Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Symbicort Turbuhaler. If you are concerned about side effects, discuss the risks and benefits of Symbicort Turbuhaler with your doctor.

The following side effects have been reported by at least 1% of people taking Symbicort Turbuhaler. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• awareness of heartbeat or fast heartbeat
• cough
• dizziness
• headache
• hoarseness
• irritation of the mouth or throat
• muscle cramps
• nausea
• restlessness or nervousness
• tremor
• trouble sleeping

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• agitation
• bone pain or fractures
• chest pain
• chest tightness
• fast or irregular heartbeat
• flu-like symptoms (sudden lack of energy, Fever, cough, sore throat) that includes rash, pins and needles sensation, worsening breathing problems)
• mood or mental changes
• signs of Depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• skin rash or Hives all over the body
• symptoms of Cataracts (e.g., clouding of the lens in the eye, blurred vision, eye pain)
• symptoms of increased pressure in the eyes (e.g., decreased or blurred vision, eye pain, red eye, swelling of the eye)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of pneumonia (e.g., fever or chills, shortness of breath, fatigue, chest pain, cough)
• symptoms of too much corticosteroid in the body (e.g., rapid weight gain, round "moon" face, excess sweating, thinning skin, easy bruising, muscle and bone weakness)
• unusual colour, amount, or consistency of phlegm
• white patches in the mouth or throat (thrush)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• breathlessness when resting
• sudden wheezing and chest pain or tightness immediately after using the medication
• signs of a Anaphylaxis (severe allergic reaction) (e.g., swelling of face, lips, tongue, throat, or eyelids; difficulty swallowing, breathing, or speaking)
• worsening breathing symptoms even after using your reliever medication

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Symbicort Turbuhaler.

Symbicort 100 Turbuhaler
Each dry powder inhaler contains 100 µg of budesonide and 6 µg of formoterol fumarate dihydrate per dose. It also contains lactose, which acts as a "carrier." The amount added does not normally cause problems for lactose-intolerant people.

Symbicort 200 Turbuhaler
Each dry powder inhaler contains 200 µg of budesonide and 6 µg of formoterol fumarate dihydrate per dose. It also contains lactose, which acts as a "carrier." The amount added does not normally cause problems for lactose-intolerant people.

Symbicort Forte Turbuhaler
Each dry powder inhaler contains 400 µg of budesonide and 12 µg of formoterol fumarate dihydrate per dose. It also contains lactose, which acts as a "carrier." The amount added does not normally cause problems for lactose-intolerant people.

Do not use Symbicort Turbuhaler if you are allergic to budesonide, formoterol, or inhaled lactose.

There may be an interaction between budesonide - formoterol turbuhaler and any of the following:

• Aldesleukin
• Alfuzosin
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• Atomoxetine
• azole antifungals (e.g., ketoconazole, itraconazole, fluconazole, Voriconazole)
• beta-blockers, including eye drops (e.g., Carvedilol, Labetalol, Metoprolol, Propranolol, Timolol eye drops)
• Betahistine
• caffeine
• cannabinoid-containing medications (e.g., cannabis, Nabilone)
• Cobicistat
• decongestant cold medications (e.g., phenylephrine, Pseudoephedrine)
• decongestant eye drops and nose sprays (e.g., naphazoline, oxymetazoline, xylometazoline)
• Deferasirox
• Desmopressin
• dexmethylphenidate
• Disopyramide
• diuretics (e.g., Furosemide, Hydrochlorothiazide, Spironolactone)
• Dronedarone
• Epinephrine
• fast-acting bronchodilators (e.g., salbutamol, terbutaline)
• Hepatitis C antivirals (e.g., dasabuvir, ombitasvir, paritaprevir)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• hyaluronidase
• Levothyroxine
• Linezolid
• lithium
• long-acting bronchodilators (e.g., formoterol, salmeterol)
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Methadone
• Methylphenidate
• mifepristone
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• Modafinil
• Primaquine
• procainamide
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin)
• rilpivirine
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• Tamoxifen
• Theophylline (e.g., Aminophylline, Oxtriphylline, theophylline)
• Trazodone
• tricyclic antidepressants (e.g., Amitriptyline, Doxepin, Nortriptyline)
• tyrosine kinase inhibitors (e.g., Ceritinib, Idelalisib)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Symbicort Turbuhaler. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Symbicort Turbuhaler.

