Knowing how long to stay on a daily inhaler like Symbicort can get confusing. You start to feel better and wonder, do I still need this? Or maybe the side effects are bothering you. Should you stop now?
Stopping too soon, or without guidance, can backfire. It could make your breathing worse or even trigger a flare-up. That’s the risk. And it’s a real one.
Still, there is a right time to reassess. Sometimes your doctor might lower your dose. Other times, long-term use is the safest path.
| 🔑 Key Takeaways ➤ Symbicort is usually taken long-term to help control asthma or COPD, and should only be stopped or changed under a doctor’s guidance. ➤ For asthma, your doctor may consider lowering the dose or stopping it after at least three months of stable symptoms. ➤ For COPD, most people stay on Symbicort for life because it helps prevent serious flare-ups and keeps symptoms in check. ➤ You should talk to your doctor if your symptoms don’t improve after a week, if you’ve had a recent flare-up, or if you notice side effects. ➤ Even if you feel better, don’t stop using Symbicort without talking to your doctor first, it could make your breathing worse. |
What is Symbicort?
Symbicort is a prescription inhaler used to treat two major chronic lung conditions:
- Asthma
- Chronic obstructive pulmonary disease (COPD)
It contains two medications, budesonide and formoterol, that work together to improve breathing over time. Budesonide is an inhaled corticosteroid that reduces inflammation in the lungs, while formoterol is a long-acting beta-agonist (LABA) that relaxes the airway muscles to help keep them open.
Symbicort is approved for asthma in patients 6 years and older, especially those who do not get enough control from using just an inhaled corticosteroid. Symbicort was approved by the FDA for asthma in 2006 and for COPD in 2009. It is used regularly, twice daily, to control symptoms and reduce flare-ups. For asthma, the standard dosage is two puffs every 12 hours, and it helps lessen the need for a rescue inhaler. Importantly, it is not meant to be used for sudden breathing problems.
Researchers have shown strong evidence for Symbicort’s benefits. According to a study involving over 800 adult asthma patients, it confirmed that budesonide/formoterol was more effective than doubling the dose of budesonide alone. It was also at least as effective and safe as using the two drugs in separate inhalers. These trials provided high-level evidence (level A) that combination inhalers like Symbicort are more effective in managing asthma that is not controlled by a single medication.
Furthermore, according to a meta-analysis of 5 randomized trials including 4,863 patients with poorly controlled asthma, using Symbicort as both a maintenance and reliever therapy (known as the SMART approach) extended the time to a severe asthma flare-up by 29% to 30% compared to standard treatments that combine corticosteroids with a separate rescue inhaler. This suggests that Symbicort not only helps maintain day-to-day control but can also reduce serious flare-ups when used correctly.
While it is sometimes used off-label for severe bronchitis not related to COPD, this is less common. Overall, Symbicort is intended for long-term use as a controller medication, not as a quick fix. If you are using it, you should begin to feel some relief within 15 minutes, but the full benefits often take a couple of weeks.
How Long Should You Stay on Symbicort?
The length of time you should stay on Symbicort depends on the condition being treated and how well your symptoms are controlled.
In most cases, Symbicort is meant for long-term, daily use. It is not a rescue inhaler and should not be used for sudden breathing problems. If you have asthma or COPD, your healthcare provider will decide how long you need to stay on it, based on your symptoms, lung function, and response to treatment.
For asthma, the goal is to control symptoms and prevent flare-ups. According to its prescribing information, Symbicort is often used when a single inhaled corticosteroid does not provide enough relief. If your asthma becomes well-controlled, your doctor may reduce your treatment over time. Your doctor may decide at some point that you can stop taking Symbicort without loss of control and switch to a simpler inhaler that contains only a corticosteroid.
However, this is a medical decision, not something you should do on your own.
In children aged 6 to 11, the standard dosage is two puffs of the 80/4.5 mcg inhaler every 12 hours. For adolescents and adults with asthma, treatment typically continues for as long as needed to maintain symptom control. Studies show that it can take up to two weeks to experience the full benefits of Symbicort, and patients are usually advised to continue using it even if they start feeling better. Stopping too soon could lead to worsening symptoms or asthma attacks.
For COPD, Symbicort is generally used long-term, often for life. The higher dose, 160/4.5 mcg, is specifically recommended for adults with COPD. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), people with severe COPD, defined as two or more flare-ups or at least one hospitalization in a year, may benefit most from daily use. One study found that in long-term studies, patients using Symbicort experienced fewer exacerbations and improved lung function over the course of 12 months.
Even though it starts to work within 15 minutes, regular use is key. If you skip doses or stop taking it without your doctor’s advice, your breathing symptoms may worsen. That’s why healthcare providers recommend staying on Symbicort as long as needed to keep your asthma or COPD under control.
So, how long should you stay on Symbicort?
