Products
Budesonide nasal sprays have been approved in many countries since 1995 (Cortinasal, generic). Rhinocort nasal spray has not been marketed since 2018. Sales of the Rhinocort turbuhaler were discontinued in 2020.
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 R01AD05) has anti-inflammatory, antiallergic, and immunosuppressive properties. The effects are due to binding to intracellular glucocorticoid receptors.
Indications
For the treatment of seasonal and perennial allergic and nonallergic rhinitis. These include, for example, hay fever, mite allergy (house dust allergy), and vasomotor rhinitis. For the treatment and relapse prevention of nasal polyps.
Dosage
According to the SmPC. The spray is usually administered into both nostrils once or twice daily (one to two strokes per nostril). It must be shaken beforehand because the active ingredient is in suspension. See also under Administering nasal sprays.
Contraindications
Budesonide is contraindicated in 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 potential adverse effects include nasal irritation, slightly bloody secretions, and nosebleeds.