Budesonide

Pulmicort

Pulmicort is a prescription medication used to treat asthma in adults and children. It is available in two forms: Pulmicort Respules, a liquid for use with a nebulizer, and Pulmicort Flexhaler, a dry powder inhaler. Dosages vary based on age and the form used, with specific instructions on usage to manage asthma symptoms effectively. It works by reducing airway inflammation and facilitating easier breathing. Common side effects include respiratory infections and oral thrush. It’s crucial to consult with a primary caregiver to tailor the dosage and address any potential interactions with other medications.

Product Overview

Pulmicort, a brand-name corticosteroid, is prescribed primarily for the treatment of asthma in both adults and children. The medication is formulated in two distinct forms: the Pulmicort Flexhaler and Pulmicort Respules. The Flexhaler dispenses a dry powder in two strengths (90 mcg and 180 mcg per puff) and is typically used twice daily. In contrast, Pulmicort Respules, available in strengths of 0.25 mg/2 mL, 0.5 mg/2 mL, and 1 mg/2 mL, are designed for use with a jet nebulizer, converting the liquid medication into an inhalable mist.

The correct usage of Pulmicort is crucial for its effectiveness in managing asthma symptoms. The Flexhaler requires a deep inhalation technique to ensure the medication reaches the lungs. Similarly, the Respules should be used only with a jet nebulizer to avoid improper administration. After each use, it’s recommended to rinse the mouth to prevent oral thrush, a common side effect. Other potential side effects include respiratory infections, nasal issues, and, in severe cases, paradoxical bronchospasm.

Patients must discuss their medical history with their primary caregiver before starting Pulmicort, as it may not suit those with certain conditions, like liver issues or untreated infections. Regular follow-ups may be necessary to adjust the dosage and monitor side effects. Pulmicort should not be used as a rescue medication for sudden asthma attacks; a separate rescue inhaler should be used for emergencies.

What Are the Uses of Pulmicort?

• Treatment of Asthma in children and adults.

What Are the Forms & Strengths of Pulmicort?

Pulmicort is available in two forms that are inhaled into the lungs:

• Pulmicort Flexhaler

• • • Form: Dry powder
    • Usage: Taken as puffs using an inhaler called the Flexhaler

• Strengths:

• • • • 90 micrograms (mcg) per puff
      • 180 mcg per puff

• Pulmicort Respules

• • • Form: Liquid inside small plastic containers (respules)
    • Usage: Taken using a nebulizer, a machine for inhalation that turns the liquid into a mist

• Strengths:

• • 0.25 milligrams (mg)/2 milliliters (mL)

• 0.5 mg/2 mL
• 1 mg/2 mL

These options allow flexibility in dosing and administration based on individual needs and preferences.

What Are the Recommended Dosage of Pulmicort?

Pulmicort Flexhaler Dosage

For both adults and children aged 6 and older:

• The specific number of puffs needed depends on the prescribed strength of the Pulmicort Flexhaler.
• For example, with the 90-mcg strength and a prescribed dose of 180 mcg twice daily, you’ll need two puffs twice a day.

Adults (18 years and older):

• Typical dosage: 180 mcg to 360 mcg, inhaled twice daily.
• Maximum dosage: 720 mcg, inhaled twice daily.

Children (6 to 17 years):

• Typical dosage: 180 mcg to 360 mcg, inhaled twice daily.
• Maximum dosage: 360 mcg, inhaled twice daily.

Pulmicort Respules Dosage for Young Children

Approved for children (12 months to 8 years):

• Dosage varies depending on the child’s needs.
• It can range from 0.5 mg one time daily to 0.25 mg twice daily.
• The maximum dosage can be up to 0.5 mg two times daily or 1 mg once daily.

Usage Instructions:

• Follow the prescribed number of puffs and frequency as directed by your healthcare provider.
• Ensure the medication is adequately inhaled to achieve effective asthma management.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Use Pulmicort?

