Budesonide Oral Inhalation - Revision history

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Prab at 01:05, 15 January 2025

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← Older revision		Revision as of 01:05, 15 January 2025
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	[[File:Budesonide ball-and-stick.png\|thumb\|Budesonide ball-and-stick]]		[[File:Budesonide ball-and-stick.png\|thumb\|Budesonide ball-and-stick]]


	<youtube>		<youtube>
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	== '''What are the uses of this medicine?''' ==		== '''What are the uses of this medicine?''' ==
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	* Budesonide Oral Inhalation does not treat the sudden symptoms (wheezing, cough, shortness of breath, and chest pain or tightness) of an asthma attack.		* Budesonide Oral Inhalation does not treat the sudden symptoms (wheezing, cough, shortness of breath, and chest pain or tightness) of an asthma attack.
	* Always have a short-acting beta2-agonist medicine (rescue inhaler) with you to treat sudden symptoms.		* Always have a short-acting beta2-agonist medicine (rescue inhaler) with you to treat sudden symptoms.


	== '''How does this medicine work?''' ==		== '''How does this medicine work?''' ==

	~~<youtube>~~
	~~title='''{{PAGENAME}}'''~~
	~~movie_url=http://www.youtube.com/v=QhmC_Kp6mko~~
	~~embed_source_url=http://www.youtube.com/v=QhmC_Kp6mko~~
	~~&rel=1~~
	~~wrap = yes~~
	~~width=750~~
	~~height=600~~
	~~</youtube>~~

	* Budesonide is '''an anti-inflammatory corticosteroid that exhibits potent glucocorticoid activity and weak mineralocorticoid activity'''.		* Budesonide is '''an anti-inflammatory corticosteroid that exhibits potent glucocorticoid activity and weak mineralocorticoid activity'''.
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	* Corticosteroids have been shown to have a wide range of '''inhibitory activities against multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages, and lymphocytes) and mediators (e.g., histamine, eicosanoids, leukotrienes, and cytokines)''' involved in allergic- and non-allergic-mediated inflammation.		* Corticosteroids have been shown to have a wide range of '''inhibitory activities against multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages, and lymphocytes) and mediators (e.g., histamine, eicosanoids, leukotrienes, and cytokines)''' involved in allergic- and non-allergic-mediated inflammation.
	* The anti-inflammatory actions of corticosteroids may contribute to their efficacy in asthma.		* The anti-inflammatory actions of corticosteroids may contribute to their efficacy in asthma.


	== '''Who Should Not Use this medicine ?''' ==		== '''Who Should Not Use this medicine ?''' ==
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	* In some pediatric patients, a starting dose of 360 mcg twice daily may be appropriate.		* In some pediatric patients, a starting dose of 360 mcg twice daily may be appropriate.
	* The maximum dosage should not exceed 360 mcg twice daily.		* The maximum dosage should not exceed 360 mcg twice daily.


	'''Administration:'''		'''Administration:'''
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	* Dispose of the inhaler after you have used the labeled number of inhalations even if it still contains some liquid and continues to release a spray when it is pressed.		* Dispose of the inhaler after you have used the labeled number of inhalations even if it still contains some liquid and continues to release a spray when it is pressed.
	* Do not swallow budesonide nebulizer suspension.		* Do not swallow budesonide nebulizer suspension.


	== '''What are the dosage forms and brand names of this medicine?''' ==		== '''What are the dosage forms and brand names of this medicine?''' ==
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	This medicine is available in fallowing brand namesː		This medicine is available in fallowing brand namesː
	* '''Pulmicort; Pulmicort Flexhaler; Pulmicort Respules'''		* '''Pulmicort; Pulmicort Flexhaler; Pulmicort Respules'''


	=='''What side effects can this medication cause?'''==		=='''What side effects can this medication cause?'''==
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	* Eye problems, including [[glaucoma]] and [[cataracts]]		* Eye problems, including [[glaucoma]] and [[cataracts]]
	* Increased [[wheezing]]		* Increased [[wheezing]]


	==''' What special precautions should I follow?''' ==		==''' What special precautions should I follow?''' ==


