DuoResp Spiromax

Easy-to-read medicine information about DuoResp Spiromax – what it is, how to use it safely and possible side effects.

What is DuoResp Spiromax?

DuoResp Spiromax is a combination of 2 medicines, budesonide and formoterol, in a single inhaler. DuoResp Spiromax is used to treat the symptoms of asthma and COPD and to prevent them from recurring.

  • Budesonide is a corticosteroid. When inhaled it prevents swelling and irritation in the walls of the small air passages in your lungs. It is also called a preventer, because when used every day it prevents shortness of breath and wheezing.
  • Formoterol is a long-acting, fast onset bronchodilator. It relaxes and opens up your air passages, making breathing easier. 

In New Zealand, DuoResp Spiromax is available in different strengths: DuoResp Spiromax 200/6 and DuoResp Spiromax 400/12.

DuoResp Spiromax has different uses


If you are using DuoResp Spiromax for COPD, it must be used twice a day every day as a preventer. Read more about medicines for COPD.


If you are using DuoResp Spiromax for asthma, it can be prescribed in three different ways:

  • regular preventer (and using a different inhaler as a reliever such as salbutamol)
  • regular preventer plus also using the same inhaler as a reliever when needed
  • reliever only without also taking it as a preventer.

The choice between these three options should be discussed with your doctor, and is based on the severity of your symptoms.


Mild asthma

If you have mild asthma, you can use DuoResp Spiromax as a reliever, without needing to use it regularly. This is called AIR therapy (anti-inflammatory reliever therapy). 

Moderate to severe asthma

If you have moderate to severe asthma, you can use your DuoResp Spiromax as a preventer only or as a preventer and a reliever. This is called SMART (which stands for single maintenance and reliever therapy). This means that you can use your DuoResp Spiromax regularly each day for symptom prevention, and also when needed for symptom relief.

Preventer: Use DuoResp Spiromax every day, once or twice daily.
Reliever: One inhalation when needed for shortness of breath. You can repeat as required, up to a maximum of 12 inhalations in one day. If you need to take more and more doses each day, see your doctor to assess your therapy. Read more about the SMART action plan.

Tips for when using DuoResp Spiromax

  • Always use your inhaler exactly as your doctor has told you. The pharmacy label on your medicine tells you how much to take, how often to take it and any special instructions.
  • DuoResp Spiromax is available in different strengths. Ask your doctor or pharmacist which strength you are taking. If your inhaler looks different to what you were expecting, ask your pharmacist about this.
  • Rinse your mouth after each use. DuoResp Spiromax can cause a sore throat and hoarse voice. Rinse your mouth after each use to prevent this.

How to use your DuoResp Spiromax

To get the most benefit, it is important to use the correct technique when using your DuoResp Spiromax. Ask your doctor, pharmacist or nurse to explain how to use your inhaler. Even if you have been shown before, ask your doctor, pharmacist or nurse to explain how to use your inhaler if you still have any questions. 

Precautions – before using DuoResp Spiromax

  • Are you pregnant or breastfeeding?
  • Are you lactose intolerant?
  • Have you ever had pulmonary tuberculosis (TB)?
  • Do you have heart disease?
  • Do you have an overactive thyroid (hyperthyroid)?
  • Do you have high blood pressure (hypertension)?
  • Do you have diabetes?
  • Do you have an irregular heartbeat or rhythm, including a very fast pulse?
  • Do you play competitive or professional sport?

If so, it’s important that you tell your doctor or pharmacist before you start using DuoResp Spiromax. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Side effects

Like all medicines DuoResp Spiromax can cause side effects, although not everyone gets them. Often side effects improve as your body adjusts to the new medicine.

Side effects What should I do?
  • Change in voice (hoarse voice)
  • Different taste in your mouth
  • Dry mouth or throat
  • Cough
  • These are quite common when you first start using your inhaler and usually go away with time. 
  • Rinse your mouth after each use
  • Tell your doctor if troublesome.
  • Signs of oral thrush (a fungal infection in your mouth) such as a very sore tongue, throat or mouth, with white sores on your tongue or in your mouth
  • Tell your doctor or pharmacist.
  • Feeling shaky
  • Nervousness
  • Tremor
  • Headache
  • Muscle cramps
  • Problems sleeping
  • These are quite common when you first start using your inhaler and usually go away with time. 
  • Tell your doctor if troublesome.
  • Changes in your heartbeat (faster)
  • Chest pain
  • Sudden changes in mood
  • Blurred vision or changes to your eyesight
  • Tell your doctor or phone Healthline 0800 611 116.

Learn more

Budesonide and formoterol NZ Formulary Patient Information
DuoResp Spiromax Medsafe Consumer Information Sheets, NZ


  1. Budesonide + formoterol NZ Formulary
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 16 Feb 2021