Pulmicort Flexhaler Instructions:

• Pulmicort Flexhaler is a powdered form of medication delivered via an inhaler.
• To use, twist the base of the inhaler to load a dose, then take a deep, forceful breath through the mouthpiece to inhale the medication.
• You may not feel the medication enter your lungs, but it usually does, so do not take an extra dose even if you are unsure.
• A healthcare professional will demonstrate the correct usage technique.
• Frequency of Use: Typically, you should use the Pulmicort Flexhaler twice daily, once in the morning and once in the evening. The exact number of puffs will be directed by your doctor.
• If your asthma symptoms are mild, occurring just a few times a month, your doctor might suggest using the Flexhaler less frequently.

Pulmicort Respules Instructions:

• Pulmicort Respules contain a liquid medication used with a jet nebulizer, which converts the liquid into an inhalable mist.
• Do not swallow the liquid in the respules. Also, avoid using ultrasonic nebulizers; only use jet nebulizers as instructed.
• Frequency of Use: Pulmicort Respules are used once or twice daily as your doctor recommends.
• Ensure to follow your doctor’s instructions carefully.

Important Usage Tips:

• Mouth Care: After each dose, rinse your mouth with water & spit it out to reduce the risk of oral thrush, a common side effect.
• Handling Sudden Breathing Issues: If you experience sudden breathing problems after using Pulmicort, use a rescue inhaler immediately. Do not take another dose of Pulmicort, and contact your doctor.
• Keep your rescue inhaler accessible at all times, as Pulmicort is not meant for sudden breathing difficulties.
• If using your rescue inhaler doesn’t relieve symptoms and you think it’s an emergency, call 911 or go to the nearest emergency room.
• If you use the rescue inhaler more frequently, inform your doctor, who may adjust your treatment.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Pulmicort Work?

Pulmicort contains budesonide, a type of corticosteroid that effectively reduces inflammation in the body. Corticosteroids prevent specific cells in your body from producing substances that cause inflammation. When you inhale Pulmicort, budesonide acts directly on the airway linings, stopping them from releasing inflammatory substances. This process decreases airway inflammation, making it easier for air to move in and out of the lungs and reducing the sensitivity of the airways to irritants that could trigger asthma attacks.

Pulmicort is classified as a maintenance medication for asthma, meaning it is designed to control symptoms by consistently reducing inflammation. It is important to use Pulmicort regularly as prescribed to achieve optimal results. Once you begin treatment, you may notice an improvement in your asthma symptoms within a few days, although it can take several weeks for the full benefits of the medication to manifest. Generally, significant improvement in asthma symptoms is observed about 1 to 2 weeks after using Pulmicort Flexhaler and approximately 4 to 6 weeks with Pulmicort Respules. Consistent daily use is crucial for maintaining the effectiveness of Pulmicort in managing asthma symptoms.

Important Safety Information for Using Pulmicort

What Are the Side Effects of Pulmicort?

Common Pulmicort Side Effects: Pulmicort, whether used via the Flexhaler or Respules, can cause some side effects that are usually not serious and tend to resolve within a few days or weeks. If these side effects persist or worsen, it’s important to consult with your healthcare provider. The common side effects of Pulmicort may include:

• Ear infections
• Conjunctivitis (pink eye)
• Respiratory infections, such as the common cold
• Hay fever
• Sore nose and throat
• Runny nose
• Cough
• Stuffy nose
• Rash
• Nausea
• Nosebleeds
• Viral gastroenteritis

Serious Pulmicort Side Effects: While rare, serious side effects can occur when using Pulmicort. If you experience any of the following, contact your doctor immediately or 911 if the symptoms seem life-threatening or you think you’re having a medical emergency. Serious side effects of both Pulmicort Respules and Pulmicort Flexhaler may include:

• Reduced bone mineral density. Signs may include:
  • Back pain
  • Breaking your bones more easily than usual
  • Losing height over time
• Oral thrush
• Paradoxical bronchospasm. Signs may include:
  • Coughing
  • Wheezing
  • Tightness or pain in your chest
  • Trouble drawing air into your lungs
• Slowed growth in children and teenagers
• Increased risk of infections. Signs may include:
  • Aches and pains
  • Fever
  • Diarrhea
  • Nausea and vomiting
  • Rash
  • Chills
  • Feeling tired
• Severe allergic reaction
• Adrenal insufficiency
• Eye problems, such as cataracts and glaucoma

[Note: This list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Are There Any Warnings for Pulmicort? 