	* [[Candida albicans]] infection of the mouth and throat may occur. Monitor patients periodically for signs of adverse effects on the oral cavity. Advise patients to rinse the mouth following inhalation.		* [[Candida albicans]] infection of the mouth and throat may occur. Monitor patients periodically for signs of adverse effects on the oral cavity. Advise patients to rinse the mouth following inhalation.
	* Do not use for the relief of [[acute]] [[bronchospasm]].		* Do not use for the relief of [[acute]] [[bronchospasm]].
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	* Caution should be exercised when considering the co-administration of budesonide inhalation suspension with [[ketoconazole]], and other known strong CYP3A4 inhibitors (e.g., ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, telithromycin) because adverse effects related to increased systemic exposure to budesonide may occur.		* Caution should be exercised when considering the co-administration of budesonide inhalation suspension with [[ketoconazole]], and other known strong CYP3A4 inhibitors (e.g., ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, telithromycin) because adverse effects related to increased systemic exposure to budesonide may occur.
	* if you are having surgery, including dental surgery, tell the doctor or dentist that you are using budesonide.		* if you are having surgery, including dental surgery, tell the doctor or dentist that you are using budesonide.



	== '''What to do in case of emergency/overdose?''' ==		== '''What to do in case of emergency/overdose?''' ==
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	Management of overdosage:		Management of overdosage:
	* {{overdose}}		{{overdose}}


	== '''Can this medicine be used in pregnancy?''' ==		== '''Can this medicine be used in pregnancy?''' ==
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	* Budesonide powder for oral inhalation (Pulmicort Flexhaler) is used in adults and children 6 years of age and older.		* Budesonide powder for oral inhalation (Pulmicort Flexhaler) is used in adults and children 6 years of age and older.
	* Budesonide suspension (liquid) for oral inhalation (Pulmicort Respules) is used in children 12 months to 8 years of age.		* Budesonide suspension (liquid) for oral inhalation (Pulmicort Respules) is used in children 12 months to 8 years of age.


	== '''What are the active and inactive ingredients in this medicine?''' ==		== '''What are the active and inactive ingredients in this medicine?''' ==
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	* '''Active ingredient:''' budesonide		* '''Active ingredient:''' budesonide
	* '''Inactive ingredient:''' lactose		* '''Inactive ingredient:''' lactose


	== '''Who manufactures and distributes this medicine?''' ==		== '''Who manufactures and distributes this medicine?''' ==
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	* Bridgewater, NJ		* Bridgewater, NJ
	* Product of Spain		* Product of Spain


	== '''What should I know about storage and disposal of this medication?''' ==		== '''What should I know about storage and disposal of this medication?''' ==
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	* Keep Pulmicort Flexhaler dry.		* Keep Pulmicort Flexhaler dry.
	* Keep your Pulmicort Flexhaler with the cover tightly in place when not in use.		* Keep your Pulmicort Flexhaler with the cover tightly in place when not in use.



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	[[Category:Aldols]]		[[Category:Aldols]]
	[[Category:Antiasthmatic drugs]]		[[Category:Antiasthmatic drugs]]

Deepika vegiraju at 10:36, 4 December 2022

2022-12-04T10:36:41Z

New page

== '''What is Budesonide Oral Inhalation?''' ==

* Budesonide Oral Inhalation ('''Pulmicort'''; '''Pulmicort Flexhaler'''; '''Pulmicort Respules''') is '''an inhaled corticosteroid''' used in maintenance treatment of [[asthma]] and as [[prophylactic]] therapy.
* Budesonide powder for oral inhalation ('''Pulmicort Flexhaler''') is used in adults and children 6 years of age and older.
* Budesonide suspension (liquid) for oral inhalation ('''Pulmicort Respules''') is used in children 12 months to 8 years of age.

