Description
Same active ingredient (budesonide/formoterol) as Symbicort®, the US brand. Foracort Inhaler 400 mcg is an Indian brand, made and licensed in India. Compare all Generic Symbicort (Budesonide/Formoterol) options.
About Foracort Inhaler 400 mcg
Foracort Inhaler 400 mcg is a prescription metered-dose inhaler containing budesonide 400 mcg and formoterol fumarate 6 mcg per puff, made by Cipla Limited, used for moderate to severe asthma that needs a high dose of inhaled steroid together with a long-acting bronchodilator. It has the same formoterol content as the lower strengths but twice the steroid of Foracort 200, so it is normally a step-up choice rather than a first inhaler. No budesonide/formoterol inhaler with this per-puff strength is sold in the US.
Why would a doctor prescribe a high steroid dose?
Asthma care follows a stepwise plan. When symptoms or attacks continue on a medium-dose steroid plus a LABA, and inhaler technique, adherence and triggers have been checked, a doctor may increase the steroid. Two puffs of this inhaler twice a day give 1,600 mcg of budesonide daily, the top of the usual adult range. Once asthma has been stable for around three months, guidelines recommend stepping down to the lowest dose that keeps control, and many people then return to a lower strength.
How to use Foracort Inhaler 400 mcg
- A typical adult dose is one puff twice a day, sometimes increased to two puffs twice daily if your doctor decides it is needed.
- Shake well, breathe out, then press the canister as you start a slow, full breath through the mouthpiece.
- Hold the breath for about 10 seconds before breathing out slowly.
- A spacer is especially worthwhile at high steroid doses, because it cuts the amount of medicine left in the mouth and throat.
- Rinse, gargle and spit after every dose.
- This strength is not meant for as-needed relief, so carry your separate reliever.
What to watch for on a high-dose steroid
Very little inhaled budesonide reaches the rest of the body, but at the top of the dose range some effects become possible over months or years. These include reduced output of the body’s own cortisol (adrenal suppression), thinning of the bones, cataracts, glaucoma and easy bruising. Tell any doctor, dentist or surgeon that you use a high-dose inhaled steroid, especially before an operation or during a severe illness, as you may need extra steroid cover. Regular eye checks and a bone health review are sensible with long-term use. This strength is generally not used in children.
Other side effects
Hoarseness, oral thrush, sore throat and cough are the commonest local effects. Formoterol can cause shakiness, headache, a fast heartbeat and muscle cramps, particularly in the first days. Get help at once if your chest tightens right after a puff, if you notice swelling of the lips or tongue, chest pain or palpitations that do not settle, or if your reliever stops working as well as usual.
Precautions and interactions
Discuss heart disease, arrhythmias, high blood pressure, thyroid problems, diabetes, osteoporosis, glaucoma, liver disease and any history of tuberculosis before starting. HIV boosters such as ritonavir and cobicistat, and antifungals like itraconazole, can raise budesonide levels enough to cause Cushing’s syndrome. Avoid beta-blockers where possible and never combine this inhaler with another LABA. In pregnancy, well-controlled asthma matters for both mother and baby; your doctor will review whether this dose is still required.
Pack sizes and storage
Each canister gives 120 puffs, enough for 60 days at one puff twice daily or 30 days at two. Choose 1, 2 or 3 inhalers, from $17. Store below 86°F (30°C) and keep the cap on when not in use.
Frequently asked questions
How is it different from Foracort Forte?
The Foracort Forte Inhaler is listed with the same budesonide dose but more formoterol per puff.
Can I step down later?
Often, yes, to Foracort Inhaler 200 mcg, once your doctor agrees. A capsule alternative is Foracort Rotacaps 400 mcg.
Which reliever should I keep?
Usually an albuterol (salbutamol) inhaler such as Asthalin. Other options are in the asthma category.
General health information only. Foracort Inhaler 400 mcg is a prescription-only, high-dose inhaler that should be reviewed regularly by your doctor.
Helpful guides
- Asthma vs COPD: What’s the Difference? Causes, Tests and TreatmentAsthma often starts in childhood and its airway narrowing largely reverses with treatment, while COPD usually follows years of smoking and causes…
- Foracort vs Symbicort: How These Budesonide/Formoterol Inhalers CompareForacort and Symbicort both combine budesonide with formoterol. Compare makers, strengths, devices, dosing, reliever (SMART) use and side effects.
- Types of Asthma Inhalers: Relievers, Preventers and How to Use Them CorrectlyLearn the types of asthma inhalers (relievers, preventers and combination inhalers), how each one works, and step-by-step tips for correct inhaler technique.