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These symptoms can interfere with a patient's daily living and affect quality of life. These 5 levels are indicators of what drug treatments should be administered. The guideline is as follows: [2] Step 1-2: Symptoms less than 4–5 days a week. Low-dose inhaled corticosteroids and formoterol combination therapy when required
Budesonide/formoterol, sold under the brand name Symbicort among others, is a fixed-dose combination medication used in the management of asthma or chronic obstructive pulmonary disease (COPD). [2] It contains budesonide, a steroid; and formoterol, a long-acting β 2-agonist (LABA). [2]
Budesonide, sold under the brand name Pulmicort, among others, is a steroid medication. [8] It is available as an inhaler, nebulization solution, pill, nasal spray, and rectal forms. [8] [9] The inhaled form is used in the long-term management of asthma and chronic obstructive pulmonary disease (COPD).
Formoterol is marketed in three forms: a dry-powder inhaler (DPI), a metered-dose inhaler (MDI) and an inhalation solution, under various brand names including Atock, Atimos/Atimos Modulite, Foradil/Foradile, Fostair, Oxeze/Oxis, Perforomist and Symbicort. Foradil/Foradile capsules for oral inhalation (Schering-Plough in the U.S., Novartis rest ...
While the use of inhaled steroids and long-acting beta2‑adrenergic agonists are recommended for the resulting improvement in control of symptoms of asthma, [10] concerns have been raised that salmeterol may increase the risk of death due to asthma, and this additional risk is not reduced by the addition of inhaled steroids. [11]
Combination of inhaled corticosteroids and salmeterol (LABA) has synergistic action and reduces the frequency of asthma attacks and also makes it less severe. In chronic obstructive pulmonary disease (COPD), LABAs may be used as monotherapy or in combination with corticosteroids.
If high doses were used for six to 10 days, reduce to replacement dose immediately and taper over four more days. Adrenal recovery can be assumed to occur within two to four weeks of completion of steroids. If high doses were used for 11–30 days, cut immediately to twice replacement, and then by 25% every four days.
In those with occasional attacks, no other medication is needed. If mild persistent disease is present (more than two attacks a week), low-dose inhaled corticosteroids or alternatively, a leukotriene antagonist or a mast cell stabilizer by mouth is recommended. For those who have daily attacks, a higher dose of inhaled corticosteroids is used.