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Budesonide
📖 About Budesonide
- Always check the BNF entry for up-to-date prescribing advice.
- Inhaled corticosteroid (ICS) used mainly in asthma and COPD (as part of triple therapy).
- Also available in oral formulations (MMX/EC) for Crohn’s disease and ulcerative colitis.
⚙️ Mode of Action
- Glucocorticoid receptor agonist → reduces airway inflammation.
- Inhibits cytokine production, eosinophil activation, and mast cell mediator release.
- Prevents but does not relieve acute bronchospasm → preventer inhaler.
🎯 Indications & Typical Doses
- Chronic asthma (inhaler): 100–800 micrograms twice daily (max 1.6 mg/day).
- Chronic asthma (nebuliser): 1–2 mg every 12 h.
- Inflammatory bowel disease (oral, specialist): 9 mg once daily (modified-release).
💊 Dose Summary
| Preparation | Dose | Frequency | Route |
|---|---|---|---|
| Budesonide inhaler | 100–800 micrograms | BD | Inhaled |
| Budesonide nebuliser | 1–2 mg | 12-hourly | Inhaled (nebulised) |
| Budesonide oral (EC/MMX) | 9 mg | OD | Oral (GI use – Crohn’s, UC) |
🔀 Interactions
- See BNF.
- Metabolised by CYP3A4 → interactions with inhibitors (e.g. ketoconazole, itraconazole, ritonavir) ↑ systemic steroid exposure.
⚠️ Cautions
- History of pulmonary TB or untreated infection.
- Prolonged high-dose use → risk of systemic steroid effects (adrenal suppression, osteoporosis, growth retardation in children).
🚫 Contraindications
- See BNF – mainly hypersensitivity to budesonide or excipients.
💥 Side Effects
- Oral candidiasis (thrush) – prevent by rinsing mouth after use.
- Hoarse voice (dysphonia).
- Paradoxical bronchospasm (rare).
- High dose / long-term: systemic corticosteroid effects (adrenal suppression, Cushingoid features).
📚 References
- BNF – Budesonide
- NICE Asthma Guidelines
- BTS/SIGN Asthma Guideline
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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