budesonide (oral inhalation, Pulmicort, Pulmicort Flexhaler)

  • Pharmacy Author:
    Eni Williams, PharmD, PhD

    Dr. Eni Williams graduated from Creighton University in 1988 with a B.S. degree in pharmacy and a Doctor of Pharmacy from Howard University in 1994. She also obtained a Ph.D. in Public Policy in 2009 at the University of Maryland, Baltimore County.

  • Medical Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

Asthma Attack Treatment

GENERIC AVAILABLE: Yes

PRESCRIPTION: Yes

PREPARATIONS:

  • Pulmicort Flexhaler (powder for inhalation), 90 mcg/act, 180 mcg/act.
  • Pulmicort (inhalation suspension), 0.25 mg/2ml, 0.5 mg/2ml suspension, and 1 mg/2ml

STORAGE: Budesonide should be stored at room temperature, 20 C - 25 C (68 F - 77 F).

DOSING: Budesonide is used to prevent asthmatic attacks and should not be used to treat an acute attack of asthma.

The Pulmicort Flexhaler

  • The Pulmicort Flexhaler is used for individuals six years of age or older.
  • Effects can be seen within 24 hours, but maximum effects may not be seen for 1-2 weeks or longer.
  • Doses vary widely.
  • Adults usually receive 2 to 4 puffs twice daily.
  • The starting dose for also is 2 to 4 puffs twice daily.
  • For those with mild asthma, treatment once daily may be sufficient.

Pulmicort

  • Pulmicort is used for individuals 12 months to eight years of age.
  • Effects are seen in 2 to 8 days, but maximum effects may not be seen for up to 4 to 6 weeks.
  • The usual dose is 0.5-1 mg daily taken in one or two divided doses. A lower starting dose of 0.25 mg once a day may be sufficient in some individuals.

DRUG INTERACTIONS: When budesonide is given with strong liver enzyme inhibitors (CYP 3A4 inhibitors) such as ketoconazole and other drugs including ritonavir (Norvir), atazanavir (Reyataz), clarithromycin (Biaxin, Biaxin XL), indinavir (Crixivan), itraconazole (Sporanox, Onmel), nefazodone, nelfinavir (Viracept), saquinavir (Invirase) and telithromycin (Ketek), the concentration in blood of budesonide may rise increasing the probability of an individual experiencing more side effects.

PREGNANCY: When given orally to animals, glucocorticoid steroids similar to budesonide have been shown to cause fetal abnormalities. Studies of pregnant women using inhaled budesonide during early pregnancy, however, do not show an increase in the rate of fetal abnormalities. Nevertheless, since these studies cannot exclude the possibility of rare effects on the fetus, inhaled budesonide should be used with caution during pregnancy.

NURSING MOTHERS: Budesonide like other drugs of its class is secreted in breast milk. It is not known whether the small amounts that may appear in breast milk have effects on the infant. Nevertheless, the benefits of breastfeeding an infant should be weighed against the possible risks associated with using budesonide in a nursing mother.

Reference: FDA Prescribing Information

Medically Reviewed by a Doctor on 9/22/2015

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