Budesonide belongs to a class of medications called corticosteroids. It is used to treat asthma. It helps to control asthma symptoms and prevent asthma attacks by controlling the swelling and inflammation in the airways of the lungs. Budesonide usually starts to work within 10 days.

The nebulized form of this medication has been developed specifically for people who are unable to efficiently use other forms of this medication (e.g., turbuhalers).

It is important to remember that this medication will not provide immediate relief for an asthma attack that has already started. This medication is intended for long-term relief. Inhalers that contain "reliever" medications with fast action (e.g., salbutamol, terbutaline) will still be needed while using this medication on a regular basis.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

Budesonide (for nebulization) should be administered and inhaled from suitable nebulizers (machines that create the inhalation mist). This medication should not be used with an ultrasonic nebulizer. The dose is individualized and based on the needs and age of the person using the medication.

In general, the usual starting dose for children (3 months to 12 years) is 0.25 mg to 0.5 mg twice a day, and the usual starting dose for adults is 1 mg to 2 mg twice a day. Regular daily use is important for its effectiveness.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, use it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double a dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

The nebulizer chamber should be cleaned after each use. Wash the nebulizer chamber and mouthpiece or face mask in warm tap water using a mild detergent. Rinse it well and dry it by connecting the nebulizer chamber to the compressor or air inlet. Read the nebulizer instructions carefully.

To ensure the proper dosage and administration of the medication, be sure to get instructions from a doctor, pharmacist, or other health professional on the use of this medication and the nebulizing equipment.

To reduce the risk of thrush infection in the mouth, rinse and gargle with water after inhaling the medication.

Store this medication at room temperature in an upright position, protect it from light, and keep it out of the reach of children. If you only use half of the contents of an ampule, the remainder must be used within 12 hours of opening. Do not use ampules from a foil envelope that has been opened for 3 months or longer.

0.25 mg/mL
Each ampule contains budesonide 0.25 mg/mL. Nonmedicinal ingredients: citric acid, disodium edetate, polysorbate 80, sodium chloride, sodium citrate, and purified water.

0.5 mg/mL
Each ampule contains budesonide 0.5 mg/mL. Nonmedicinal ingredients: citric acid, disodium edetate, polysorbate 80, sodium chloride, sodium citrate, and purified water.

0.125 mg/mL
Each ampule contains budesonide 0.125 mg/mL. Nonmedicinal ingredients: citric acid, disodium edetate, polysorbate 80, sodium chloride, sodium citrate, and purified water.

Do not take budesonide (for nebulization) if you:

• are allergic to budesonide or to any of the ingredients of the medication
• are having an asthma attack, have status asthmaticus (a severe asthma attack), or have moderate to severe bronchiectasis (a chronic lung problem associated with damaged bronchial tubes)
• currently have or have had pulmonary tuberculosis in the past that was not treated
• have an untreated fungal, bacterial, or viral chest infection

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• bad taste
• cough
• diarrhea
• dry throat
• headache
• hoarseness
• nausea
• tiredness
• thirst
• throat irritation

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• behaviour changes (children)
• depression
• nervousness
• rash on the face
• restlessness
• slowed growth (children)
• symptoms of adrenal insufficiency (e.g., tiredness, headache, nausea, vomiting, muscle or joint pain)
• white patches in the mouth or throat

Stop taking the medication and seek immediate medical attention if any of the following occur:

• shortness of breath, troubled breathing, tightness in chest, or wheezing
• signs of allergic reaction (e.g., hives; difficulty breathing; or swelling of the face, lips, or eyelids)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Asthma control: This medication is not to be used as a "reliever" medication. If you start developing an asthma attack, be sure to use your "reliever" medication for rapid relief of your asthma symptoms. Contact your doctor immediately if you find you are using your "reliever" medications (e.g., salbutamol, terbutaline, formoterol) more often or if they are not working as well as they used to. This may mean your asthma is not controlled. Your doctor may want you to temporarily change the dose of this medication or may start you on an oral corticosteroid.

Bone problems: When used for long periods of time, this medication may reduce bone density and increase the risk of developing osteoporosis. Your doctor may monitor for this periodically.

Breathing problems: If you experience wheezing or difficulty breathing right after using this medication, stop using this medication and use your "reliever" medication (e.g., salbutamol, terbutaline, or formoterol) instead. Contact your doctor as soon as possible.

Eye problems: This medication may increase the risk of cataracts, increased pressure in the eye, and glaucoma when used for long periods of time. Your doctor will monitor you by checking your eyes periodically.

Face irritation: Using a nebulizer with a face mask may cause facial skin irritation. To prevent skin irritation, wash your face after using the face mask or apply a thin layer of petrolatum jelly on your face before using the mask.

Infections: Infections such as chickenpox and measles can be more serious for people taking medications such as budesonide. If you are exposed to someone with chickenpox or measles, contact your doctor.

Liver problems: If you have cirrhosis, your doctor may monitor you more closely for side effects.

Oral hygiene: Adequate oral hygiene, such as rinsing your mouth with water after using this medication, helps reduce the chances of developing a yeast infection of the mouth or throat (thrush). If you develop symptoms of thrush, such as white patches in your mouth, contact your doctor.

Steroid medication use: If you have taken or are still taking an oral steroid medication (e.g., prednisone) during the last several months, consult your doctor before using this medication. In times of stress or during a severe asthma attack, your doctor may want you to start your steroid medication again.

Stopping medication: Do not stop this medication abruptly. When this medication is stopped, it should be stopped gradually, as directed by your doctor.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: Budesonide passes into breast milk. If you are breast-feeding and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

There may be an interaction between budesonide and any of the following:

• aldesleukin
• azole antifungals (e.g., fluconazole, itraconazole, ketoconazole)
• cobicistat
• conivaptan
• diltiazem
• grapefruit juice
• HIV protease inhibitors (e.g., ritonavir, nelfinavir, ritonavir, saquinavir)
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• mifepristone
• protein kinase inhibitors (e.g., crizotinib, imatinib, nilotinib)
• verapamil

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.