[[File:Budesonide.svg|thumb|Budesonide]]

[[File:Budesonide.png|thumb|Budesonide]]

[[File:Budesonide ball-and-stick.png|thumb|Budesonide ball-and-stick]]

<youtube>
title='''{{PAGENAME}}'''
movie_url=http://www.youtube.com/v=EenQgAnxQSA
embed_source_url=http://www.youtube.com/v=EenQgAnxQSA
&rel=1
wrap = yes
width=750
height=600
</youtube>

== '''What are the uses of this medicine?''' ==

* Budesonide inhalation suspension ('''Pulmicort Respules''') is a long-term maintenance medicine used to control and prevent [[asthma]] symptoms in children ages 12 months to 8 years.
* Budesonide powder for oral inhalation (Pulmicort Flexhaler) is used for long-term (maintenance) treatment of asthma and to prevent asthma symptoms in adults and children 6 years of age and older.

* Inhaled corticosteroids help to decrease inflammation in the lungs.
* Inflammation in the lungs can lead to asthma symptoms.
* Budesonide inhalation suspension helps reduce swelling and inflammation in the lungs, and helps keep the airways open to reduce asthma symptoms.

'''Limitations of use:'''
* Budesonide Oral Inhalation does not treat the sudden symptoms (wheezing, cough, shortness of breath, and chest pain or tightness) of an asthma attack.
* Always have a short-acting beta2-agonist medicine (rescue inhaler) with you to treat sudden symptoms.

== '''How does this medicine work?''' ==

<youtube>
title='''{{PAGENAME}}'''
movie_url=http://www.youtube.com/v=QhmC_Kp6mko
embed_source_url=http://www.youtube.com/v=QhmC_Kp6mko
&rel=1
wrap = yes
width=750
height=600
</youtube>

* Budesonide is '''an anti-inflammatory corticosteroid that exhibits potent glucocorticoid activity and weak mineralocorticoid activity'''.
* The precise mechanism of corticosteroid actions on inflammation in asthma is not well known.
* Inflammation is an important component in the pathogenesis of asthma.
* Corticosteroids have been shown to have a wide range of '''inhibitory activities against multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages, and lymphocytes) and mediators (e.g., histamine, eicosanoids, leukotrienes, and cytokines)''' involved in allergic- and non-allergic-mediated inflammation.
* The anti-inflammatory actions of corticosteroids may contribute to their efficacy in asthma.

== '''Who Should Not Use this medicine ?''' ==

This medicine cannot be used in patients:
* to treat sudden symptoms of asthma
* if your child is allergic to budesonide or any of the ingredients in budesonide inhalation suspension.

== '''What drug interactions can this medicine cause?''' ==

* Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Be sure to mention any of the following:
* [[antifungals]] such as itraconazole (Onmel, Sporanox) and ketoconazole (Nizoral)
* [[clarithromycin]] (Biaxin)
* HIV [[Protease inhibitor|protease inhibitors]] such as atazanavir (Reyataz, in Evotaz), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra, in Viekira Pak, others), and saquinavir (Invirase)
* medications for [[seizures]], [[nefazodone]]
* oral [[steroids]] such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos)
* [[telithromycin]] (Ketek)

== '''Is this medicine FDA approved?''' ==

* '''Initial U.S. Approval:''' 2000

== '''How should this medicine be used?''' ==

'''Recommended dosage:'''
'''Budesonide inhalation suspension (Pulmicort Respules):'''
* Recommended dosing based on previous therapy.

'''Start with the lowest recommended dose:'''
* Bronchodilators alone: 0.25 mg twice daily
* Inhaled corticosteroids: 0.25 mg twice daily up to 0.5 mg twice daily
* Oral corticosteroids: 0.5 mg twice daily
* Once asthma stability is achieved, titrate the dose downwards.

'''Budesonide powder for oral inhalation (Pulmicort Flexhaler):'''
'''Patients 18 Years of Age and Older:'''
* For patients 18 years of age and older, the recommended starting dosage is 360 mcg twice daily.
* In some adult patients, a starting dose of 180 mcg twice daily may be adequate.
* The maximum dosage should not exceed 720 mcg twice daily.

'''Patients 6 to 17 Years of Age:'''
* The recommended starting dosage is 180 mcg twice daily.
* In some pediatric patients, a starting dose of 360 mcg twice daily may be appropriate.
* The maximum dosage should not exceed 360 mcg twice daily.

