Budesonide
Budesonide (Rhinocort)
Budesonide
(byou- DES-oh-nyd)
Pregnancy Category: C Entocort Gen-Budesonide Aq. Pulmicort Nebuamp Pulmicort Turbuhaler Rhinocort Rhinocort Aqua Rhinocort Turbuhaler (Rx)

Classification: Corticosteroid

See Also: See also Corticosteroids .

Action/Kinetics: Exerts a direct local anti-inflammatory effect with minimal systemic effects when used intranasally. Exceeding the recommended dose may result in suppression of hypothalamic-pituitary-adrenal function. t 1/2: 2-3 hr. Metabolism of absorbed drug is rapid. Excreted through both urine and feces.

Uses: Treat symptoms of seasonal or perennial allergic rhinitis in adults and children over 6 years of age. Also, nonallergic perennial rhinitis in adults. The Turbuhaler is used for maintenance treatment of asthma as prophylaxis in adults and children 6 years of age and older; also for those requiring oral corticosteroid therapy for asthma.

Contraindications: Hypersensitivity to the drug. Untreated localized nasal mucosa infections. Lactation. Use in children less than 6 years of age or for acute or life-threatening asthma attacks, including status asthmaticus.

Special Concerns: Use with caution in clients already on alternate day corticosteroids (e.g., prednisone), in clients with active or quiescent tuberculosis infections of the respiratory tract, or in untreated fungal, bacterial, or systemic viral infections or ocular herpes simplex. Use with caution in clients with recent nasal septal ulcers, recurrent epistaxis, nasal surgery, or trauma. Exposure to chicken pox or measles should be avoided.

Side Effects: Respiratory: Nasopharyngeal irritation, nasal irritation, pharyngitis, increased cough, hoarseness, nasal pain, burning, stinging, dryness, epistaxis, bloody mucus, rebound congestion, bronchial asthma occasional sneezing attacks (especially in children), rhinorrhea, reduced sense of smell, throat discomfort, ulceration of the nasal mucosa, sore throat, dyspnea, localized infections of nose and pharynx with Candida albicans, wheezing (rare). CNS: Lightheadedness, headache, nervousness. GI: Nausea, loss of sense of taste, bad taste in mouth, dry mouth, dyspepsia. Miscellaneous: Watery eyes, immediate and delayed hypersensitivity reactions moniliasis, facial edema, rash, pruritus, herpes simplex, alopecia, arthralgia, myalgia, contact dermatitis (rare).

Overdose Management: Symptoms: Symptoms of hypercorticism, including menstrual irregularities, acneiform lesions, and cushingoid features (all are rarely seen, however). Treatment: Discontinue the drug slowly using procedures that are acceptable for discontinuing oral corticosteroids.

How Supplied: Inhalation Powder: 200 mcg/inh; Aerosol Aqua Nasal Spray

Dosage
?Inhalation Aerosol Powder Seasonal or perennial rhinitis.
Adults and children 6 years of age and older, initial: 256 mcg/day given as either 2 sprays in each nostril in the morning and evening or 4 sprays in each nostril in the morning. Doses greater than 256 mcg/day are not recommended. Maintenance: Reduce initial dose to the smallest amount necessary to control symptoms; decrease dose q 2-4 weeks as long as desired effect is maintained. If symptoms return, the dose may be increased briefly to the initial dose.
?Aerosol Aqua Nasal Spray Seasonal and perennial allergic rhinitis.
Adults and children over 6 years, initial: 1 spray/nostril once daily.
?Pulmicort Turbuhaler Prevention or treatment of asthma.
Adults: 200-400 mcg b.i.d., not to exceed 400 mcg b.i.d. For mild to moderate asthmatics well controlled on inhaled corticosteroids, initial dose is 200-400 mcg (1-2 inhalations) once daily either in the morning or evening. Children, over 6 years of age: 200 mcg b.i.d., not to exceed 400 mcg b.i.d. Each actuation actually delivers about 160 mcg of budesonide to the client however.