GENERIC NAME: budesonide (oral inhalation)
BRAND NAME: Pulmicort, Pulmicort Flexhaler
DISCONTINUED BRANDS: Pulmicort Respules, Pulmicort Turbuhaler
DRUG CLASS AND MECHANISM: Budesonide is a man-made glucocorticoid steroid related to the naturally-occurring hormone, cortisol or hydrocortisone which is produced in the adrenal glands. It is used for treating asthma by inhalation. Glucocorticoid steroids such as cortisol or budesonide have potent anti-inflammatory actions that reduces inflammation and hyper-reactivity (spasm) of the airways caused by asthma. When used as an inhaler, the budesonide goes directly to the inner lining of the inflamed airways to exert its effects. Only 39% of an inhaled dose of budesonide is absorbed into the body, and the absorbed budesonide contributes little to the effects on the airways. While some improvement in the symptoms of asthma may occur within 24 hours, it may take a few weeks to obtain the maximum therapeutic benefits of budesonide when used to treat asthma.
PRESCRIBED FOR: The budesonide inhaler is used for the control of asthma in persons requiring continuous, prolonged treatment. Such patients may include those with frequent asthmatic episodes requiring bronchodilators, for example, albuterol (Ventolin HFA and Proventil HFA) or those with asthmatic episodes at night.
- The most commonly noted side effects associated with inhaled budesonide are mild cough or wheezing; these effects may be minimized by using a bronchodilator inhaler, for example, albuterol (Ventolin HFA), prior to the budesonide.
- Oral candidiasis or thrush (a fungal infection of the throat) may occur in 1 in 25 persons who use budesonide without a spacer device on the inhaler. The risk is even higher with large doses, but is less in children than in adults.
- Hoarseness or sore throat also may occur in 1 in 10 persons. Using a spacer device on the inhaler and washing the mouth out with water following each use reduces the risk of both thrush and hoarseness.
- Less commonly, alterations in voice may occur.
High doses of inhaled glucocorticoid steroids may decrease the formation and increase the breakdown of bone leading to weakened bones and ultimately osteoporosis and fractures. High doses may suppress the body's ability to make its own natural glucocorticoid in the adrenal gland. It is possible that these effects are shared by budesonide. People with suppression of their adrenal glands (which can be tested for by the doctor) need increased amounts of glucocorticoid steroids orally or intravenously during periods of high physical stress, for example, during infections, to prevent serious illness and shock.
Hypersensitivity reactions, which have been reported with the issue of inhaled budesonide include
Use of budesonide should be discontinued if such reactions occur.
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