Budesonide

Indications
 Oral
Inflammatory bowel disease
Adult: Active disease: 9 mg daily; up to 8 wk, reduce dose before stopping therapy. Recurring episodes of active disease: May repeat an 8-wk course. Maintenance of remission: 6 mg once daily, for up to 3 mth; thereafter, gradually reduce dose before stopping treatment.
Hepatic impairment: Dose reduction may be needed.
Nasal
Treatment and prophylaxis of rhinitis
Adult: Initially, 200 mcg into each nostril daily, reduced to 100 mcg into each nostril daily until symptoms are controlled. Or initially, 100 mcg into each nostril bid.
Nasal
Nasal polyps
Adult: 100 mcg bid into each nostril up to 3 mth.
Inhalation
Asthma
Adult: MDI: 400 mcg daily in 2 divided doses, increased up to 1.6 mg daily in severe cases. Maintenance: 200-400 mcg daily. As dry powd inhaler: 200-800 mcg daily in single dose or 2 divided doses. As nebulised solution: Usual dose: 1-2 mg inhaled bid. Maintenance dose: 0.5-1 mg bid.
Child: MDI: 50-400 mcg bid. Nebulised solution: 3 mth-12 yr: Initially, 0.5-1 mg bid. Maintenance dose: 0.25-0.5 mg bid.
Max Dosage: Adult: Dry powd inhaler: 800 mcg bid.

Special Populations: Budesonide is not indicated for acute attacks of asthma. Patients should be instructed to rinse the mouth with water after each dosing.
Contraindications
 Hypersensitivity. Acute infections uncontrolled by antimicrobial chemotherapy.
Warnings / Precautions
 Active or doubtfully quiescent tuberculosis, paradoxical bronchospasm; children, elderly; pregnancy, lactation.
Adverse Reactions
 Loss of skin collagen and SC atrophy; local hypopigmentation of deeply pigmented skin; dryness, irritation, epistaxis, rarely ulceration or perforation of the nasal septum; smell and taste disturbances; hoarseness and candidiasis of the mouth or throat.
Mechanism of Actions
 Budesonide controls the rate of protein synthesis, depresses the migration of polymorphonuclear leukocytes, fibroblasts, reverses capillary permeability and lysosomal stabilisation at the cellular level to prevent or control inflammation.
Absorption: Rapid and almost complete after oral admin but has poor systemic availability.
Metabolism: Undergoes first-pass metabolism.
Administration
 Should be taken with food. (Swallow whole, do not chew/crush. Avoid grapefruit juice.)
Storage Conditions
 Inhalation: Store at 20-25°C. Nasal: Store at 20-25°C. Oral: Store at 20-25°C.
ATC Classification
 D07AC09 - budesonide ; Belongs to the class of potent (group III) corticosteroids. Used in the treatment of dermatological diseases.
A07EA06 - budesonide ; Belongs to the class of corticosteroids acting locally. Used in the treatment of intestinal inflammation.
R01AD05 - budesonide ; Belongs to the class of topical corticosteroids used for prophylaxis and treatment of allergic rhinitis.
R03BA02 - budesonide ; Belongs to the class of other inhalants used in the treatment of obstructive airway diseases, glucocorticoids.
Storage
 Inhalation: Store at 20-25°C. Nasal: Store at 20-25°C. Oral: Store at 20-25°C.
Available As
  • Budesonide 0.02% w/v
  • Budesonide 0.25 mg
  • Budesonide 0.5 mg
  • Budesonide 1 mg
  • Budesonide 100 mcg
  • Budesonide 200 mcg
  • Budesonide 3 mg
  • Budesonide 400 mcg
  • Budesonide 50 mcg
  • Budesonide 64 mcg

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