The answer is: as long as your doctor recommends. For asthma, it may be months or years, with the possibility of stepping down treatment when symptoms improve. For COPD, it’s usually a long-term part of your treatment plan. Always talk to your doctor before making any changes.
| ⚠️ Important Considerations Even if you’re feeling better, stopping Symbicort on your own can be risky. Sudden withdrawal can lead to rebound inflammation, worsening symptoms, or serious complications like adrenal crisis, especially in those who’ve used corticosteroids for a long time. If you’re unsure whether it’s time to adjust or stop, ask yourself: ➤ Have I been stable for at least three months? ➤ Have I had any recent flare-ups? ➤ Am I experiencing side effects? ➤ Have I talked to my doctor about my current dose? If the answer to that last question is no, that’s your first step. |
When Should You Reassess Symbicort Use?
You should talk to your doctor about Symbicort if your symptoms don’t improve after a week, you need your rescue inhaler more often, or you have side effects. It’s also smart to reassess after flare-ups, after being stable for three months, or if you’re using it as part of SMART therapy. Specifically, here’s what you should do:
- If your symptoms don’t improve after one week. Are your breathing problems still bothering you even after using Symbicort regularly? That’s a clear sign to reassess. You should contact your doctor if your symptoms don’t get better after one week of treatment. You should also speak up if you start needing your rescue inhaler more often, especially if you’re using it two or more days in a row. These signs may mean your asthma or COPD is not well controlled, and you might need a stronger or different approach.
- If you’ve been stable for at least three months. Have things been calm for a while? That’s great, but it might also be time to step down. If your asthma has stayed well controlled for three months or longer, guidelines from the Global Initiative for Asthma (GINA) recommend considering a lower dose or fewer medications.
- After any asthma or COPD flare-up. If you’ve had a flare-up, or worse, ended up in the hospital, it’s time to review your current plan. People with COPD should reassess their medication after each exacerbation to decide whether adjustments are needed. A recent attack means your condition may have changed and your treatment may no longer be enough.
- If you start experiencing side effects. Are you noticing a sore throat, stomach pain, or white patches in your mouth? These could be side effects of Symbicort. Even though many are mild, they still deserve attention. Frequent issues like oral thrush, vomiting, or headaches could mean that the dose is too high or that your inhaler technique needs fixing. According to a study, long-term use of inhaled corticosteroids can raise the risk of oral candidiasis and pneumonia, especially in people with COPD. Reassessing your dose or technique can help reduce those risks.
- If you’re using SMART therapy. If you’re using Symbicort as both a daily and as-needed inhaler (SMART therapy), regular check-ins are even more important. Using Symbicort this way reduces the risk of severe asthma attacks by about 30% and prolongs the time before the first major flare-up. But this approach only works if your doctor confirms it’s right for you, and that it’s working as planned. That’s why follow-up visits are a must.
Wrap Up
If your asthma or COPD is under control, your doctor might suggest adjusting the dose or even stepping down. But that choice should never be made alone. Skipping doses or quitting without guidance can lead to serious setbacks.
So, when should you reassess?
After a flare-up, if side effects show up, or if you’ve been stable for months. These moments matter. Keep talking with your doctor. Symbicort works best when it’s part of an ongoing, flexible plan built around your needs.
FAQs on Symbicort
How often should I take symbicort?
Take 2 puffs twice a day—once in the morning and once in the evening.
Should I use symbicort during a sudden asthma attack?
No. Use a rescue inhaler for sudden symptoms. SYMBICORT is not for quick relief.
How do I know when my inhaler is running low?
Check the counter on top. When it gets close to 20, it’s time to get a refill.
What if I haven’t used my inhaler in over a week?
Shake it, then spray it once into the air. Shake again and spray a second time to prime it.
Can I use another inhaler with a LABA while on symbicort?
No. Don’t use any other medicine with a LABA while taking symbicort.
What are common side effects?
You might get a sore throat, thrush (white patches in your mouth), or a cough.
Sources
- AstraZeneca. (2010). Symbicort (budesonide/formoterol fumarate dihydrate) inhalation aerosol: Highlights of prescribing information (Revised June 2010) [Prescribing information]. U.S. Food and Drug Administration. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021929s021lbl.pdf
- Lange-Vaidya, N., Hartert, T., Bochner, B. S., Dixon, A. E., & Dieffenbach, P. (2025). Initiating asthma therapy and monitoring in adolescents and adults. UpToDate. Retrieved from https://www.uptodate.com/contents/initiating-asthma-therapy-and-monitoring-in-adolescents-and-adults
- Miravitlles, M., Auladell-Rispau, A., Monteagudo, M., Vázquez-Niebla, J. C., Mohammed, J., Nuñez, A., & Urrútia, G. (2021). Systematic review on long-term adverse effects of inhaled corticosteroids in the treatment of COPD. European Respiratory Review, 30(160), 210075. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9488732/