Budesonide

Budesonide

Budesonide is a powerful synthetic corticosteroid medication that doctors prescribe to manage and treat various inflammatory conditions. This versatile drug primarily targets the airways and gastrointestinal tract, making it an effective treatment option for several health issues.

Budesonide Uses

This powerful corticosteroid medication has many applications in treating various inflammatory conditions. Some of the uses for budesonide are as follows:

Respiratory Conditions:

• Doctors prescribe budesonide to treat asthma in both adults and children. The medication helps prevent difficulty breathing, chest tightness, wheezing, and coughing caused by this condition. 
• For individuals with Chronic Obstructive Pulmonary Disease (COPD), including chronic bronchitis and emphysema, budesonide combined with formoterol helps maintain airway function and reduce exacerbations. 

Gastrointestinal Disorders:

• Budesonide plays a crucial role in managing inflammatory bowel diseases. The medication helps induce remission in active mild to moderate Crohn's disease and maintains remission following treatment.
• For ulcerative colitis, a condition causing swelling and sores in the colon and rectum lining, budesonide serves as a second-line therapeutic agent

Other Uses

Budesonide has additional applications in treating various conditions:

• Allergic rhinitis and upper respiratory allergies (nasal spray form)
• Prevention of nasal polyps
• Treatment of eosinophilic oesophagitis (EoE)
• Management of primary immunoglobulin A nephropathy (kidney disease)

How to Use Budesonide

The proper use of budesonide depends on its formulation and the condition being treated. Patients should follow their doctor's instructions carefully and maintain the prescribed dosage and frequency.

• Oral Administration: For oral use, budesonide comes in delayed-release capsules and extended-release tablets. These should be swallowed whole without breaking, crushing, chewing, or opening. 
• Inhalation Methods: Budesonide inhalation comes in two forms: a powder and a suspension. The powder is inhaled using a special inhaler, while the suspension requires a jet nebuliser.
• For the powder inhaler:
  • Hold the inhaler upright and load a dose by turning the grip entirely right and left until it clicks.
  • Exhale away from the inhaler.
  • Place the mouthpiece between the lips and inhale deeply and forcefully.
  • Hold your breath for about ten seconds after inhaling.
  • Repeat if a second puff is prescribed.
  • Rinse mouth with water and spit after each treatment.
• For the nebuliser suspension:
  • Shake the ampule gently in a circular motion.
  • Open the ampule and pour all the liquid into the nebuliser reservoir.
  • Connect the nebuliser to the mouthpiece or face mask and compressor.
  • Have the patient sit upright and breathe calmly until the mist stops forming.
  • Rinse the patient's mouth with water and spit after each treatment.
• Nasal Application: Budesonide is also available as an over-the-counter nasal spray. Patients should follow the instructions and guidelines provided with the product for proper nasal application.
• Rectal Administration: For rectal use, budesonide comes in foam, enema, and suppository forms. The specific instructions for these formulations will vary, and patients should carefully follow the directions provided by their doctor.

Side Effects of Budesonide

The following are some common budesonide side effects:

• Dry throat or hoarseness
• Stomach pain or indigestion
• Headaches
• Bad taste
• Muscle pains
• Skin reactions (rash, acne, or slow-healing wounds)
• Oral thrush (white patches in the patient's mouth or throat)

Serious Side Effects:

• Easy bruising or bleeding
• Severe weakness
• Vision issues
• Muscle weakness
• Unusual hair growth
• Allergic reactions
• Mood changes, such as depression, irritability, or mood swings
• Increased susceptibility to infections due to weak immunity from chronic use of corticosteroids
• Long-term use of budesonide, especially at higher doses, can suppress the hypothalamic-pituitary-adrenal (HPA) axis. It can lead to adrenal insufficiency, characterised by symptoms like nausea, vomiting, loss of appetite, lethargy, and fatigue. 

Precautions

Budesonide is a powerful medication that requires careful use and monitoring, such as:

• Firstly, budesonide is not suitable for treating acute asthma attacks or status asthmaticus. 
• People with hypersensitivity to budesonide or any of its ingredients should avoid using this medication. 
• People with compromised liver function or acute pulmonary tuberculosis are also advised against its use. 
• Budesonide treatment requires caution in patients with latent tuberculosis, ocular herpes simplex, and active bacterial, viral, fungal, or parasitic infections. 
• During periods of stress, such as infections, surgery, or trauma, patients with suppressed HPA axis may require additional systemic corticosteroids to prevent adrenal crisis. 
• Budesonide may weaken the immune system, increasing the risk of infections. 

People with certain medical conditions exercise caution:

• Hepatic impairment
• Infections
• Lactose intolerance
• Ocular herpes simplex
• Ocular toxicities
• Osteoporosis
• Hyperadrenocorticism

How Budesonide Works

Budesonide can influence the body's inflammatory response. This medication works by binding to & activating glucocorticoid receptors (GR) in the cytoplasm of effector cells, such as those found in the bronchi. Once activated, the budesonide-GR complex moves into the cell nucleus, interacting with specific proteins to regulate gene expression.