Asthma attacks: Symbicort Turbuhaler works by decreasing the frequency and severity of asthma attacks, and it can be used as a "reliever" medication. If you start developing asthma symptoms, be sure to use your "reliever" medication or an additional inhalation (or puff) of Symbicort Turbuhaler for rapid relief of your asthma symptoms. It is very important that you have your "reliever" medication available with you at all times, whether you're using Symbicort Turbuhaler or another rescue medication. If you persistently use more of your "reliever" medication, contact your doctor.

Budesonide - formoterol is not intended to be used before exercise to prevent difficulty breathing as a result of exercise.

Asthma-related deaths: Formoterol, as with other long-acting bronchodilators, may increase the risk of asthma-related deaths. It is not clear whether using corticosteroids, such as budesonide, reduces this risk. If you have concerns, speak with your doctor.

Bone health: Long-term use of inhaled corticosteroids has been associated with a decrease in bone density. This may lead to brittle bones or Osteoporosis. If you have risk factors for thinning or brittle bones, such as a slight build; long-term, regular alcohol use; poor nutrition; or a family history of osteoporosis, you may be at a greater risk of thinning bones. Discuss with your doctor how Symbicort Turbuhaler may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Symbicort Turbuhaler, and whether any special monitoring is needed.

Diabetes: Budesonide - formoterol may cause changes in blood sugar levels (may cause a loss of blood glucose control) and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using Symbicort Turbuhaler.

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Symbicort Turbuhaler may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Symbicort Turbuhaler, and whether any special monitoring is needed.

Eye problems: Budesonide may increase the risk of developing cataracts or Glaucoma. If you are at risk of developing either of these conditions, have your eyes checked by your doctor before starting long-term treatment with Symbicort Turbuhaler. You should have your eyes monitored at regular intervals while using Symbicort Turbuhaler. Report any changes in vision to your doctor as soon as possible while you are taking Symbicort Turbuhaler.

Heart disease: If you have heart disease or high blood pressure, discuss with your doctor how Symbicort Turbuhaler may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Symbicort Turbuhaler, and whether any special monitoring is needed.

Infections: Thrush infections of the inside of the mouth and throat may occur with use of Symbicort Turbuhaler. If an infection develops, call your doctor. You can reduce the risk of infection by rinsing your mouth out with water after each dose and by practicing good oral hygiene. Also, tell your doctor if you are exposed to Chickenpox or Measles while using Symbicort Turbuhaler, as you may be more prone to infection.

People using budesonide - formoterol to treat COPD may be more likely to develop lung infections, such as pneumonia. If you experience new or worsening shortness of breath or cough, fever, or other symptoms of infection at any time while you are taking Symbicort Turbuhaler, contact your doctor as soon as possible.

Liver function: Liver disease or reduced liver function may cause Symbicort Turbuhaler to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Symbicort Turbuhaler may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Symbicort Turbuhaler, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Symbicort Turbuhaler.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Medical conditions: If you have Epilepsy or low blood potassium, discuss with your doctor how Symbicort Turbuhaler may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Symbicort Turbuhaler, and whether any special monitoring is needed.

Steroid medication use: If you have taken or are still taking steroid medication over the last several months, talk to your doctor before using Symbicort Turbuhaler. In times of stress or during a severe asthma attack, your doctor may want you to start your steroid medication again.

Stopping medication: Do not stop Symbicort Turbuhaler abruptly, as this may cause your condition to get worse. When Symbicort Turbuhaler is stopped, it should be stopped gradually as directed by your doctor.

Thyroid disease: If you have thyroid disease, discuss with your doctor how Symbicort Turbuhaler may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Symbicort Turbuhaler, and whether any special monitoring is needed.

Pregnancy: Symbicort Turbuhaler should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Symbicort Turbuhaler, contact your doctor immediately.

Breast-feeding: Budesonide passes into breast milk. It is not known if formoterol passes into breast milk. If you are a breast-feeding mother and are using Symbicort Turbuhaler, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of Symbicort Turbuhaler for the treatment of asthma have not been established for children younger than 12 years of age. Adolescents may experience slowing of growth while using Symbicort Turbuhaler. Your doctor will monitor for this. Talk to your doctor if you have any concerns.

Symbicort Turbuhaler should not be used to treat chronic bronchitis or emphysema for anyone younger than 18 years of age.