Budesonide

Budesonide - nasal route

Budesonide is an over the counter and prescription medication that is used to treat and relieve the symptoms of allergic reactions, such as runny nose, watery eyes, headache and sore throat.

Overview

It is commonly used as a treatment for hay fever. Budesonide should not, however, be used to treat the symptoms caused by a common cold or flu. This drug is a steroid, so may impact growth if used by children. Although the full impact of the drug on children is not known, you should proceed with caution when administering to a child.

Budesonide comes in a range of forms. This page relates to the nasal spray specifically used to treat allergies such as hay fever, and allergies to cats, dogs, dust and other substances. Hay fever occurs when a person suffers from an allergic reaction to pollen, which is typically produced by certain plants in abundance in the spring season. It can be treated and eased with a number of medications. However, it cannot be cured by budesonide.

Budesonide is part of a family of drugs called the corticosteroids, which work to reduce allergic symptoms by blocking the release of the natural substances that cause them.

The drug is also used to prevent nasal polyps from returning. Nasal polyps, although not harmful, can be unpleasant for those affected by them. They are non-cancerous growths that are painless and soft and hang down from the nose. The only threat to the person’s health is that the polyps may obstruct the nasal passages. Therefore, removal is often sought. Nasal polyps are usually caused by recurring infection, allergies, drug use, immune system conditions or inflammation caused by asthma. Sprays such as budesonide can help to stop these from forming.

This drug is also marketed and sold under its brand name Rhinocourt (or Rhinocourt Aqua) in the United States.

Conditions treated:

  • Hay fever
  • Common allergies, such as those related to pets, dust or pollen
  • Nasal polyps

Type of medicine:

  • Nasal spray, supplied as a liquid solution

Dosage:

The dosage of Budesonide recommended depends on the medical history of the patient and also on the severity of the symptoms. However, the usual dosage is one spray in each nostril per day, at the same time each day. It is important not to take more than one spray during each dose; this will not make any positive difference to your condition.

Adults will be recommended a higher dose than children during the initial stages of treatment. This dose will then be reduced depending on the effectiveness of the drug and the reduction of unpleasant symptoms of allergic reactions.

A child will start the treatment of budesonide on a lower dose, and then this dose will be increased if the child’s symptoms do not improve. As soon as the child’s symptoms improve, the dose should then be decreased. This medicine should not be used by children under six years of age.

As Budesonide can be offered over the counter as well as by a doctor, you should always read the instructions on the label very carefully. If there is anything that is unclear, you should always ask your pharmacist to clarify. It is important that instructions for use are followed carefully as misuse can cause it to be ineffective or can lead to unpleasant side effects.

Do not use more than the recommended daily dose. If your symptoms are not improving, you should always tell your doctor and ask him or her for advice. You may need to take an alternative medication.

In order to take the medication correctly, first blow your nose to clear the airways. Then insert the tip of the bottle into one of your nostrils, while keeping the other nostril closed with a finger. Spray the drug into the nostril and inhale quickly to ensure it enters the airways. Then repeat this step with the other nostril.

You should then refrain from blowing your nose for several minutes after the application.

Side effects

There are various side effects that you may experience when taking this drug. Most of them are minor and are nothing to worry about. However, if you notice any severe or persistent side effects, you should stop taking budesonide immediately. The following side effects are serious and should be reported to a doctor straight away:

  • Nosebleeds that are persistent or recurring
  • Sores in the nose, particularly those that do not heal
  • Coughing or wheezing
  • Difficulty breathing or shortness of breath
  • Impact on the vision e.g. poorer or blurry vision
  • Chills or feeling cold
  • Fever and flu symptoms
  • Aching feeling in any part of the body

Some of the less severe side effects, and those that are more common, include the below. Most people do not experience any side effects when taking this medication, but occasionally, there are reports of the following:

  • dry or sore throat
  • runny nose or cold like symptoms
  • common cough or slight wheezing
  • Irritation in the nose or eyes
  • watery or running eyes
  • itchiness in the nose
  • burning feeling in the throat or nose
  • sores in the nose
  • white patches around the nose
  • itching throat
  • swelling in the throat area
  • headache
  • slight rushing feeling after taking the spray
  • light-headedness

Major drug interactions

Before taking Budesonide, speak to your doctor about any other medications that are may be taking. This is because it is not always safe to take certain medicines at the same time. This can lead to adverse side effects, or make either drug become ineffective in treating your conditions. In some cases, it could even make either of your conditions worse and therefore lead to dangerous health implications.

