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Budesonide Oral Inhalation

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Why is this medication prescribed?

Budesonide is used to stop asthmatic symptoms such coughing, wheezing, tightness in the chest, and difficulty breathing. For oral inhalation, budesonide powder (Pulmicort Flexhaler) is prescribed for both adults and children older than six years old. The recommended age range for using Pulmicort Respules, a liquid budesonide suspension, is 12 months to 8 years old. Budesonide is a member of the corticosteroid drug class. It facilitates easier breathing by reducing inflammation and swelling in the airways.

How should this medicine be used?

Budesonide is available as a powder for oral inhalation with an inhaler and as a suspension for oral inhalation with a unique jet nebulizer (machine that turns medication into a mist that can be inhaled). Most people inhale budesonide powder twice day for oral inhalation. It is typical to inhale budesonide suspension for oral inhalation once or twice per day. Utilize budesonide every day at a consistent time or times. Ask your doctor or pharmacist to explain any instructions on your prescription label that you do not understand, and carefully follow their instructions. Apply budesonide exactly as recommended. Use only as directed by your doctor, neither more nor less of it, nor more frequently.

As part of your budesonide inhalation therapy, discuss with your doctor how you should use any additional oral or inhaled asthma treatments. Your doctor might want to gradually reduce the dosage of any oral steroids you were taking, such as dexamethasone, methylprednisolone (Medrol), or prednisone (Rayos), once you start using budesonide.

Although it does not treat asthma, budesonide manages its symptoms. Even though your asthma may improve right away after taking the drug, its full effects might not become apparent for 1–2 weeks after using the powder and 4–6 weeks after regularly taking the suspension. Even if you feel good, keep taking budesonide. Without consulting your doctor, do not stop taking budesonide. If your symptoms or your child’s symptoms do not get better during the first two weeks (powder) or first six weeks (suspension) or if they worsen, call your doctor right away.

While budesonide can help prevent asthma attacks (acute episodes of wheezing, coughing, and shortness of breath), it cannot halt an attack that has already begun. To use during asthma attacks, your doctor will prescribe a short-acting inhaler. If your asthma gets worse while you’re receiving therapy, tell your doctor.

Depending on its size, each budesonide inhaler is intended to deliver 60 or 120 inhalations. Later inhalations could not contain the prescribed dosage of medication if the labelled number of inhalations has been reached. You ought to keep note of how many breaths you’ve taken. To determine how many days your inhaler will last, divide the number of inhalations it has by the number of inhalations you use daily. Even if the inhaler still has some liquid within and continues to spray when the button is pressed after you have used the designated number of inhalations, discard the device.

Budesonide nebulizer suspension should not be ingested.

Read the enclosed written instructions before using the budesonide inhaler or jet nebulizer for the first time. Make sure you can identify every component of the inhaler or nebulizer by carefully studying the diagrams. You should ask your physician, pharmacist, or respiratory therapist to demonstrate how to use the inhaler or nebulizer properly. To ensure you are using the inhaler or nebulizer correctly, practise using it in front of the patient.

Follow these procedures to use the inhaler to breathe in the powder:

  • The protective cover may be turned and lifted off.
  • You must prime a brand-new budesonide inhaler before using it for the first time. To do this, hold the inhaler upright (with the mouthpiece up) and fully rotate the brown grip to the right until it stops, then fully rotate it back to the left. A click will be audible. Repeat. Now that the device has been primed, the first dose can be loaded. After this, even if you don’t use the inhaler for a while, you don’t need to prime it again.
  • Turn the grip completely to the right and completely to the left until it clicks while holding the inhaler upright.
  • Exhale while turning your head away from the inhaler. Never exhale into or blow into the inhaler. After loading the inhaler, do not jiggle it.
  • Hold the inhaler horizontally or upright with the mouthpiece up. Put the mouthpiece firmly within your mouth between your lips. Lean your head back a little. Do not bite or chew the mouthpiece; instead, tightly seal your lips around it. Inhale strongly and deeply. Make sure your teeth or tongue are not in the way of the mist entering your throat.
  • After taking the inhaler out of your mouth, hold your breath for around ten seconds. Never breath or blow through the inhaler.
  • Repeat steps 4-6 if you need to take two breaths in at once. The inhaler must be loaded in the upright position just before use in order to take the subsequent puff. Until it clicks, fully rotate the grip to the right, then fully to the left.
  • Put the inhaler’s protective cap back on and twist it closed.
  • Spit out the water you used to clean your mouth after each treatment. Don’t ingest the water.
  • Keep the inhaler covered firmly at all times, clean, and dry.