'''Administration:'''
* Budesonide comes as a powder to inhale by mouth using an inhaler and as a suspension to inhale by mouth using a special [[jet nebulizer]] (machine that turns medication into a mist that can be inhaled).
* Budesonide powder for oral inhalation is usually inhaled twice a day.
* Budesonide suspension for oral inhalation is usually inhaled once or twice a day.
* Try to use budesonide at around the same time(s) every day.
* If you were taking an oral steroid such as [[dexamethasone]], [[methylprednisolone]] (Medrol), or [[prednisone]] (Rayos), your doctor may want to gradually decrease your steroid dose starting after you begin to use budesonide.
* Budesonide controls symptoms of asthma but does not cure it.
* Improvement in your asthma may occur as soon after using the medication, but full effects of may not be seen for 1 to 2 weeks after using the powder and 4 to 6 weeks after using the suspension on a regular basis. Continue to use budesonide even if you feel well.
* Do not stop using budesonide without talking to your doctor.
* Each budesonide inhaler is designed to provide 60 or 120 inhalations, depending on its size.
* After the labeled number of inhalations has been used, later inhalations may not contain the correct amount of medication.
* You should keep track of the number of inhalations you have used.
* Dispose of the inhaler after you have used the labeled number of inhalations even if it still contains some liquid and continues to release a spray when it is pressed.
* Do not swallow budesonide nebulizer suspension.

== '''What are the dosage forms and brand names of this medicine?''' ==

This medicine is available in fallowing doasage form:
* As Inhalation suspension: 0.25 mg/2 mL and 0.5 mg/2 mL.
* FLEXHALER device containing budesonide (90 mcg or 180 mcg) as an inhalation powder

This medicine is available in fallowing brand namesː
* '''Pulmicort; Pulmicort Flexhaler; Pulmicort Respules'''

=='''What side effects can this medication cause?'''==

The most common side effects of this medicine include:
* respiratory infections. Symptoms may include stuffy nose, sore nose and throat.
* [[runny nose]]
* cough
* viral infections
* viral irritation and [[inflammation]] of the stomach and intestine ([[gastroenteritis]]).
* Gastroenteritis symptoms may include: stomach area pain, [[diarrhea]], nausea and vomiting, and [[loss of appetite]].
* ear infections
* [[nosebleed]]
* pink eye ([[conjunctivitis]])
* rash

Budesonide Oral Inhalation may cause serious side effects which may include:
* thrush ([[candida]]), a fungal infection in your mouth and throat
* worsening of [[asthma]] or sudden asthma attacks
* allergic reactions
* [[Immune system]] effects and a higher chance of infections
* [[Adrenal insufficiency]]
* Decrease in [[bone mineral density]]
* Slowed or delayed growth problems in children
* Eye problems, including [[glaucoma]] and [[cataracts]]
* Increased [[wheezing]]