There are no drugs that cause a major reaction with the nasal spray form of Budesonide. However, the drugs below have been found to have a moderate reaction and therefore their combination with Budesonide should usually be avoided:

  • amiodarone
  • amoxicillin, clarithromycin, lansoprazole
  • amoxicillin, clarithromycin, omeprazole
  • amprenavir
  • aprepitant
  • atazanavir
  • atazanavir, cobicistat
  • bicalutamide
  • boceprevir
  • ceritinib
  • chloramphenicol
  • ciprofloxacin
  • clarithromycin
  • clotrimazole
  • cobicistat
  • cobicistat, darunavir
  • conivaptan
  • crizotinib
  • cyclosporine
  • dalfopristin, quinupristin
  • danazol
  • darunavir
  • dasabuvir, ombitasvir, paritaprevir, ritonavir
  • dasatinib
  • delavirdine
  • diltiazem
  • diltiazem, enalapril
  • dronedarone
  • emtricitabine, lopinavir, ritonavir, tenofovir
  • emtricitabine, nelfinavir, tenofovir
  • erythromycin
  • erythromycin, sulfisoxazole
  • fluconazole
  • fluvoxamine
  • fosamprenavir
  • fosaprepitant
  • goldenseal
  • grepafloxacin
  • idelalisib
  • imatinib
  • indinavir
  • isavuconazonium
  • isoniazid
  • isoniazid, pyrazinamide, rifampin
  • isoniazid, rifampin
  • itraconazole
  • ivacaftor
  • ivacaftor, lumacaftor
  • ketoconazole
  • lapatinib
  • lomitapide
  • lopinavir, ritonavir
  • mibefradil
  • miconazole
  • mifepristone
  • nefazodone
  • nelfinavir
  • netupitant, palonosetron
  • nifedipine
  • nilotinib
  • ombitasvir, paritaprevir, ritonavir
  • pazopanib
  • posaconazole
  • ranolazine
  • ritonavir
  • saquinavir
  • telaprevir
  • telithromycin
  • ticagrelor
  • trandolapril, verapamil
  • troleandomycin
  • verapamil
  • voriconazole
  • zafirlukast

Warnings

Children and babies

The medication should not be used for children under the age of six. Alternative medication must be used as budesonide can cause serious side effects in young children.

Budesonide is a steroid, and can, therefore, be harmful to children, particularly in their growth. If you notice any abnormalities in your child’s growth when they are taking this drug, you should stop them taking it immediately.

Children should also be supervised and helped during administration. This is because it is important that the correct dosage is taken – no more or no less.

Hygiene

Do not share your budesonide prescription. The bottle comes with an applicator that is designed to be inserted straight into the nostril, so it is not suitable to share for hygiene reasons. Sharing the spray may spread germs and bacteria and may make your condition worse or lead to infections. After using the spray, always clean the nozzle, preferably with an anti-bacterial solution.

Administration

This nasal spray is designed only for administration in the nasal route. You should not attempt to swallow the medication via the mouth. Nor should you apply the solution to skin or eyes. If you get the medication into the mouth or eyes, you should rinse it out immediately.

Usage warnings

Budesonide is a drug that can relieve the symptoms of allergies, but it does not cure conditions such as hay fever, nor does it prevent you from being allergic to a particular substance. Therefore, you should always take other precautions to prevent future allergic reactions.

You should expect to wait up to around two weeks to see the full benefits of using this nasal spray. During that timeframe, you should use the medication regularly as stated in the instructions, in order to see the full benefits. You should start to see an improvement in your symptoms after one to two days. However, if there is no improvement after two weeks, you should stop using this drug. It is not intended as a long-term treatment for hay fever or allergies.