Before starting Pulmicort, discussing your health history with your doctor is important. Pulmicort may not be suitable for you if you have certain medical conditions or health factors, including:

• Tuberculosis (TB): Pulmicort can weaken your immune system. If you have an active TB infection, you’ll need treatment for TB before starting Pulmicort. If you’ve been exposed to TB in the past, Pulmicort might reactivate it. Your doctor will decide if you need monitoring or treatment for TB while using Pulmicort.
• Untreated Infections: Pulmicort can reduce your body’s ability to fight infections. If you have any serious untreated infections (bacterial, viral, fungal, or parasitic), you will need appropriate treatment before using Pulmicort. Inform your doctor about any infections you have.
• Allergy to Milk Proteins: Flexhaler of Pulmicort contains lactose, which contains tiny amounts of milk proteins. Do not use it if you have a severe milk protein allergy, as it can cause an allergic reaction. Pulmicort Respules do not contain lactose and may be an option, depending on your age and doctor’s advice.
• Ocular Herpes Infections: If you’ve had herpes infections in your eyes, Pulmicort might increase the risk of flare-ups. Discuss your eye health with your doctor, who may prescribe antiviral medication to prevent flare-ups and eye damage.
• Lack of Immunization for Measles or Chickenpox: Pulmicort can make infections like measles and chickenpox more severe. If you haven’t been immunized or never had these infections, avoid exposure to them. Contact your doctor right away if you come into contact with someone who has chickenpox or measles.
• Reduced Bone Mineral Density: Long-term use of Pulmicort can weaken bones, increasing fracture risk. Your doctor might recommend calcium supplements or other medications to strengthen your bones, especially if you have risk factors such as:
  • Post-menopause
  • Family history of osteoporosis
  • Inactive lifestyle
  • Poor diet
  • Long-term use of bone-weakening medications (such as anticonvulsants and oral corticosteroids)
  • Smoking
  • Age over 65
• Eye Problems: Using Pulmicort for the long term can cause or worsen eye problems like increased eye pressure, glaucoma, or cataracts. If you have existing eye conditions, your doctor may suggest regular eye exams. Report any vision changes to your primary caregiver immediately.
• Liver Problems: Pulmicort is processed in the liver. If your liver isn’t functioning well, Pulmicort might build up in your body, increasing the risk of side effects. Your doctor can closely monitor your liver function during treatment.

What Are the Pulmicort Precautions?

• Pulmicort and Breastfeeding: Budesonide, the active ingredient in Pulmicort, does pass into breast milk in very small amounts. However, it is generally considered safe to use inhaled corticosteroids like Pulmicort while breastfeeding. If you plan to breastfeed while using Pulmicort, discuss the potential risks and benefits with your doctor to ensure the best outcome for you and your baby.
• Pulmicort and Birth Control: There is no specific need to avoid pregnancy while using Pulmicort unless your asthma is not well-managed. If you are sexually active and can become pregnant, consult your primary caregiver to determine if you need to use birth control while taking Pulmicort.
• Pulmicort and Pregnancy: Inhaled corticosteroids like budesonide, the active ingredient in Pulmicort, have been studied for use during pregnancy. These studies have shown that inhaled corticosteroids do not increase the risk of harm to developing fetuses. It is crucial to manage asthma effectively during pregnancy, as poorly controlled asthma and asthma attacks can pose more significant risks to the fetus than the medication itself. According to the GINA (Global Initiative for Asthma), it is recommended not to stop using inhaled corticosteroids, such as Pulmicort, during pregnancy. If you become pregnant while using Pulmicort, talk to your doctor immediately. Your asthma may need closer monitoring, and your doctor can help you weigh the benefits & risks of continuing treatment.

