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Budesonide, Pulmicort, Turbuhaler, Rhinocort

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Budesonide, Blue Cross Blue Shield of Massachusetts (BCBSMA):"Tell your doctor your medical history, especially of: liver problems, tuberculosis, high blood pressure, diabetes, brittle bones (osteoporosis), stomach problems (e.g., peptic ulcer), personal or family history of eye problems (e.g., cataracts, glaucoma), any allergies (especially to other steroid medications like prednisone). Avoid contact with people currently infected with the chicken pox or the measles. Consult your doctor immediately if you think you have been exposed to the chicken pox or measles virus. Serious infection or injury, emotional stress, or major surgery may increase your bodies need for steroids. Consult your doctor or pharmacist for details. Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding."
http://www.ahealthyme.com/viewmonograph?selectedDrugId=274798&selectedDrugDescription=Budesonide+Oral+Capsule%2C+SR+24HR+3+mg

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Budesonide, Canadian Lung Association:"Gen-Budesonide Aq nasal spray contains budesonide. Form: metered dose pump. Route: Nasalinhalation. Budesonide is indicated for the prevention, and reduction of severity of asthma symptoms that are responsive to orally inhaled corticosteroids. It is also used intranasally to relieve nasal congestion in the treatment of seasonal and perennial rhinitis (runny nose) where inflammation of the lining of the nose causes it to run. Budesonide nasal preparations are also used in the treatment of nasal polyps and prevention of nasal polyps after surgical removal. Budesonide nasal spray is used to relieve nasal congestion in the treatment seasonal and perennial rhinitis (runny nose) where inflammation of the lining of the nose causes it to run. Budesonide nasal spray is also used to treat nasal polyps and to prevent nasal polyps after surgical removal."
http://www.lung.ca/drugs/pages/318.html

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Budesonide, Crohn's & Colitis Foundation of America, Inc.:"Back in the 1950s, doctors realized that corticosteroids could suppress severe attacks of ulcerative colitis and Crohn's disease. For many inflammatory bowel disease (IBD) sufferers, these potent anti-inflammatory drugs are still the only effective therapy. But steroids can cause serious side effects, especially if long-term treatment is needed. Thus, one of researchers' goals is to develop a steroid that is as powerful as those currently in use, yet is far less toxic. The primary steroid that has been undergoing clinical trials in Europe and North America is budesonide, a highly potent drug. Studies in laboratory mice and preliminary tests in humans have shown considerable promise. But extensive tests must be conducted in humans before researchers can confirm whether budesonide answers the need for a better steroid. A budesonide enema has proved as effective as 5-ASA and hydrocortisone enemas for people with ulcerative proctosigmoiditis (colitis that is limited to the rectum and the lower portion of the colon). However, the Food & Drug Administration (FDA) has not yet approved this drug for distribution in the U.S. Meanwhile, researchers are testing budesonide tablets. Unlike prednisone, oral budesonide delays its release until it reaches the terminal ileum (the junction of the small intestine and the colon). Once budesonide is absorbed into the bloodstream, approximately 90% of the drug is inactivated. Researchers theorize that because little of the drug is carried to the rest of the body, its side effects should be minimal."
http://www.ccfa.org/medcentral/research/clinical/budeson.htm

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Budesonide, Crohn's & Colitis Foundation of America, Inc.:"Recent research has indicated that budesonide, a steroid that has been approved by the FDA only for the treatment of respiratory disease, may be as effective in treating IBD (inflammatory bowel disease) as fellow steroids prednisone and prednisolone--with fewer side effects. Now, budesonide has proved more effective than mesalamine, a 5-ASA preparation, in treating certain patients with active Crohn's disease. Dr. Ole Ostergaard Thomsen and colleagues (The International Budesonide-Mesalamine Study Group) report these findings in the August 6, 1998 issue of The New England Journal of Medicine."
http://www.ccfa.org/news/news821.htm