Use the jet nebulizer as directed below to inhale the suspension:

  • Take one inhalation suspension ampul out of the foil pouch.
  • Shake the ampule in a circular motion with gentleness.
  • Twist off the ampule’s cap while holding the ampule upright. Fill the reservoir of the nebulizer with the entire liquid. Do not combine budesonide in the reservoir with other drugs.
  • Connect the face mask or mouthpiece to the nebulizer reservoir.
  • Connect the compressor and nebulizer.
  • Use the face mask or put the mouthpiece in your child’s mouth. Turn on the compressor while your youngster is sitting erect and comfortably.
  • Tell your youngster to inhale steadily, calmly, and deeply up until the mist in the chamber stops accumulating.
  • Have your youngster spit out the water after each treatment; they should not swallow it.
  • Put the empty ampule and its lid in a garbage container that is out of kids’ and animals’ reach.
  • Regularly clean your nebulizer. If you have any concerns about cleaning your nebulizer, carefully follow the manufacturer’s instructions and see your physician or pharmacist.

Other uses for this medicine

Ask your doctor or pharmacist for more details if you’re interested in using this drug for any other conditions.

What special precautions should I follow?

Before using budesonide inhalation,

  • If you have any allergies, including to budesonide, other drugs, or any of the chemicals in budesonide inhalation powder or nebulizer solution, notify your doctor and pharmacist right away. Tell your doctor if you have a milk protein allergy if you want to use the inhalation powder. For a list of the ingredients, consult the Medication Guide or speak with your pharmacist.
  • Inform your doctor and pharmacist about any prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products you are now using or have recently used. Be certain to bring up any of the following: HIV protease inhibitors such ritonavir (Norvir, in Kaletra, in Viekira Pak, among others), itraconazole (Onmel, Sporanox), and ketoconazole (Nizoral), as well as clarithromycin (Biaxin), atazanavir (Reyataz, in Evotaz), indinavir (Crixivan), nelfinavir (Viracept), and saquinavir (Invirase); nefazodone, oral steroids including dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos), as well as telithromycin, are seizure medicines (Ketek). Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects. Tell your doctor about all of your current medications, including any not on this list, as many other drugs may also interact with budesonide inhalation.
  • Use of budesonide during an asthma episode is not advised. To use during asthma attacks, your doctor will prescribe a short-acting inhaler. If an asthma attack persists despite the use of a fast-acting asthma medicine or if you need to use more fast-acting medication than normal, contact your doctor right away.
  • Inform your doctor if you or anyone in your family has ever experienced osteoporosis (a condition in which the bones deteriorate and are more prone to fracture), cataracts (clouding of the lens of the eye), glaucoma (an eye disease), high eye pressure, or liver disease. TB is a serious lung infection. Additionally, let your doctor know if you have herpes in your eyes or any other untreated infections anywhere on your body (a type of infection that causes a sore on the eyelid or eye surface).
  • Inform your physician if you are nursing a baby, intend to get pregnant, or are already pregnant. Call your doctor if you become pregnant while taking budesonide.
  • Inform your doctor or dentist that you are using budesonide if you are having surgery, including dental surgery.
  • Your other health issues, such asthma, arthritis, or eczema (a skin problem), could get worse if your oral steroid dosage is cut back. If this occurs or if you encounter any of the following symptoms at this time, let your doctor know right away: Extreme fatigue, muscle weakness or pain, sudden pain in the stomach, lower body, or legs, appetite loss, weight loss, upset stomach, vomiting, diarrhoea, dizziness, fainting, depression, irritability, and skin darkening are all symptoms that might occur. During this time, your body may not be as capable of handling stressors like injury, illness, severe asthma attack, or surgery. In the event that you become ill, contact your physician straight away, and make sure that any medical professionals who care for you are aware that you recently switched from an oral steroid to budesonide inhalation. To alert emergency responders that you could require steroid treatment in an emergency, carry a card or wear a medical identification bracelet.
  • If you have never had chickenpox or measles and you have not received a vaccination against these diseases, let your doctor know. Avoid sick people, especially those who have the measles or chickenpox. Call your doctor right once if you are exposed to one of these infections or if you start to exhibit signs of one of these infections. To keep yourself safe from certain infections, you might need therapy.
  • You should be aware that budesonide inhalation occasionally results in wheezing and breathing difficulties right away. Use your fast-acting (rescue) asthma medicine as soon as possible and call your doctor if this occurs. Inhaling budesonide should not be done again unless your doctor instructs you to.