What Are the Contraindications of Pulmicort?

You should not use Pulmicort if you are allergic to any of its ingredients. Specifically, for Pulmicort Flexhaler, avoid using it if you have an allergy to milk proteins, as it contains lactose. Always inform your doctor about any allergies you have to ensure Pulmicort is safe for you to use.

What If You Missed a Dose of Pulmicort?

If you forget to take a dose of Pulmicort, simply skip the missed dose and continue with your next scheduled dose. Do not take two doses at once to make up for the missed one. To avoid missing doses in the future, use a medication timer or consider setting a reminder on your phone. These tools can help ensure you take your medication consistently and on time.

[Note: If you have missed a medication dose and are unsure when to take the next one, immediately consult your doctor or pharmacist.]

What Happens If You Take Too Much of Pulmicort?

Taking more than the recommended dose of Pulmicort for a short time usually doesn’t cause problems. However, using too much Pulmicort over a long period can lead to serious side effects. These can include:

• Developing a hump between your shoulders
• Bruising more easily than usual
• Weight gain
• Stretch marks on your skin
• Your face becomes rounder.
• Acne
• Slow healing of cuts or wounds

If you believe you’ve taken too much Pulmicort, contact your doctor right away.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

How to Store a Pulmicort?

Pulmicort Flexhaler Storage:

• Keep the Pulmicort Flexhaler at room temperature.
• Make sure the cover of the inhaler is always tightly closed to protect the medication.
• Store the Flexhaler in a dry place. Avoid damp or wet areas such as bathrooms to prevent moisture from affecting the medication.

Pulmicort Respules Storage:

• These Respules should also be stored at room temperature.
• Once you open the foil envelope, the respules can be used for up to 2 weeks. After this period, any unused respules should be disposed of.
• Keep the respules upright, and inside the aluminum foil envelope they came in. This envelope protects the medication from light.

Disposal of Pulmicort:

• If you no longer need this medication or have leftovers, it is important to dispose of it safely. Proper disposal helps prevent accidental use by others, including children and pets, and protects the environment.
• Talk to your local waste disposal company or pharmacist for specific instructions or guidelines on how to safely dispose of Pulmicort. This will ensure that the medication is handled in a way that is safe for everyone and the environment.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

What Medications Interact with Pulmicort?

Pulmicort can interact with various medications, and these interactions can affect how well Pulmicort works or increase the risk of side effects. Before starting Pulmicort, it’s crucial to inform your primary caregiver about all other medications you are taking.

Pulmicort and Certain Antimicrobials

Antimicrobial medications are used to treat infections caused by bacteria, fungi, and viruses, including HIV. Some of these antimicrobials are strong inhibitors of a protein called CYP3A4, which plays a significant role in metabolizing medications in your body, including Pulmicort. CYP3A4 helps break down and eliminate Pulmicort from your body. When the action of CYP3A4 is inhibited by certain antimicrobials, Pulmicort may not be metabolized as quickly. This may lead to an increased concentration of Pulmicort in your body, potentially raising the risk of side effects. Examples of antimicrobial drugs that are strong CYP3A4 inhibitors include:

• Antifungals may consist of:
  • Sporanox (itraconazole)
  • Vfend (voriconazole)
• Antivirals may consist of:
  • Norvir (ritonavir)
  • Reyataz (atazanavir)
  • Viracept (nelfinavir)
• Antibiotics that may consist of:
  • Clarithromycin

What Are the Other Pulmicort Interactions?

• Pulmicort and Herbs and Supplements: There are no specific herbs or supplements known to interact directly with Pulmicort. However, because individual responses can vary and some products might affect your overall health or asthma, it’s important to consult your doctor or pharmacist before you start using any new herbs or supplements while taking Pulmicort.
• Pulmicort and Alcohol: Pulmicort itself does not interact with alcohol. Nonetheless, it’s worth noting that for some individuals, consuming alcohol can trigger asthma symptoms. If you consume alcohol while using Pulmicort, discuss with your healthcare provider about the amount of alcohol that may be safe for you to drink. This conversation can help ensure that your asthma remains well-controlled while you are being treated with Pulmicort.

