The Turbuhaler^® family comprises Symbicort^®, Pulmicort^®, Oxis^®, Bricanyl^® and Rhinocort^® (this may differ between countries). Turbohaler^® is a trademark used in some countries.

Clinical studies show that Turbuhaler^® can be used by children at ages as low as 3-4 years. Generally, Turbuhaler^® is approved for use from the age of 5 years, with local variations ranging from 3-6 years. Please, check the local prescribing information.

The different products are available in different strengths and contain up to 200 doses (this may differ between countries). Bricanyl^®, Pulmicort^® and Rhinocort^® contain only active drug while Symbicort^® and Oxis^® also contain additional lactose to secure dose consistency of the very small amounts of formoterol (metered doses of only 6 or 12 µg). The amount of lactose added is less than 1 mg compared with some other inhalers such as Diskus™/Accuhaler™, which contains 12 mg of lactose per blister. Regarding milk protein hypersensitivity and lactose intolerance, see below.

Overall, the Turbuhaler^® system is very similar for all products. Symbicort^® Turbuhaler^® is the latest member and has some new features: these include a re-designed mouthpiece with improved fit in the mouth and a more informative dose indicator. The dose indicator has division marks for every 10th dose, and every 20th dose is displayed numerically.

Rhinocort^® Turbuhaler^® has a specially designed nasal adaptor instead of a mouthpiece.

Symbicort^® Turbuhaler^® dose indicator marks every 10th dose, and every 20th dose is displayed numerically. It turns red when the inhaler is empty.

During the last years there have been discussions within the medical community with regard to milk protein allergy from lactose containing dry powder inhalers. This issue is complicated because there is a need to differentiate between ''milk allergy'' and lactose intolerance. Affected patients should consult their doctor to clarify which category they fit in, as patients with a lactose intolerance will often quote that they have a "milk allergy" given that this is a common source of lactose.

Generally, milk allergy is not considered to be a contraindication to treatment neither with tablets containing lactose nor inhalation products containing lactose. Lactose is commonly present in pharmaceutical products, but do not appear to have caused clinical problems on a general scale. However, although the amount of lactose is small in Turbuhaler^® products (Oxis^® and Symbicort^®) and the amount of milk protein residuals will be extremely small, such reactions cannot be excluded. If a specific patient did react with life threatening anaphylaxis to milk protein, one should consider the theoretical possibility that the protein fragments in lactose could still have antigenic properties in that patient. Patients with such known hypersensitivity to milk protein should therefore be treated with Pulmicort^® and Bricanyl^® Turbuhaler^®, which contain only pure drug substance.

Patients with lactose intolerance, which is an inborn incapability to absorb lactose from the intestine, seldom experience gastrointestinal symptoms after use of Oxis^® and Symbicort^® Turbuhaler^®, as the amounts of lactose are small and a high proportion of the delivered dose is deposited in the lungs.