==''' What special precautions should I follow?''' ==

* [[Candida albicans]] infection of the mouth and throat may occur. Monitor patients periodically for signs of adverse effects on the oral cavity. Advise patients to rinse the mouth following inhalation.
* Do not use for the relief of [[acute]] [[bronchospasm]].
* [[Anaphylaxis]], [[rash]], [[Contact dermatitis|contact dermatitis]], [[urticaria]], [[angioedema]], and [[bronchospasm]] have been reported with use of budesonide inhalation suspension. Discontinue budesonide inhalation suspension if such reactions occur.
* Potential worsening of infections (e.g., existing [[tuberculosis]], fungal, bacterial, viral, or parasitic infection; or ocular [[herpes simplex]]). Use with caution in patients with these infections. More serious or even fatal course of [[chickenpox]] or [[measles]] can occur in susceptible patients.
* Risk of impaired adrenal function when transferring from oral steroids. Taper patients slowly from systemic corticosteroids if transferring to budesonide inhalation suspension.
* [[Hypercortisolism|Hypercorticism]] and adrenal Suppression may occur with very high dosages or at the regular dosage in susceptible individuals. If such changes occur, reduce budesonide inhalation suspension slowly.
* Decreases in [[bone mineral density]] (BMD) have been observed with long-term administration of products containing inhaled corticosteroids. Monitor patients with major risk factors for decreased bone mineral content.
* Orally inhaled corticosteroids, including budesonide, may cause a reduction in growth velocity when administered to pediatric patients. Monitor growth of pediatric patients.
* [[Glaucoma]], increased [[intraocular pressure]], and [[cataracts]] have been reported following the long-term administration of inhaled corticosteroids, including budesonide. Therefore, close monitoring is warranted in patients with a change in vision or with a history of increased intraocular pressure, glaucoma, and/or cataracts.
* As with other inhaled asthma medications, [[bronchospasm]], with an immediate increase in wheezing, may occur after dosing. If acute bronchospasm occurs following dosing with budesonide inhalation suspension, it should be treated immediately with a fast-acting inhaled [[bronchodilator]].
* In rare cases, patients on inhaled corticosteroids may present with systemic eosinophilic conditions. Some of these patients have clinical features of vasculitis consistent with [[Churg-Strauss syndrome]], a condition that is often treated with systemic corticosteroids therapy.
* Caution should be exercised when considering the co-administration of budesonide inhalation suspension with [[ketoconazole]], and other known strong CYP3A4 inhibitors (e.g., ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, telithromycin) because adverse effects related to increased systemic exposure to budesonide may occur.
* if you are having surgery, including dental surgery, tell the doctor or dentist that you are using budesonide.

== '''What to do in case of emergency/overdose?''' ==

Symptoms of overdose may include:
* [[hypercorticism]] or growth suppression

Management of overdosage:
* {{overdose}}

== '''Can this medicine be used in pregnancy?''' ==

* There are no adequate well-controlled studies of budesonide inhalation suspension in pregnant women.
* There are no adequate well-controlled studies of Pulmicort Flexhaler in pregnant women.

=='''Can this medicine be used in children?'''==

* Budesonide powder for oral inhalation (Pulmicort Flexhaler) is used in adults and children 6 years of age and older.
* Budesonide suspension (liquid) for oral inhalation (Pulmicort Respules) is used in children 12 months to 8 years of age.

== '''What are the active and inactive ingredients in this medicine?''' ==

'''Budesonide inhalation suspension:'''
* Active ingredient: budesonide
* Inactive ingredients: sodium chloride, disodium edetate, polysorbate 80, citric acid, tri sodium citrate, and water for injection.

'''Budesonide powder for oral inhalation (Pulmicort Flexhaler):'''
* '''Active ingredient:''' budesonide
* '''Inactive ingredient:''' lactose

== '''Who manufactures and distributes this medicine?''' ==

'''Budesonide powder for oral inhalation (Pulmicort Flexhaler):'''
* Manufactured for: [[AstraZeneca Pharmaceuticals LP]], Wilmington DE 19850
* By: AstraZeneca AB, Södertälje, Sweden
* Product of Sweden

'''Budesonide inhalation suspension:'''
'''Manufactured by:'''
* [[Catalent Pharma Solutions]]
* Woodstock, IL USA

'''Manufactured for:'''
* [[Amneal Pharmaceuticals LLC]]
* Bridgewater, NJ
* Product of Spain

== '''What should I know about storage and disposal of this medication?''' ==

'''Budesonide inhalation suspension:'''
* Store budesonide inhalation suspension in an upright position between 68° to 77°F (20° to 25°C).
* Keep budesonide inhalation suspension in the aluminum foil envelope to protect from light until ready to use.
* After a budesonide inhalation suspension ampule is opened it should be used right away.
* Budesonide inhalation suspension ampules can be stored for 2 weeks after opening the protective aluminum foil envelope.
* Throw away budesonide inhalation suspension ampules if not used within 2 weeks of opening the protective aluminum foil envelope.
* Do not refrigerate or freeze.

'''Budesonide powder for oral inhalation (Pulmicort Flexhaler):'''
* Store Pulmicort Flexhaler at 68° to 77°F (20° to 25°C).
* Keep Pulmicort Flexhaler dry.
* Keep your Pulmicort Flexhaler with the cover tightly in place when not in use.

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