[Note: This isn’t a complete list, and there could be other drugs that interact with Pulmicort. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

What Are the Pulmicort Alternatives?

There are various alternative medications available for treating asthma if Pulmicort does not suit your needs. If you’re considering alternatives, it’s important to discuss this with your doctor, who can provide recommendations based on your specific health requirements. Pulmicort is part of a drug class known as corticosteroids, which are used daily as maintenance treatments to manage asthma symptoms effectively. Examples of other maintenance medications for asthma that you might discuss with your doctor include:

• LABAs (long-acting beta2-agonists), including:
  • Serevent Diskus (salmeterol)
  • Perforomist (formoterol fumarate)
  • Spiriva Respimat (tiotropium)
• Inhalers that contain a combination of drugs, including:
  • Dulera (mometasone/formoterol fumarate)
  • Advair (fluticasone propionate/salmeterol)
  • Symbicort (budesonide/formoterol fumarate)
• Inhaled corticosteroids other than Pulmicort, including:
  • Asmanex HFA (mometasone)
  • Alvesco (ciclesonide)
  • Qvar (beclomethasone dipropionate HFA)
  • Arnuity Ellipta (fluticasone furoate)
  • Flovent HFA, Flovent Diskus (fluticasone propionate)
• Leukotriene modifiers, including:
  • Accolate (zafirlukast)
  • Zyflo (zileuton)
  • Singulair (montelukast)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

Pulmicort Cost & Coupons

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Frequently Asked Questions

Will I need to use this drug long term?

Pulmicort is designed for the long-term treatment of asthma. If your doctor finds Pulmicort safe and effective, you will likely use it over an extended period. It is crucial not to stop taking Pulmicort without your doctor’s approval, even if you are not currently experiencing asthma symptoms. Pulmicort helps control asthma by managing symptoms over time, but it does not cure the condition. Consistent use is necessary to maintain its effectiveness. If you discontinue Pulmicort abruptly, your asthma symptoms may return or worsen. Always follow your doctor’s instructions regarding the use of Pulmicort to ensure optimal management of your asthma.

Will I have side effects if I stop using Pulmicort abruptly?

Stopping Pulmicort suddenly can lead to side effects, particularly if you have been taking a high dose or using it for a long time. If you stop and don’t switch to another corticosteroid medication, your asthma symptoms might worsen.

Additionally, abruptly discontinuing Pulmicort after prolonged high-dose usage might lead to adrenal insufficiency. This condition occurs because long-term use of corticosteroids like Pulmicort can suppress your adrenal glands’ natural ability to produce cortisol, a hormone critical for managing stress responses in the body. Stressors could include severe illness, infections, injuries, or surgery. Symptoms of adrenal insufficiency include:

• Tiredness
• Weakness
• Nausea and vomiting
• Low blood pressure

Can Pulmicort be used with long-acting inhalers to treat asthma?

Yes, Pulmicort can be used alongside long-acting beta2-agonist (LABA) inhalers to treat asthma effectively. However, combining LABAs with a corticosteroid inhaler like Pulmicort is essential. Using LABAs alone without a corticosteroid can increase the risk of asthma-related complications, including death. Examples of LABA inhalers that should be used with a corticosteroid inhaler include:

• Arformoterol tartrate (Brovana)
• Formoterol fumarate (Perforomist)
• Salmeterol xinafoate (Serevent Diskus)

Should I use Pulmicort to treat sudden breathing problems?

No, Pulmicort should not be used to treat sudden breathing problems. For quick relief during an unexpected breathing difficulties or asthma attack, you should use rescue medication. Rescue medications, such as short-acting beta2-agonists (SABAs), work fast to open your airways. Common examples include albuterol sulfate (found in Proventil, Ventolin HFA, and ProAir) and levalbuterol tartrate (Xopenex). Pulmicort is classified as a maintenance medication, not a rescue inhaler. It is designed to be used regularly to manage and prevent asthma symptoms by reducing lung inflammation.

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