Budesonide for inhalation (Latin name budesonid) is a fairly effective remedy that is often prescribed by doctors for home treatment of respiratory diseases. This medicine has a number of contraindications and side effects, so it is important for patients to undergo Budesonide therapy only after it has been prescribed by a doctor.
In order for the medication to be beneficial after the first inhalations, the drug must be used in a strict dosage and following the rules for using the aerosol. What is the effect of the medicine in the patient’s body, and in what cases is Budesonide native prescribed?
Composition and release form of the drug
Budesonide Active contains active ingredients such as budesonide and formoterol fumarate dihydrate (Latin).
Easyhaler Budesonide is available in several forms, namely:
- Micronized powder for inhalation. One inhaler contains 200 doses of powdered medicinal product. The bottle has a cap with a special lock, and on the side of the bottle there is a counter - it shows the remaining drug in the bottle. Inside the aerosol there is a white powder, which has a therapeutic effect on the patient’s health.
- Solution for inhalation. It is produced by a pharmaceutical company in two dosages - 0.025 mg/ml and 0.5 mg/ml. The medicine is presented in the form of a colorless liquid, which contains opalescence components.
Also on the modern pharmaceutical market there is a medicine based on this drug, called Budenit Steri-Neb. This form of the drug is presented in the form of a white, finely dispersed suspension that has no odor.
It is permissible to use a suspension or other form of medication (ointment, nasal drops) only after it has been prescribed by a doctor. Otherwise, if there is a risk of developing unpleasant side effects or worsening the symptoms of the disease.
Therapeutic effect
After the therapeutic vapor from inhalation penetrates the respiratory organs, its main components fill the entire cavity of the lungs, after which they penetrate into the bloodstream through natural gas exchange. Thanks to Budesonide native, it is possible to suppress the excessive activity of the bronchi, which is negative for health, which often makes itself felt during inflammatory processes.
Budesonide, produced in the form of a suspension, is able to block androceptors, and it also does not allow blood to penetrate into the inflamed areas of the respiratory system. As a result, the reproduction time of pathogenic microorganisms is significantly reduced, and the functioning of immune cells is improved, which begin to destroy pathogenic bacteria much faster.
Although the drug has powerful anti-inflammatory properties, it cannot be classified as an antibacterial remedy. The anti-inflammatory effect in the patient’s body occurs as a result of blocking the lung receptors (precisely those that are responsible for the supply of blood to all respiratory organs).
Therefore, treatment with Budesonide must be combined with taking antibacterial drugs, which will help have a powerful therapeutic effect on the patient’s health. This group of medications will help prevent the proliferation of bacteria dangerous to health, as well as normalize the functioning of the respiratory system.
In patients suffering from bronchial asthma, or more precisely, from its attacks, with the correct use of the inhaler, it will be possible to prevent the development of a spasm, as well as stop an acute attack characterized by swelling of the respiratory organs.
pharmachologic effect
When used topically, Budesonide helps to provide an anti-inflammatory effect on the mucous membranes of the respiratory tract. The first positive effect appears a few hours/day after using the drug; the maximum therapeutic effect can be achieved after 7-14 days of regular use of the drug. The active component budesonide also has the following pharmacological effects :
- Prevents the release of arachidonic acid (a mediator of the inflammatory process).
- Helps reduce inflammatory exudation and restore the response of the bronchi to the effects of bronchodilators (medicines that relax the muscular walls of the bronchi and increase their lumen), reducing the patient's need to use them.
- Helps reduce swelling of the mucous membranes, mucus production with subsequent sputum production, as well as hyperactivity of the respiratory system.
- In addition, the use of the drug helps to provide immunosuppressive and antiallergic effects.
Inhalation prevents attacks of bronchial asthma, but does not relieve acute attacks of bronchospasm.
The active substance has low absorption. After the inhalation procedure, a little more than 20% of the drug enters the small bronchi. The other part of the active component enters the gastrointestinal tract and is subsequently transformed in the liver to inactive metabolites. Maximum concentration can be achieved 15-45 minutes after the procedure.
The half-life is 3 hours, excretion is carried out mainly by the kidneys, to a small extent - by the intestines.
Pharmacological group
Budesonide in RLS is presented as a powerful glucocorticoid. This medication is an analogue of the hormone of the adrenal cortex, thanks to which carbohydrate metabolism is regulated in the patient’s body.
Due to this effect on the body, this medicinal product can be used for inhalation and local use. However, the aerosol must be prescribed by a doctor who will take into account all the characteristics of the body and prescribe the correct dosage of Budesonide to the patient.
