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combination inhalers - Symbicort

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  • combination inhalers - Symbicort

    Hi. I have asthma since childhood that only flares up occasionally when I have a cold, more so in pregnancy and in the postpartum period. I am currently taking Ventolin (salbutamol) and Beclazone (beclometasone) twice a day but am not sure if it is controlling my symptoms adequately, I have ended up with wheezing/gunk/chest tightness during and after colds on several occasions since my son was born six months ago and have been prone to chest infections. I previously got great results from Symbicort but haven't been able to find definitive information about its safety in breastfeeding, or for any of the other combination inhalers. Would like to be armed with up-to-date facts when I discuss managing my chest symptoms/changing inhalers with my doctor. Thanks in advance.

  • #2
    Dear leedy,

    Budesonide and Formoterol fumarate (Symbicort) is a drug combination product of an anti-inflammatory (budesonide) agent along with a bronchodilator (formoterol). It is FDA approved for treatment of asthma and chronic obstructive pulmonary disease (COPD). The transfer of this combination product into breastmilk has not been studied. Budesonide, however, is a preferred steroid for use in breastfeeding women. It is rapidly cleared by the liver. It is poorly absorbed orally. And it produces the least adreno-cortical suppression when compared with many of the other oral steroids. Steroids in general enter milk poorly. Maternal use via intranasal or inhalation is unlikely to be clinically relevant in a breastfeeding infant. No data are available on transfer of formoterol into human milk, but the extremely low plasma levels would suggest that milk levels would be incredibly low, if even measurable. Studies of oral absorption in adults suggests that while absorption is good, plasma levels are still below detectable levels and may require large oral doses prior to attaining measurable plasma levels. It is not likely the amount present in human milk would be clinically relevant to a breastfed infant. If you have further questions, please call the InfantRisk Center at 806-352-2519. We are open Monday through Friday, 8 to 5, CDT.

    Sincerely,
    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center

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