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Budesonide, The Cochrane Library:"A substantive amendment to this systematic review was last made on 29 June 1999. Cochrane reviews are regularly checked and updated if necessary. Background: Inhaled budesonide is a widely used inhaled corticosteroid for asthma. Objectives: The objectives of this review was to compare the efficacy of budesonide with placebo in the treatment of chronic asthma. Search strategy: The Cochrane Airways Group Trial Register and reference lists of articles was searched. We contacted trialists for additional studies and searched abstracts of major respiratory society meetings (1997-1999). Selection criteria: Randomised trials in children and adults comparing budesonide to placebo in the treatment of chronic asthma. Data collection and analysis: Two reviewers independently assessed articles for inclusion and methodological quality. One reviewer extracted data. Main results: 43 studies met the inclusion criteria (2801 subjects). In non-oral steroid treated asthmatics, budesonide led to significant improvements in a number of measures of airway function. These included FEV1, Weighted Mean Difference (WMD) 3.7% predicted (95% CI 0.1, 7.2%); improvement in morning peak flow (PEF) from baseline WMD 29 L/min (95% CI 22, 36 L/min); improvement in evening PEF from baseline WMD 21 L/min (95% CI 13, 29 L/min). Varying methods of reporting symptoms limited the pooling of studies but all high methodological quality studies demonstrated significant improvements compared to placebo. Health status was not reported. Risk of trial withdrawal due to asthma exacerbation was lower with budesonide compared to placebo, relative risk 0.17 (95% CI 0.09, 0.33). Doses of 500-800 mcg/d appeared to have slightly larger effect sizes than lower doses, but no advantage for high doses were apparent. A single high quality RCT reported significant reductions in daily prednisolone requirement and the number of patients able to discontinue prednisolone completely in budesonide treated subjects compared to placebo. No difference in risk of oropharyngeal soreness/hoarseness or oral Candidiasis was apparent for budesonide compared to placebo. Long-term risk of adrenal insufficiency was not reported."
http://www.cochrane.org/cochrane/revabstr/ab003274.htm

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Budesonide, Doctor's Guide:"United Kingdom Approves Symbicort Turbohaler (Budesonide/Eformoterol) for Asthma in Adolescents Twelve and Older. LONDON, ENGLAND -- April 15, 2002 -- Symbicort Turbohaler® (budesonide/eformoterol) from AstraZeneca has been granted a license in the United Kingdom for use in adolescents (age 12 years and older), providing healthcare professionals with a highly effective, adjustable treatment option. "Any doctor or nurse treating teenage asthma patients will tell you of the difficulties they face," commented Dermot Ryan, MD a member of the General Practice Airways Group."
http://www.pslgroup.com/dg/2150ee.htm

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Pulmicort, Who is this for, Drug Digest:"This is an anti-inflammatory medication (corticosteroid) used in the prevention of asthma. It is not used to relieve an asthma attack. If an asthma attack occurs, use other medication as prescribed."
http://www.drugdigest.org/DD/DVH/Uses/0,3915,6048|Pulmicort,00.html

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Budesonide Inhalation, What is budesonide inhalation, Drugs.com:"Budesonide is a steroid. It prevents the release of substances in the body that cause inflammation.

Budesonide inhalation is used to prevent asthma attacks.

Budesonide may also be used for purposes other than those listed in this medication guide."
http://www.drugs.com/xq/cfm/pageid_0/htm_d04276A1.htm/type_mtm/tgid_36/bn_budesonide%20inhalation/qx/index.htm

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Pulmicort, Possible side effects, Drugstore.com:"SIDE EFFECTS, that may go away during treatment, include cough, runny nose, stomachache, and nose bleeds. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience wheezing, sinus infection, ear infection, or white patches in mouth or throat. CONTACT YOUR DOCTOR IMMEDIATELY if you experience swelling of the face, lips, or tongue; depression; irritability; or personality change. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist."
http://www.drugstore.com/pharmacy/prices/drugprice.asp?ndc=00186198804&trx=1Z5006