Contraindications for use
Many studies have shown that Budesonide has a number of contraindications in which inhalation is strictly prohibited. These include:
- intolerance to the components included in the medicinal product,
- treatment of patients whose age is less than 6 years,
- the presence of rare hereditary diseases, for example, an insufficient amount of lactose, lactase intolerance or glucose-galactose malabsorption.
The medication should be used with caution for inhalation during the following diseases:
- tuberculosis,
- bacterial, viral or fungal infections that attack the respiratory system,
- cirrhosis of the liver,
- diabetes,
- development of herpes near the eyes or lips,
- pregnancy and breastfeeding baby,
- obstructive type cardiomyopathy,
- aneurysm,
- ARVI or ARI,
- hypothyroidism,
- osteoporosis,
- IHD,
- severe hypertension,
- tachyarrhythmia,
- glaucoma.
The effect of the drug in this case will be negative, therefore, in order to avoid deterioration of health, it is necessary to replace it with an analogue in order to cure diseases of the respiratory system, without thereby harming the health and functioning of the entire body.
Instructions for use BUDESONIDE-INTELI
Particular caution is required if it is necessary to use the drug in patients with asymptomatic pulmonary tuberculosis, fungal, bacterial and viral infections of the respiratory system.
Patients who did not take GCS:
The therapeutic effect is usually achieved within 7 days. However, for selected patients with excess secretion of the bronchial mucosa, short-term (about 2 weeks) additional oral corticosteroids may be prescribed initially. Exacerbation of bronchial asthma caused by a bacterial infection requires antibiotic therapy and a possible increase in the dose of budesonide or, if necessary, the use of systemic corticosteroids.
Patients taking GCS:
when switching from oral corticosteroids to budesonide, the patient's condition should be in a relatively stable phase. High dose budesonide is used in combination with a previously used dose of an oral steroid for about 10 days.
After this, the dose of oral corticosteroids should be gradually reduced (for example, every month by 2.5 mg of prednisolone or equivalent) to the minimum effective level. In many cases, it is possible to completely replace oral GCS with Budesonide Intel. The transition from oral corticosteroid treatment to inhaled budesonide treatment should be carried out with special precautions, mainly due to the slow normalization of the function of the hypothalamic-pituitary-adrenal axis, previously impaired by oral corticosteroid use. It may take several months to achieve this normalization. During this substitution of oral corticosteroids, patients may experience rhinitis, eczema or fatigue, headache, muscle or joint pain, and rarely nausea and vomiting. In such cases, it is necessary to begin additional symptomatic treatment.
Patients who have previously received systemic corticosteroids for a long time or in high doses may develop symptoms of adrenal suppression. In such patients, adrenal function should be regularly monitored, and the dose of systemic corticosteroids should be reduced with caution.
Budesonide-Inteli is not intended for the relief of an acute attack of bronchial asthma.
Treatment with budesonide should not be stopped suddenly. It is very important that the dose of the drug is reduced to the minimum value at which effective control of bronchial asthma is maintained.
In vivo studies have shown that oral administration of ketoconazole and itraconazole (known inhibitors of CYP3A4 activity in the liver and intestinal mucosa) increases the systemic effect of budesonide. Concomitant treatment with ketoconazole and itraconazole or other strong CYP3A4 inhibitors should be avoided. If this is not possible, the time interval between administration of interacting medicinal products should be as long as possible. It is also necessary to consider the possibility of reducing the dose of budesonide.
The use of these inhaled corticosteroids, incl. the drug Budosonide-Intel in athletes can give a positive result of a doping test.
Impact on the ability to drive vehicles and operate machinery
Budesonide does not affect the ability to drive vehicles or operate machinery.
Possible side effects
There are very few side effects after inhalation with Easyhaler Budesonide, but they still sometimes make themselves felt. These include:
- frequent cough that worsens after inhalation,
- dry mouth,
- nausea, which may progress to vomiting,
- loss of appetite (loss of appetite is often observed),
- stomatitis,
- laryngitis,
- severe hoarseness,
- noise in ears,
- depletion of the adrenal cortex, which is associated with a decrease in the level of production of the hormone adrenaline (endocrine disorder),
- arterial hypertension,
- a sharp decrease in glucose in the body.
These side effects occur in adults and children. If they are detected, you must stop using the solution and be sure to report side effects to your doctor. After all, such a reaction may be associated with intolerance to the components of the drug, which means it will need to be replaced with an analogue.
Drug interactions
The simultaneous use of corticosteroids with any medications should be discussed with your doctor, since a negative effect on the effectiveness of such therapy and increased adverse reactions cannot be ruled out. It is especially important to take into account the following points:
- Drugs that work on substances that interact with isoenzymes of the cytochrome P450 3A4 system (these include ketoconazole, itraconazole, ethinyl estradiol, nelfinavir) stimulate an increase in the plasma concentration of the active substance.
