Asthma inhalers guide: Symbicort, budesonide and how to use them well
Understand modern asthma treatment, compare inhalers and tablets, learn the technique that gets medicine into your lungs, and know the signs that need urgent help.
Updated October 2026 by the MyRxBox team
At a glance
- ConditionAsthma
- Key medicinesBudesonide-formoterol, budesonide, montelukast
- DevicesTurbuhaler, spray inhaler, nebuliser
- Symbicort strengths80/4.5, 160/4.5, 320/9
- PrescriptionRequired
How asthma works and why treatment has two jobs
Asthma is long-term inflammation of the airways. Inflamed airways are oversensitive, so triggers such as colds, allergens, smoke, cold air or exercise make the muscles around them tighten and the lining swell. The result is wheezing, coughing, chest tightness and breathlessness.
Treatment has two jobs: controlling the underlying inflammation so flare-ups happen less often, and relieving symptoms quickly when they do. Medicines that reduce inflammation, mainly inhaled corticosteroids (ICS), are the foundation of modern asthma care. For a full map of medicine names, see asthma medication names: a complete classification guide.
Modern treatment: why reliever-only isn't recommended
For years, many people used only a blue reliever inhaler, such as salbutamol (albuterol). International guidance from the Global Initiative for Asthma (GINA) no longer recommends reliever-only treatment for adults and adolescents, because relieving symptoms without treating inflammation leaves people at higher risk of severe attacks.
Instead, many adults and teenagers now use an inhaler combining an inhaled steroid, Budesonide, with a fast-acting long-acting bronchodilator, Formoterol:
- As-needed relief: budesonide-formoterol used when symptoms appear, so every reliever puff also delivers anti-inflammatory treatment.
- Maintenance and reliever therapy (MART): the same inhaler taken daily, plus extra puffs when needed, up to a daily maximum set in your action plan.
Other approaches use a separate daily preventer, such as Fluticasone or Mometasone, sometimes combined with Salmeterol, plus a separate reliever. Your doctor chooses based on your age, symptoms and history. Don’t switch approaches without a plan from your doctor.
Asthma inhalers and medicines compared
| Medicine | Type | Used for | Products at MyRxBox |
|---|---|---|---|
| Budesonide + formoterol | ICS + fast-acting LABA | As-needed relief, MART or daily maintenance | Symbicort 80/4.5, Symbicort 160/4.5, Symbicort 320/9 |
| Budesonide | Inhaled corticosteroid (preventer) | Daily control of inflammation | Budecort 100 mcg inhaler, Budecort 200 mcg inhaler |
| Budesonide respules | Nebulised corticosteroid | Children and people who can’t use inhalers well | Budecort 0.5 mg respules, Budecort 1 mg respules |
| Salbutamol nebuliser solution | Short-acting reliever | Nebulised relief as prescribed | Asthalin respirator solution |
| Montelukast | Leukotriene receptor antagonist tablet | Add-on control, especially with allergies | Montair 10 mg, Montair FX (with fexofenadine) |
Other options a specialist may prescribe include Ipratropium, long-acting bronchodilators such as Arformoterol and olodaterol, and biologic injections for severe asthma such as Omalizumab and Benralizumab. Brand pages: Symbicort Turbuhaler, Budecort, Montair.
Inhaler technique: getting the medicine into your lungs
Studies repeatedly find that most people make at least one mistake with their inhaler, and poor technique is a common reason asthma stays uncontrolled. Ask your pharmacist or nurse to check yours.
Turbuhaler (dry powder), such as Symbicort
- Unscrew the cap and hold the inhaler upright.
- Twist the grip one way and back until it clicks to load a dose.
- Breathe out fully, away from the mouthpiece.
- Seal your lips around the mouthpiece and breathe in quickly and deeply.
- Hold your breath for about 10 seconds, then breathe out away from the inhaler.
- Rinse your mouth with water and spit after steroid doses.
Pressurised inhaler (spray), such as Budecort
Shake well, breathe out, then start a slow, deep breath as you press the canister once. Hold your breath for 10 seconds. Using a spacer makes these inhalers much more effective and reduces steroid left in the mouth; spacers are recommended for children and for anyone who finds the timing hard.
