Budesonide (Inhalation)

Products

Budesonide is commercially available as a monopreparation for inhalation as a powder inhaler and suspension (Pulmicort, generics). It is also combined fixed with formoterol (Symbicort Turbuhaler, Vannair Dosage Aerosol). This article refers to monotherapy. Budesonide has been approved in many countries since 1988.

Structure and properties

Budesonide (C25H34O6, Mr = 430.5 g/mol) is a racemate and exists as a white, crystalline, odorless, tasteless powder that is practically insoluble in water.

Effects

Budesonide (ATC R03BA02) has anti-inflammatory, antiallergic, and immunosuppressive properties. The effects are due to binding to intracellular glucocorticoid receptors.

Indications

For the treatment of obstructive airway disease:

  • Bronchial asthma
  • Chronic obstructive bronchitis

Budesonide is not indicated for the treatment of an acute asthma attack.

Dosage

According to the SmPC. Medicines are usually inhaled once or twice daily. Afterwards, something to eat or the mouth should be rinsed carefully to prevent the development of oral thrush.

Contraindications

Budesonide is contraindicated in cases of hypersensitivity. For complete precautions, see the drug label.

Interactions

Budesonide is metabolized by CYP3A4 and has marked first-pass metabolism. Drug-drug interactions are possible with CYP inhibitors, which may increase systemic availability.

Adverse effects

The most common possible adverse effects include irritation of the pharyngeal mucosa with difficulty swallowing, cough, and hoarseness. Rarely, fungal infection (oral thrush) is possible. Systemic glucocorticoid side effects are rare.