What special dietary instructions should I follow?

Keep eating normally unless your doctor instructs you otherwise.

What should I do if I forget a dose?

Ignore the missed dose and carry on with my normal dosing routine. To make up for a missing dose, do not take a second one.

What side effects can this medication cause?

Side effects from budesonide inhalation are possible. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Headache
  • Runny or congested nose
  • Unwell throat
  • Diarrhoea
  • Reduced appetite
  • Abdominal pain
  • Difficulty Sleeping or remaining asleep
  • Back or neck ache
  • Infected ears
  • Nosebleeds

Some adverse effects can be very harmful. Get emergency medical attention if you develop any of the following symptoms or those listed in the SPECIAL PRECAUTIONS section.

  • Mouth sores or patches that are white
  • Rash
  • Hives
  • Itching
  • Edoema of the hands, feet, ankles, lower legs, cheeks, neck, tongue, lips, and eyes
  • Hoarseness
  • Breathing or swallowing challenges
  • Wheezing
  • Cough
  • Chest ache
  • Anxiety
  • Fever, chills, or other infection-related symptoms
  • Tiredness
  • Nausea
  • Vomiting
  • Weakness
  • Alterations to vision

Children’s growth may be slowed down by budesonide intake. If taking budesonide reduces the height that children will eventually reach when they stop growing, such information is not yet available. While your child is receiving budesonide, the doctor will closely monitor their growth. The hazards of administering this drug to your kid should be discussed with their doctor.

Rarely, long-term budesonide users may experience glaucoma or cataract development. As part of your therapy, ask your doctor how frequently you should have your eyes checked and any potential hazards associated with using budesonide.

Your chance of developing osteoporosis may increase if you take budesonide (a condition in which the bones become thin and weak and break easily). Discuss the dangers of using this drug with your doctor.

Other negative effects from inhaling budesonide are possible. If you experience any strange issues while taking this drug, call your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

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

Keep this medication tightly closed in the original container and out of the reach of children. Until you’re ready to use them, keep the nebulizer ampules wrapped in their foil bags. Inhaler and nebulizer solution should be kept at normal temperature, away from sources of extreme heat and moisture (not in the bathroom). The nebulizer solution should not be chilled or frozen. Replace your old inhaler whenever you get a new prescription if you use the inhalation powder. After opening the foil packet and utilising the nebulizer solution, you must discard any unused ampules.

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medicines website at for additional information.

What other information should I know?

Keep all of your appointments with your physician and the lab.

Do not share your medication with anybody else. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Pulmicort®
  • Pulmicort® Flexhaler
  • Pulmicort® Respules
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