Nebulisers (respules and solutions)
Use only the dose and dilution prescribed, sit upright, breathe normally through the mouthpiece or mask until the mist stops, and clean the nebuliser parts after each use.
Side effects and safety
- Inhaled steroids: hoarseness and oral thrush are the most common side effects. Rinsing your mouth after use, and using a spacer, reduces both. At usual doses, inhaled steroids carry far fewer risks than steroid tablets.
- Formoterol and salbutamol: shakiness, a fast heartbeat and headache, especially at higher doses.
- Montelukast: carries a boxed warning about mood and behaviour changes, including agitation, sleep problems, depression and suicidal thoughts. Stop it and contact your doctor if these occur.
- Oral steroid courses such as prednisolone are sometimes prescribed for flare-ups. Frequent courses are a sign your asthma needs a better long-term plan. See our Medrol dose pack example.
Call emergency services if you’re too breathless to speak in full sentences, your reliever isn’t helping, your lips or fingertips look blue or grey, or you feel drowsy or confused. Use your reliever as your action plan directs while you wait.
Is your asthma well controlled?
Well-controlled asthma means few symptoms and an almost normal life. Talk to your doctor about stepping up treatment if, over the past four weeks, you’ve had any of these:
- Daytime symptoms more than twice a week
- Waking at night because of asthma
- Needing a separate reliever inhaler more than twice a week
- Any limitation of activity because of asthma
Every person with asthma should have a written action plan that says what to take every day, what to do when symptoms worsen and when to get emergency help. Reducing triggers matters too: avoiding smoke, treating allergies and getting recommended vaccines all help. For allergy treatments, see the prescription allergy medications list, the allergy medication list and anti-allergic medicines such as Allegra 180 mg and Rupanex 10 mg. If you’re wondering about non-prescription options, read over-the-counter asthma medication first.
Ordering asthma medicines from MyRxBox
- Order the exact inhaler, strength and device you’re prescribed. Different devices need different techniques, so don’t swap types without your doctor.
- Choose from our asthma category and order a spare reliever in good time.
- Upload your prescription through our secure form.
- Check the dose counter on your inhaler and reorder well before it reaches zero. See how to refill a prescription.
Compare prices in the medicine price index. Country rules: USA, UK, Australia. Never rely on an online order for your only reliever: always keep one at home.
Shop asthma medicines
Symbicort Turbuhaler, Budecort inhalers and respules, and montelukast.
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Questions before you order?
Email order.myrxbox@gmail.com, or send us a message.
More breathing and allergy guides
Reading on asthma medicines, allergies and steroid courses.
More MyRxBox buying guides
Asthma inhaler questions, answered
Symbicort, preventers, technique and safety.
Still have a question? Contact our team.
Can Symbicort be used as a reliever?
Yes. For many adults and adolescents, budesonide-formoterol is recommended as an as-needed reliever, or as both preventer and reliever (MART). Your doctor will tell you which plan and daily maximum apply to you.
What's the difference between Symbicort strengths?
The numbers show the budesonide and formoterol dose per inhalation. 160/4.5 is the usual adult strength; 80/4.5 is lower; 320/9 delivers double the 160/4.5 dose in one inhalation.
Why should I rinse my mouth after my inhaler?
Rinsing and spitting removes steroid left in the mouth and throat, which reduces hoarseness and oral thrush.
Do I need a spacer?
For pressurised spray inhalers, a spacer improves how much medicine reaches the lungs and is recommended for children. Dry powder inhalers like Turbuhaler aren’t used with spacers.
Is montelukast safe?
Many people take it without problems, but it carries a warning about mood and behaviour changes. Stop it and contact your doctor if you notice these.
Can I switch inhaler brands?
Same-device generics with the same doses may be fine, but switching device types changes technique. Always agree changes with your doctor or pharmacist.
When should I seek emergency help?
If you can’t speak in full sentences, your reliever isn’t helping, your lips look blue or you feel drowsy. See when it’s an emergency.
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Information on MyRxBox is general and educational. It does not replace advice from your doctor or pharmacist. Prescription-only medicines require a valid prescription, and rules on importing medicines differ by country, so please check your local regulations before ordering. Read our terms, privacy policy and refund policy.
