Budesonide (Inhalation suspension)

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[edit] BRAND NAMES

[edit] STRUCTURE

Budesonide.jpg

[edit] MECHANISM OF ACTION

Budesonide is an anti-inflammatory corticosteroid that exhibits potent glucocorticoid activity and weak mineralocorticoid activity.

Inflammation is an important component in the pathogenesis of asthma. Corticosteroids have been shown to have a wide range of inhibitory activities against multiple cell types (eg, mast cells, eosinophils, neutrophils, macrophages, and lymphocytes) and mediators (eg, histamine, eicosanoids, leukotrienes, and cytokines) involved in allergic- and non-allergic-mediated inflammation. The anti-inflammatory actions of corticosteroids may contribute to their efficacy in asthma.

Improvement in the control of asthma symptoms following inhalation of Budesonide suspension can occur within 2-8 days of beginning treatment, although maximum benefit may not be achieved for 4-6 weeks

[edit] INDICATIONS

  • FDA: Maintenance treatment of asthma and as prophylactic therapy in children 12 months to 8 years of age.
  • Budesonide (Inhalation suspension) is also indicated in infants, children and adults with acute laryngotracheobronchitis (croup).

Budesonide (Inhalation suspension) is not indicated for the relief of acute bronchospasm

[edit] DOSAGE

  • FDA: For children 12 month - 8 years with chronic asthma:
    • 0.5 mg once daily or 0.25 mg twice daily
  • Acute laryngotracheobronchitis:
    • Adults (including elderly and children 12 years and older): Initiate therapy with 1 - 2 mg twice daily. Maintenance: 0.5 mg-1 mg twice daily
    • Children 3 months to 12 years: Initiate therapy with 0.5 – 1 mg twice daily. Maintenance: 0.25 - 0.5 mg twice daily.

Budesonide (Inhalation suspension) should be administered from suitable nebulisers (Not for use with ultrasonic devices)

[edit] DOSAGE FORMS AND STRENGTHS

  • PULMICORT RESPULES:
    • 0.25 mg/2 mL
    • 0.5 mg/2 mL
    • 1 mg/2 mL

[edit] CONTRAINDICATIONS

  • Acute relief of asthma (status asthmaticus) or acute bronchospasm

[edit] WARNINGS AND PRECAUTIONS

  • Monitor growth in children with long-term use
  • Rinse mouth with water to prevent oral cadidiasis
  • Immediate and delayed hypersensitivity reactions including rash, contact dermatitis, urticaria, angioedema, and bronchospasm have been reported. Discontinue the drug if such reactions occur.
  • Potential worsening of existing tuberculosis, fungal, bacterial, viral, or parasitic infections, or ocular herpes simplex
  • Increased susceptibility to respiratory infections
  • Will not relieve acute asthma attacks

[edit] INTERACTIONS

  • Increased effect: Concomitant administration of inhibitors of CYP3A4 (eg, ketoconazole, itraconazole, clarithromycin, erythromycin, etc.) may inhibit the metabolism of, and increase the systemic exposure to, budesonide. Care should be exercised when budesonide is coadministered with long-term ketoconazole and other known CYP3A4 inhibitors.

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category B (US). Budesonide (Inhalation suspension) should be used during pregnancy only if clearly needed.
  • Budesonide, like other corticosteroids, is secreted in human milk and should be used in nursing women only if clinically appropriate. Prescribers should weigh the known benefits of breastfeeding for the mother and the infant against the potential risks of minimal budesonide exposure in the infant.

[edit] SIDE EFFECTS

Most common adverse reactions include: Respiratory infection, rhinitis, coughing, otitis media, viral infection, moniliasis, gastroenteritis, vomiting, diarrhea, abdominal pain, ear infection, epistaxis, conjunctivitis, rash

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