Symbicort Smart: Using Symbicort As A Rescue Inhaler

The Symbicort Smart Program was introduced in Europe back in the late 1990s, but the FDA, in its infinite caution, held off approving it until 2023. My guess? The program worked so well in Europe that the FDA finally had no choice but to relent.

Interestingly, I’ve had coworkers only recently learn about the Symbicort Smart Program. One of them expressed concern, saying, “You can’t give a SABA to a patient more than twice a day—that’s bad for their heart.” So, I explained the success of this program in Europe, but she still seemed uneasy about the potential for overuse of Symbicort.

I think it was in light of this that my boss sent out a mass email to me and my fellow RTs. The email explained how about the Symbicort Smart program. 

Here’s how it works:

The Symbicort Smart program allows patients to use Symbicort as a rescue inhaler—up to eight times a day, with 1–2 puffs per use, depending on the prescription. Why? Because, like Albuterol, Symbicort is fast-acting and opens airways quickly. The idea is that if a patient needs rescue medication, they’ll also benefit from the added steroid to reduce inflammation.

I’ll admit, I’ve used Symbicort as a rescue inhaler myself during flare-ups, even before the FDA approved this approach. It worked well for me, but I ran into two issues: 1) Severe tremors, which can be a common side effect, and 2) Running out of my Symbicort before the month was over. Since my insurance only allowed one inhaler per month, this created a problem.

My boss addressed this insurance issue in her email.  She noted that while it’s now FDA-approved to use Symbicort as a rescue inhaler, many insurance companies haven’t updated their policies to reflect this change. For patients relying on the Smart program, running out of medication too soon could leave them unable to refill their prescription. As slow as the FDA can be, insurance companies tend to be even slower.

Now, we’re seeing similar developments with medicines like Airsupra. This combination inhaler pairs Albuterol with Budesonide—a SABA and an inhaled steroid. The idea is the same: if you’re using a rescue inhaler, why not also get the anti-inflammatory benefits of a steroid? It’s a promising direction, but like with Symbicort, it’s likely to face hurdles with insurance coverage.https://respiratorytherapycave.blogspot.com/search?q=symbicort+smart