Taking an easy deep breath is something most people take for granted, while for others this natural act is a struggle due to asthma and COPD.
According to the American Lung Association (www.lung.org) there may be as many as 24 million Americans living with Chronic Obstructive Pulmonary Disease, also known as “COPD”. The COPD Foundation (www.copdfoundation.org) defines COPD as “an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, and refractory (non-reversible) asthma.”
Symptoms of COPD may vary from person to person, but typical symptoms include wheezing, tightness in the chest, increased shortness of breath and breathlessness, and frequent coughing. It is also not uncommon for someone with COPD to have other health conditions such as high blood pressure, diabetes, or heart disease.
Most people living with asthma and/or COPD take prescription medication to help manage their condition. Two of the most common medications are Symbicort and Vannair.
Symbicort is the brand name of an inhaled medication used to treat both asthma and COPD. It contains two active medicinal ingredients: budesonide (a corticosteroid whose job it is to decrease inflammation in the lungs) and formoterol (a long acting beta 2 adrenergic agonist, abbreviated LABA, whose job it is to relax the muscles around the airways to prevent wheezing, cough, chest tightness and shortness of breath).
The Symbicort available in the US is manufactured by Astra Zeneca. It available as an inhalation aerosol, or metered dose inhaler, in two strengths: Symbicort 160/4.5 and Symbicort 80/4.5. These numbers reflect the dose of the two medicinal ingredients delivered from the mouthpiece of the device. In order to deliver this amount from the mouthpiece, the valve of the device (upstream) actually dispenses a total of 200/6 and 100/6.
In other countries – Canada, New Zealand and the United Kingdom – Symbicort is also available as a brand name medication from Astra Zeneca but is marketed differently.
Instead of indicating the amount of active ingredients delivered from the mouthpiece, their labels show the total amount of drugs dispensed from the valve of the device, which is a little higher – 200/6 form the valve is the same as 160/4.5 from the mouthpiece and 100/6 from the valve is the same and 80/4.5 from the mouthpiece. When you read the product monographs for these products, both sets of numbers are explained, but only the total higher dose dispensed from the valve is shown in the product labeling. This may lead to confusion and an incorrect conclusion that they are a higher strength than their US equivalents whereas in fact they are identical.
In the United Kingdom only the higher strength of Symbicort inhaler is available, marketed as Symbicort inhalation aerosol 200/6, which delivers 160/4.5 from the mouthpiece.
In New Zealand, Vannair is the same as Symbicort
In New Zealand, both inhaler strengths are marketed by Astra Zeneca, but under a different brand name – Vannair. The Vannair aerosol inhaler 200/6 delivers 160/4.5 from the mouthpiece, while the Vannair aerosol inhaler 100/6 delivers 80/4.5 from the mouthpiece. These products are not currently available with dose counters.
Symbicort Turbuhaler – Available in Canada, New Zealand and the United Kingdom
To make the Symbicort product even more complicated, it is also marketed as a dry powder inhaler called Turbuhaler in Canada, New Zealand and the United Kingdom. The Symbicort Turbuhaler 200/6 delivers 160/4.5 from the mouthpiece and the Symbicort Turbuhaler 100/6 delivers 80/4.5 from the mouthpiece, making it equivalent to the Symbicort aerosol inhaler in terms of the delivered medication dose. The Turbuhaler is a different delivery system however, which does not dispense an aerosol suspension of the medication but a breath activated dose of dry powder instead. It is important to know that with a Symbicort Turbuhaler, each delivered dose of powder contains lactose as well, which may be of concern for some patients.
The bottom line – Symbicort and Vannair are the same product but with different names in different countries.
In summary, the US Symbicort aerosol inhaler 80/4.5 is the same as the Vannair aerosol inhaler 100/6 from New Zealand and the US Symbicort inhaler 160/4.5 is the same as the Vannair aerosol inhaler 200/6 from New Zealand or the Symbicort aerosol inhaler 200/6 from the United Kingdom.
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