budesonide at a glance
Medicine class
Corticosteroid with predominantly local anti-inflammatory action.
Main treatment areas
Asthma, allergic rhinitis, nasal polyps, eosinophilic oesophagitis, Crohn’s disease, microscopic colitis and ulcerative proctitis, depending on formulation.
What is budesonide used for?
Licensed uses depend on the product and route.
Persistent asthma: Easyhaler budesonide is a preventer, not an acute reliever.
Asthma where standard inhalers are unsuitable, and hospital-managed croup in infants and children: nebuliser suspension.
Allergic rhinitis and nasal polyps in adults: aqueous nasal spray.
Eosinophilic oesophagitis in adults: Jorveza orodispersible tablets.
Ulcerative colitis limited to the rectum in adults: budesonide suppositories.
Crohn’s disease affecting the ileum or ascending colon, and active or remitted microscopic colitis: Entocort CR capsules.
How does budesonide work?
Budesonide binds to glucocorticoid receptors and changes inflammatory gene activity, reducing inflammatory responses. Targeted formulations deliver it to affected tissue, while extensive first-pass liver metabolism generally limits systemic exposure after swallowed medicine.
budesonide preparations and strengths
Inhaled preparation
Route: Inhaled
Strengths: 0.5 mg, 1 mg
Nasal preparation
Route: Nasal
Strengths: 64 micrograms, 64 micrograms/actuation
How to take budesonide
Follow the instructions for the specific product; formulations are not interchangeable.
Use inhalers with the demonstrated technique. Rinse the mouth afterwards and clean the device only as directed.
Use nebuliser suspension with a suitable jet nebuliser and compressor; ultrasonic nebulisers are unsuitable. Afterwards, rinse the mouth, wash skin exposed by a face mask and clean the equipment.
Shake and prime the nasal spray as instructed. Blow the nose gently, keep the bottle upright and direct the nozzle away from the nasal septum.
Place Jorveza on the tongue, allow it to dissolve and swallow the medicated saliva gradually. Do not chew or swallow it whole.
Swallow Entocort CR capsules whole with water; do not chew them.
Insert suppositories rectally. Emptying the bowel beforehand may help the medicine remain in contact with the rectum.
budesonide side effects
Common or expected effects
- Oral, throat or oesophageal thrush; inhaled forms may also cause throat irritation, cough or hoarse voice.
- Nasal irritation or dryness, minor bleeding, nosebleeds and throat discomfort.
- Oral capsules may cause indigestion, muscle cramps, palpitations, skin reactions, menstrual changes, or mood and sleep changes.
- Rectal forms may cause headache, abdominal discomfort, wind, flushing or rash.
Get urgent medical advice
- Severe allergic reaction, including angioedema or anaphylaxis.
- Unexpected worsening of wheeze or breathing immediately after inhalation.
- Symptoms of adrenal suppression or excess systemic steroid exposure, particularly with prolonged treatment, high exposure or several steroid medicines.
- New blurred vision or another visual disturbance.
- Significant or persistent infection; corticosteroids may increase susceptibility or mask symptoms.
budesonide in pregnancy
Inhaled budesonide should usually be continued during pregnancy because controlling breathing disease is important, and available evidence does not show harm to the baby. Nasal budesonide can also be used. Oral, oesophageal or rectal products require an individual benefit–risk discussion. Do not stop prescribed corticosteroid treatment without advice.
budesonide interactions
Check all medicines, including other corticosteroids and non-prescription products.
Potent CYP3A inhibitors, including itraconazole, ketoconazole, clarithromycin, ritonavir and cobicistat
Can markedly increase budesonide exposure and systemic corticosteroid adverse effects; combinations may need avoiding or closer monitoring.
Common questions about budesonide
Answers are fully visible for fast scanning and source review.
Is budesonide a steroid?
Yes. It is a corticosteroid that reduces inflammation, not an anabolic steroid.
Can a budesonide-only inhaler stop an asthma attack?
No. It is preventive treatment and does not replace prescribed medicine for sudden symptoms.
Why should I rinse my mouth after inhaled budesonide?
Rinsing and spitting reduces medicine left in the mouth and lowers the risk of thrush, soreness and hoarseness.
Can I have grapefruit with budesonide?
Avoid grapefruit and grapefruit juice with swallowed formulations such as Jorveza and Entocort CR because they can increase budesonide exposure.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.