Disease Interactions

You should always tell your doctor if you have any other conditions, or have suffered from any in the past. This is because budesonide can be harmful to other conditions and can make them worse. And vice versa, there are some other conditions that can alter the effectiveness of your budesonide spray. The conditions that will be of particular interest to your doctor are below. You should generally not take this medication if you have any of these conditions:

  • tuberculosis – whether you are experiencing it now or in the past
  • serious bacterial infection
  • viral infections
  • liver disease or liver transplant
  • glaucoma
  • cataracts
  • herpes in the eyes
  • ulcers in the nose
  • sores in the nose
  • a weak immune system or vulnerability to developing infections
  • any recent injury or surgery in the nose

Pregnancy and breastfeeding

Although it is not thought to be harmful to women or unborn babies during pregnancy, budesonide can enter the breast milk and therefore be consumed by nursing babies. It is therefore advised that you do not take this drug if you are breastfeeding, or expect to be breastfeeding in the near future.

Alcohol and food interactions

There are no serious alcohol or food interactions. However, you should tell your doctor if you are taking any supplements or vitamins, as these may have a slight impact on the medication. You should also avoid taking too much alcohol while taking this medication. Budesonide may make you more vulnerable to the effects of alcohol, such as light-headedness, headache, blurred vision, lack of judgment, nausea, vomiting. When taking this drug, you should keep your alcohol intake to moderate; a maximum of one drink per day for women is recommended, and two drinks per day for men.

Storage

This medication should always be kept in the bottle with which it was supplied. This bottle is specifically designed for easy insertion into the nostrils; without it, the liquid cannot be correctly administered. You should also always keep the medication out of the sight and reach of children, preferably in a cupboard that can be locked. The medication can be dangerous if consumed by children. In the United States alone, there are more than 60,000 children that have to be taken to accident and emergency rooms because they have consumed medication that was not intended for them. Budesonide, although it can be purchased over the counter, can still have very harmful effects on children – particularly younger children.

You should also keep your budesonide spray at room temperature at all times. This is generally a temperature of between 15 to 25 degrees centigrade. Keep it away from direct sources of light or heat (e.g. not near radiators or in sunlight). You should also keep it away from damp conditions (so don’t store it in the bathroom). If kept in the wrong conditions, this can impact the effectiveness of your budesonide.

Disposal

Once your budesonide has reached its expiry date, you should not use it. This is generally 28 days after opening. After this time, the drug becomes less effective. You should also throw the drug away after your two-week treatment has ended. This is because the drug generally will not keep for long enough for you to use it again in the future.

The best way to get rid of drugs that you don’t need anymore is to contact your local take-back scheme. These are dedicated schemes set up by the FDA to ensure the safe disposal of medicines. This helps to reduce the number of casualties admitted from people taking drugs that were not intended for them. It also helps prevent any harm to the environment or animals. You can find out about local take-back schemes in your area by visiting the website of the FDA.

If there are no take-back schemes available in your area, you can dispose of it yourself. You can find out by reading the label of your medication whether it is suitable for flushing. The nasal form of budesonide is suitable for flushing down the sink or toilet. You can do this by opening the bottle and tipping any excess liquid away. Then flush immediately and rinse the basin. You can then throw away the bottle and packaging into your regular trash.

Summary

Budesonide is a relatively safe and easy treatment for those with allergies and persistent conditions such as hay fever. It generally has a high success rate and results in an improvement in the quality of life of those that suffer from symptoms caused by common allergies. It is important, however, that patients are aware that budesonide is not a cure for these conditions; therefore they should take care to ensure they stay away from those substances that are causing the reactions.

Although there are no major drug interactions, it is still important that patients are open to their doctors about any other medication that they are taking. Medicines with moderate or mild interactions can still cause unpleasant side effects if taken at the same time as budesonide, and there are alternative drugs that can be given. Likewise, there are various other conditions that should not be mixed with this drug; it can aggravate certain conditions such as infections and sores.

It is particularly important with budesonide that usage instructions are adhered to. A common misconception with this drug is that, because it can be obtained over the counter, it is less dangerous if misused. Budesonide can cause serious health implications if misused, particularly in children. There have been studies that have suggested budesonide can cause harm to unborn babies and can lead to serious side effects in young children. The long-term health implications of this drug on children are as yet unknown. Those that take too much of this medication are also likely to experience unpleasant side effects.

Overall, the medication is a good, medium-term solution for those that live with allergies. If patients need to use it on a long-term basis, health should be monitored by a doctor to ensure no long-term side effects.

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Last Reviewed:
December 25, 2017
Last Updated:
December 22, 2017
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