Indications
Budesonide is a corticosteroid (steroid) medicine that reduces inflammation. It comes in several forms:
- Inhaler or nebuliser solution: to prevent asthma symptoms and attacks, and in some people with COPD. Nebuliser solution is also used for croup in children.
- Nasal spray: for allergic rhinitis (hay fever) and nasal polyps.
- Capsules or tablets taken by mouth: for Crohn’s disease and ulcerative colitis, as prescribed by a specialist.
How It Works
Budesonide calms inflammation and swelling in the lining of the airways, nose or gut. Used regularly, it makes the airways less sensitive and reduces attacks. It acts mainly where it is applied, and much of any swallowed amount is broken down by the liver, so it has fewer whole-body effects than steroid tablets such as Prednisolone.
Dosage and Administration
- Inhaler, adults: as prescribed, commonly 200 to 400 mcg twice a day; the doctor adjusts it to the lowest dose that controls symptoms.
- Nebuliser solution: as prescribed, by a doctor or with clear instructions from one.
- Nasal spray, adults: usually 1 to 2 sprays in each nostril once or twice a day, as directed on the pack; reduce to the lowest dose that works.
- Capsules or tablets for bowel disease: as prescribed.
- Children: only as prescribed.
Use inhalers every day, even when well; they do not relieve a sudden attack. Rinse your mouth with water and spit it out after each inhaled dose. Do not stop tablets or capsules suddenly after long use.
Interactions
Some medicines raise budesonide levels and increase steroid side effects, such as Ketoconazole, Itraconazole, Clarithromycin and HIV medicines such as Ritonavir. Grapefruit juice can also raise levels of the tablets and capsules. Other steroids add to its effects.
Contraindications
- Allergy to budesonide or any ingredient of the product.
- Untreated fungal, bacterial or viral infections of the area being treated, such as untreated tuberculosis of the lungs for inhaled forms.
- Tablets and capsules: severe liver disease.
Side Effects
Inhaled: hoarse voice, sore throat, cough and oral thrush (white patches in the mouth). Nasal: dryness, irritation and small nosebleeds. By mouth: indigestion, acne, mood changes, swelling and, with long use, typical steroid effects such as weight gain and raised blood sugar.
Get urgent medical help if breathing suddenly worsens right after using the inhaler, for signs of a serious allergy, severe infection or fever, vision changes such as blurring, or, after long use of tablets, severe tiredness, dizziness, vomiting or fainting during illness.
Pregnancy and Lactation
Inhaled and nasal budesonide is widely used in pregnancy and breastfeeding when needed, because uncontrolled asthma is more risky for mother and baby. Use the lowest effective dose and follow your doctor’s advice. Tablets and capsules are used only if a doctor decides they are needed.
Precautions and Warnings
- Inhaled budesonide does not stop a sudden asthma attack; carry a quick-relief inhaler such as Salbutamol.
- See a doctor if you need your reliever more often, as asthma may be getting worse.
- Long-term or high-dose use may affect growth in children, bones, eyes (cataract, glaucoma) and blood sugar; regular reviews are needed.
- Avoid contact with chickenpox or measles if you have not had them, and tell your doctor if exposed.
- Use with care in liver disease, tuberculosis and diabetes.
Overdose
A single extra dose is unlikely to cause harm. Using too much for a long time can cause steroid side effects such as weight gain, a round face, high blood sugar and weak bones. Contact a doctor; do not stop suddenly without advice.
Therapeutic Class
Corticosteroid (inhaled, nasal and gut-acting glucocorticoid).
Storage
Store below 30°C, away from light and moisture. Do not freeze. Keep nebuliser ampoules in their foil pouch until use. Do not puncture or burn inhaler canisters. Keep out of reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.