- The systemic effect of the use of glucocorticosteroid hormones decreases if they are combined with rifampicin, phenobarbital (substances that induce microsomal oxidation).
- Budesonide can be combined with low doses of oral contraceptives, but it is better not to combine with high doses of estrogens or steroid contraceptives to avoid increasing its concentration.
- If Budesonide is prescribed simultaneously with methandrostenolone or estrogen drugs, the effect of its use will be enhanced.
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Administration schedule and dosage
The instructions contain information that Budesonide in inhalation form is prescribed to patients in the following dosage:
- adults in the first days of therapy need to use 400-1600 mcg/day, divided into 2-4 doses, and then use 200-400 mcg twice a day (during an exacerbation of the disease, the dose can be increased to 1600 mcg),
- children need to use 50-200 mcg/day, which needs to be divided into 2 times.
In this case, the doctor will prescribe the patient a number of other tablets and capsules, which also need to be taken according to the instructions.
A solution with the main active ingredient in powder form must be used in the following way:
- open the bottle of medicine and pour the required amount of saline solution into the nebulizer,
- shake the bottle thoroughly until the powder dissolves,
- use the bottle as described in the instructions for use.
The inhalation drug must be diluted in the dosage prescribed by the doctor (he will tell you how much saline solution and powder to use).
The solution for administration into the nose is used as follows: the patient needs to use 2 injections into each nostril 2 times a day. Before using the spray, shake it well.
Mode of application
Budesonide inhalation solution should be used in accordance with the manufacturer's recommendations described in the instructions for the medicine. It is necessary to open the bottle of medicine and pour the required amount through the upper opening of the nebulizer. The further inhalation process should be carried out in accordance with the instructions for use for the device used by the patient.
The volume of the active component that enters the lungs depends on a number of factors:
- Inhalation time.
- The filling level of the nebulizer chamber and its technical characteristics.
- It is important whether the patient uses a mask or a mouthpiece.
- The ratio of inspiratory and expiratory volumes, as well as the patient's tidal volume, should also be taken into account.
In order to ensure the proper therapeutic effect and reduce the likelihood of complications, the following recommendations should be taken into account:
- After each procedure, you must thoroughly rinse your mouth with plain water.
- If the patient uses a mask during inhalation, you must make sure that it fits tightly to the face. After each procedure, you must wash your face thoroughly.
Particular attention should be paid to cleaning the nebulizer chamber, mask and mouthpiece: they are washed with warm water and mild detergents, taking into account the manufacturer’s recommendations.
Features of therapy for pregnant women and during lactation
The use of the medicine by women during pregnancy and breastfeeding is allowed only if the woman’s health condition is unsatisfactory. At the same time, it is necessary to regularly examine the fetus and newborn, which will help you always be aware of his health status and the functioning of the adrenal cortex.
Therefore, the doctor must prescribe the dose of the medicine based on the patient’s health condition. Doctors usually reduce the amount of milligrams of the drug for pregnant and lactating women, as it can have a negative effect on the child. However, the patient will still need to take antibacterial drugs to quickly restore the health of the affected organs.
Drug analogues
Budesonide analogues are prescribed to patients if for some reason it is not suitable for treatment. The analogues have a similar composition to Budesonide, and are also endowed with the same mechanism of action on the respiratory system.
The radar lists many analogues of the drug - they are:
- Symbicort,
- Pulmicort Turbuhaler,
- Klenil UDV,
- Flixotide,
- Berodual.
Breathing with such medicinal products is required only after doctor’s testimony. At the same time, they begin to act as quickly as Budesonide. The indications for their use are the same, but the active substances are different, so the dosage of the drugs must be prescribed by a doctor.
Analogs
The following drugs are analogues of the drug Budesonide:
- Budenit (suspension, ampoules for inhalation).
- Benacort (powder for inhalation).
- Budenofalk (capsules).
- Pulmicort (suspension, powder for inhalation).
If it is necessary to select a replacement, it is recommended to first consult with a doctor, agreeing on the dosage, frequency and duration of use of the medicine.
Inhaled budesonide is not intended for the treatment of exacerbations of asthma or bronchospasm. To eliminate these conditions, it is recommended to use appropriate treatment regimens.
In order to achieve the desired therapeutic effect, the drug must be used regularly and without omissions, in accordance with the manufacturer's recommendations. Even if the patient is not bothered by the symptoms of bronchial asthma, the drug should be used continuously. Abrupt discontinuation of the use of budesonide for inhalation is not recommended.
Elena Antonova,
