increased appetite
• weight gain

If you have diabetes, you may need to monitor your blood sugar more frequently while taking prednisone.

More serious side effects with long-term prednisone use can include:

• impaired growth,
• increased risk of infection (mild to severe)
• electrolyte (sodium, calcium, potassium) changes
• more severe behavioral and mood disturbances
• thinning of skin
• decrease in bone density (osteoporosis)
• cataracts, eye infections, glaucoma
• reactivation of certain latent diseases

Your doctor should slowly discontinue your dose of prednisone after you have been on longer-term or high dose therapy, but high doses are rarely needed for asthma or COPD flare-ups. Slowly stopping will help to prevent serious side effects from corticosteroid insufficiency, such as severe fatigue, weakness, body aches, dizziness, thirst, and nausea or vomiting.

Prednisone should not be used if you have a serious fungal infection or if you have an allergy to prednisone.

You should not receive live or live, attenuated vaccines if you are on high doses of prednisone.

Common side effects with Symbicort

Symbicort is usually well-tolerated. The most common side effects you might see while using Symbicort for asthma or COPD include:

• headache
• throat irritation or pain
• nasal congestion
• upper respiratory tract infections, the flu
• sinusitis (inflammation of the sinus membranes)
• body aches or back pain
• stomach discomfort
• thrush (white patches) in the mouth or throat (rinse your mouth with water after use to help prevent this effect)
• vomiting

Before you start treatment with Symbicort, tell your doctor about all of your medical conditions, including if you have heart problems or high blood pressure. Some patients taking Symbicort may experience increased blood pressure, heart rate, or a change in heart rhythm.

Bottom Line

• If your symptoms don't improve or get worse after you use your rescue medications, seek immediate medical care or call 911.
• Your doctor may prescribe a short course of oral prednisone to use with your Symbicort if you are having severe symptoms of asthma or COPD. Treatment with prednisone can vary, but is usually about 5 to 10 days in length.
• Higher doses and longer-term treatment with prednisone can be linked with more serious side effects than lower doses for a shorter period of time. Ask your doctor what side effects you may see with your treatment course.
• Learn to recognize what triggers your asthma flare-ups or COPD exacerbations and avoid them if possible.

This is not all the information you need to know about Symbicort for safe and effective use. Review the full product information here, and speak to your health care provider if you have questions or concerns.