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Rhinocort, Most important fact about this drug, Health Square:"Because steroids can suppress the immune system, people taking Rhinocort may become more susceptible to infections, and their infections could be more severe. Anyone taking Rhinocort or other corticosteroids who has not had infections such as chickenpox and measles should avoid exposure to them. If you are taking Rhinocort and are exposed, tell your doctor immediately."
http://www.healthsquare.com/newrx/rhi1378.htm

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Budesonide, Journal Club:" The primary endpoints were the rates of severe and mild exacerbations of asthma per patient per year. Severe exacerbations were those that required treatment with oral steroids (as judged by the investigators, and which was fixed at 10 days of treatment) or that produced a decrease in peak flow of greater than 30% from baseline for at least two consecutive days. Patients with 3 severe exacerbations within 3 months or 5 severe exacerbations total were withdrawn from the study."
http://www.journalclub.org/vol2/a57.html

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Pulmicort Nebuamp, How does this medication work, Mediresource.com:"Budesonide is a corticosteroid used for the treatment of asthma. It helps to control asthma symptoms and prevent asthma attacks by controlling the swelling and inflammation in the airways of the lungs. It will not relieve an asthma attack once it has already started.

The nebulized form of this medication has been developed specifically for people who are unable to efficiently use other forms of this medication (e.g., inhalers)."
http://www.mediresource.com/zellers/health/DrugInfo.asp?BrandNameID=955

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Budesonide, How should this medicine be used, MEDLINEplus:"Budesonide comes as an aerosol nasal spray to be sprayed in the nose. Budesonide usually is used once or twice a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use budesonide exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor."
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a601030.html

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Budesonide, National Asthma Council:"Budesonide has been approved for once daily use in adults with asthma controlled by 400mcg or less of inhaled steroid per day. Its potency is approximately equivalent to beclomethasone. It is available as an MDI and a Turbuhaler. It is anticipated that it will soon be available in combination with eformoterol See Combination Medications. When changing to a Turbuhaler from a budesonide MDI and spacer, if the patient is stable, a lower dose may maintain symptom control and lung function."
http://www.nationalasthma.org.au/publications/amh/med_preventer_bu.htm

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Rhinocort, What side effects may occur, PDR.net:"More common side effects may include: Airway spasm, increased coughing, irritation of the nasal passages, nosebleeds, sore throat.

Less common side effects may include: Bad taste in mouth, dry mouth, facial swelling, hoarseness, indigestion, inflammation of the skin, itching, muscle and joint pain, nasal sores or pain, nausea, nervousness, rash, reduced sense of smell, shortness of breath, yeast infection of the vagina or mouth, wheezing."
http://www.gettingwell.com/drug_info/rxdrugprofiles/drugs/RHI1378.shtml

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Budesonide, RxList:"The pharmacokinetics of budesonide have been studied following nasal, oral, and intravenous administration. Budesonide is relatively well absorbed after both inhalation and oral administration, and is rapidly metabolized into metabolites with low corticosteroid potency. The activity of budesonide nasal spray, nasal inhaler, and oral inhalation powder is due to the parent drug, budesonide. In glucocorticoid receptor affinity studies, the 22R form was two times as active as the 22S epimer. In vitro studies indicated that the two forms of budesonide do not interconvert. The 22R form was preferentially cleared by the liver with systemic clearance of 1.4 L/min vs. 1.0 L/min for the 22S form. The terminal half-life, 2-3 hours, was the same for both epimers and was independent of dose."
http://www.rxlist.com/cgi/generic/budesonide_cp.htm

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Budesonide, Range and Frequency, Whole Health Md:"Nasal inhalant: 2 sprays (32 micrograms [mcg] each) in each nostril in the morning and evening or 4 sprays in each nostril in the morning. Oral inhalation: 200 to 800 mcg (1 to 4 inhalations), 2 times a day. Highest dose for children is 400 mcg (2 inhalations), 2 times a day. The dose may be increased or decreased as determined by your doctor, based on the patient's response."
http://www.wholehealthmd.com/refshelf/drugs_view/1,1524,69,00.html

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Last updated by Andrew Lopez, RN on Monday, November 22, 2010


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