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ALIMENTARY TRACT AND METABOLISM › ANTIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS › INTESTINAL ANTIINFLAMMATORY AGENTS › Corticosteroids acting locally
budesonide
A07EA06
Forms & Strengths
- Oral capsule (delayed-release): 3 mg
- Oral tablet (extended-release): 9 mg
- Inhalation suspension: 0.25 mg/2 mL, 0.5 mg/2 mL
- Inhalation powder (Turbuhaler): 90 mcg, 180 mcg/inhalation
- Nasal spray: 32 mcg/actuation
- Rectal foam: 2 mg/actuation
Adult Dosing
- Crohn's disease (mild-to-moderate): 9 mg orally once daily for up to 8 weeks
- Ulcerative colitis (induction): 9 mg orally once daily for up to 8 weeks
- Ulcerative colitis (rectal): 2 mg (one applicatorful) rectally twice daily for 2 weeks, then once daily for 4 weeks
- Asthma: 200 to 400 mcg inhaled twice daily (max 1.6 mg/day)
- Allergic rhinitis: 64 mcg (two sprays per nostril) once daily
Pediatric Dosing
- Asthma (children 6 years and older): 200 mcg inhaled twice daily
- Asthma (children 1 to 8 years, via nebulizer): 0.5 mg once daily or 0.25 mg twice daily
- Crohn's disease (pediatric patients 8 to 17 years, weight >40 kg): 9 mg orally once daily for 8 weeks
Indications
- Treatment of active, mild-to-moderate Crohn's disease involving the ileum and/or ascending colon
- Induction of remission in active, mild-to-moderate ulcerative colitis
- Maintenance of clinical remission of ulcerative colitis
- Maintenance treatment of asthma as prophylactic therapy
- Management of symptoms of seasonal or perennial allergic rhinitis
Mechanism of Action
- Synthetic glucocorticoid with high topical anti-inflammatory potency and substantial first-pass hepatic metabolism
- Binds to glucocorticoid receptors, suppressing multiple signaling pathways and inhibiting inflammatory cytokine production
Contraindications
- Hypersensitivity to budesonide or any formulation excipients
- Primary treatment of status asthmaticus or other acute episodes of asthma requiring intensive measures
Adverse Reactions
- Headache
- Respiratory infection
- Nausea
- Back pain
- Dyspepsia
- Dizziness
- Abdominal pain
- Flatulence
- Vomiting
- Fatigue
- Weight gain
- Hypercortism and adrenal suppression (with systemic absorption)
Drug Interactions
- Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, clarithromycin): significantly increase systemic exposure of budesonide
- CYP3A4 inducers (e.g., carbamazepine, rifampin): may decrease budesonide plasma concentrations
- Grapefruit juice: may inhibit intestinal CYP3A4 and increase systemic bioavailability of oral budesonide
Curated Content: Needs Vetting Before Put to Clinical Use