Budesonide's anti-inflammatory effects are multifaceted:

• It inhibits the activation of eosinophils by increasing apoptosis.
• It suppresses the activation of inflammatory cells, including mast cells, neutrophils, T-lymphocytes, macrophages, and dendritic cells.
• It decreases the formation of arachidonic acid derivatives by inhibiting phospholipase A2.
• It inhibits NF-Kappa B and other inflammatory transcription factors.
• It promotes anti-inflammatory genes like interleukin-10.

Can I Take Budesonide with Other Medicines?

Some common medicines that interact with budesonide include:

• Acetaminophen
• Alprazolam
• Aspirin
• Cetirizine
• Diphenhydramine
• Fluticasone
• Heart and blood pressure medications
• Montelukast
• Mental health medications: Duloxetine 
• Supplements: CoQ10, Fish Oil, Vitamin B12, Vitamin C, and Vitamin D3

Dosing Information

• For asthma maintenance, adults and children six years and older typically start with 360 mcg via oral inhalation twice daily using the inhalation powder. 
• Children aged 1 to 8 years use the inhalation suspension in a nebuliser, and those previously treated with bronchodilators alone use 0.5 mg once a day or 0.25 mg two times a day.
• For those previously treated with inhaled corticosteroids: 0.5 mg once or 0.25 mg twice daily, possibly increasing up to 0.5 mg twice daily.
• For those previously treated with oral corticosteroids: 1 mg once daily or 0.5 mg twice daily.
• The maximum daily dose for children in this age group is 1 mg.
•  For Crohn's disease, adults take 9 mg of enteric-coated capsules orally once daily in the morning for up to 8 weeks. 

Conclusion

Budesonide helps various inflammatory conditions, offering relief to patients with asthma, COPD, and gastrointestinal disorders. Its versatility in formulations allows for targeted treatment, making it an asset for managing inflammation throughout the body. However, like all medications, it comes with potential side effects and interactions that require careful consideration and monitoring. Understanding how to use budesonide correctly, being aware of its side effects, and knowing its interactions with other medications are crucial for safe and effective treatment. 

FAQ's

1. What is budesonide mainly used for?

Budesonide is primarily used to:

• Prevent asthma attacks in adults and children
• Treat chronic obstructive pulmonary disease (COPD)
• Manage Crohn's disease and ulcerative colitis
• Control allergic rhinitis and upper respiratory allergies
• Treat eosinophilic oesophagitis 
• Reduce proteinuria in patients with primary immunoglobulin A nephropathy

2. Who needs to take budesonide?

Budesonide is prescribed for individuals with the following conditions:

• Asthma (adults and children)
• COPD
• Crohn's disease (adults and children eight years and older)
• Ulcerative colitis
• Allergic rhinitis
• Eosinophilic oesophagitis (adults and children 11 years and older)
• Primary immunoglobulin A nephropathy

3. Is it bad to use budesonide every day?

Most people take budesonide as a short course, typically for up to 8 weeks. However, some conditions may require longer-term use to keep symptoms under control. For autoimmune hepatitis, doctors might prescribe budesonide for up to 2 years.

4. Is budesonide safe?

Budesonide is generally safe when used as prescribed. It has a reduced risk of side effects when compared to other corticosteroids because it primarily works in the gut, liver, or food pipe, limiting the amount reaching the rest of the body.

5. Who Cannot use budesonide?

Budesonide should not be used by individuals who:

• Have an allergy to budesonide or any of its ingredients
• Have acute pulmonary tuberculosis
• Have a severe liver impairment
• Are experiencing an acute asthma attack (budesonide is not a quick-relief medication)

6. Is budesonide safe for kidneys?

Budesonide has been used to treat primary immunoglobulin A nephropathy, a kidney disease. In high-risk IgA nephropathy patients, it can effectively reduce hematuria and proteinuria while maintaining stable renal function.

7. Is budesonide only for asthma?

While budesonide is commonly used to treat asthma, it has various other applications, such as:

• Chronic obstructive pulmonary disease (COPD)
• Crohn's disease
• Ulcerative colitis
• Allergic rhinitis
• Eosinophilic oesophagitis
• Primary immunoglobulin A nephropathy

8. Does budesonide help with cough?

Budesonide can help with cough, mainly related to asthma or COPD. By reducing inflammation in the airways, budesonide can alleviate symptoms such as wheezing, shortness of breath, and coughing.

8. Is budesonide good for your lungs?

Budesonide positively affects lung health for individuals with certain respiratory conditions. It helps control and prevent symptoms of asthma and COPD by reducing inflammation and swelling in the airways.

9. Can I take budesonide at night?

The timing of budesonide administration depends on the specific formulation and your doctor's instructions. For some conditions, taking budesonide once daily in the morning is recommended. However, for others, it may be prescribed twice daily.

Disclaimer: The information provided here is not meant to substitute an advice from a healthcare professional. The information is not intended to cover all the possible uses, side-effects, precautions, and drug interactions. This information is not intended to suggest that using a specific drug is suitable, safe, or efficient for you or anyone else. The absence of any information or warning regarding the drug should not be interpreted as an implicit guarantee from the organisation. We strongly advise you to consult a doctor if you have any concerns about the drug and never use the medication without a doctor’s prescription.