{"ok":true,"entry":{"slug":"budesonide","kind":"medication","name":"budesonide","aliases":["Pulmicort","Symbicort (with formoterol)"],"brands_sg":["Pulmicort","Symbicort","DuoResp Spiromax","Giona Easyhaler","Budenofalk"],"class":"inhaled/oral corticosteroid","tags":["respiratory"],"use_for":"prescribed as a preventer for asthma and copd","use_after":"fda: pulmicort flexhaler is inhaled twice daily","use_duration":null,"take_with":"a water rinse after inhaling · nhs: not swallowed","pros":["nhs: very little reaches the rest of the body","nhs: a spacer cuts mouth and throat side effects","nhs: using too much is unlikely to harm you"],"cons":["nhs: oral thrush, dry or sore throat, hoarse voice","fda: not for relief of acute bronchospasm","nhs: high long-term doses risk adrenal and bone harm"],"dose_note":"the us fda label for pulmicort flexhaler sets a 360 mcg twice-daily starting dose for adults 18 and over and states 'the maximum dosage should not exceed 720 mcg twice daily' — 1,440 mcg a day, the highest inhaled figure that label carries; for ages 6 to 17 it says 'the maximum dosage should not exceed 360 mcg twice daily'. for the budesonide-formoterol inhaler the us label says more frequent administration or more than 2 inhalations twice daily 'is not recommended', and nhs adds that where such an inhaler is also used as a reliever this 'can be up to 12 puffs a day in total'. the oral delayed-release capsule is a separate ceiling entirely: 9 mg once daily for up to 8 weeks in active crohn's disease. singapore registers inhalers, nebuliser suspensions, nasal sprays, rectal foam and oral capsules and tablets. in singapore the prescriber sets the dose.","dosage":null,"ul_status":null,"sg_class":"prescription-only","cautions":["nhs: past tuberculosis, or other steroid medicines recently","fda: severe hypersensitivity to milk proteins (flexhaler)","fda: not for status asthmaticus or acute asthma episodes","nhs: pregnancy or trying to get pregnant"],"clashes":[{"src":["fda_bud_di","fda_sym_di"],"note":"fda: may inhibit budesonide metabolism and increase systemic exposure and corticosteroid effects","with":"strong cyp3a4 inhibitors (ritonavir, ketoconazole, itraconazole, clarithromycin)"},{"src":["nhs_bud_adrenal"],"note":"nhs: on high doses these raise the chance of underactive adrenal glands","with":"other steroid medicines, or medicines for fungal infection or hiv"},{"src":["fda_sym_di"],"note":"fda: with the formoterol-containing inhaler, extreme caution — formoterol's vascular effect may be potentiated","with":"maois and tricyclic antidepressants"},{"src":["fda_sym_di"],"note":"fda: may block the bronchodilator effect of the beta-agonist component and produce severe bronchospasm","with":"beta-blockers"},{"src":["fda_sym_di"],"note":"fda: ecg changes and hypokalaemia may worsen with the beta-agonist component","with":"non-potassium-sparing diuretics"}],"sources":[{"id":"hsa_register","url":"https://data.gov.sg/datasets/d_767279312753558cbf19d48344577084/view","label":"HSA — Listing of Registered Therapeutic Products (data.gov.sg open dataset, 5,511 rows, cached in full and filtered locally)","quote":"All 19 budesonide rows read Forensicclassification 'Prescription Only' — including nasal sprays (Esonide), Pulmicort Respules and Turbuhaler, Symbicort, DuoResp Spiromax, Breztri, Giona Easyhaler, Budenofalk, Nefegan and Cortiment.","accessed":"2026-08-27"},{"id":"nhs_bud_about","url":"https://www.nhs.uk/medicines/budesonide-inhalers/","label":"NHS Medicines A-Z — Budesonide inhalers: about","quote":"Budesonide inhalers: steroid medicine used for asthma and chronic obstructive pulmonary disease … Find out how budesonide inhalers treat asthma and chronic obstructive pulmonary disease (COPD) symptoms and how to use them. Brand names: Pulmicort, Budelin","accessed":"2026-08-27"},{"id":"nhs_bud_howto","url":"https://www.nhs.uk/medicines/budesonide-inhalers/how-and-when-to-use-budesonide-inhalers/","label":"NHS Medicines A-Z — Budesonide inhalers: how and when to use (dosage)","quote":"The usual dose for budesonide inhalers as a preventer for asthma or chronic obstructive pulmonary disease (COPD) is 1 or 2 puffs, once or twice a day … This can be up to 12 puffs a day in total.","accessed":"2026-08-27"},{"id":"nhs_bud_spacer","url":"https://www.nhs.uk/medicines/budesonide-inhalers/how-and-when-to-use-budesonide-inhalers/","label":"NHS Medicines A-Z — Budesonide inhalers: using an inhaler with a spacer","quote":"If you're using a pressurised metered dose inhaler (pMDI), your doctor or nurse may give you a spacer … Spacers can also reduce the risk of steroid side effects affecting your mouth and throat.","accessed":"2026-08-27"},{"id":"nhs_bud_over","url":"https://www.nhs.uk/medicines/budesonide-inhalers/how-and-when-to-use-budesonide-inhalers/","label":"NHS Medicines A-Z — Budesonide inhalers: if you use too much","quote":"Using too much budesonide is unlikely to harm you. If you're worried, talk to your doctor or a pharmacist.","accessed":"2026-08-27"},{"id":"nhs_bud_se","url":"https://www.nhs.uk/medicines/budesonide-inhalers/side-effects-of-budesonide-inhalers/","label":"NHS Medicines A-Z — Budesonide inhalers: common side effects","quote":"Common side effects … Oral thrush … Dry or sore throat, or hoarse voice … try rinsing your mouth with water or brushing your teeth after using your inhaler","accessed":"2026-08-27"},{"id":"nhs_bud_se_low","url":"https://www.nhs.uk/medicines/budesonide-inhalers/side-effects-of-budesonide-inhalers/","label":"NHS Medicines A-Z — Budesonide inhalers: how much reaches the body","quote":"When you inhale budesonide, very little medicine gets into the rest of your body, so it's unlikely to give you side effects","accessed":"2026-08-27"},{"id":"nhs_bud_se_long","url":"https://www.nhs.uk/medicines/budesonide-inhalers/side-effects-of-budesonide-inhalers/","label":"NHS Medicines A-Z — Budesonide inhalers: long-term side effects in adults","quote":"Adults taking high doses (either using an inhaler or nebuliser) have an increased risk of getting adrenal gland problems or weak bones (osteoporosis) over time. This is because more of the steroid gets into your body.","accessed":"2026-08-27"},{"id":"nhs_bud_adrenal","url":"https://www.nhs.uk/medicines/budesonide-inhalers/side-effects-of-budesonide-inhalers/","label":"NHS Medicines A-Z — Budesonide inhalers: adrenal insufficiency with other medicines","quote":"If you're on high doses of budesonide, or you're also taking other steroid medicines or certain medicines for fungal infections or HIV, you may get underactive adrenal glands (adrenal insufficiency) as a side effect.","accessed":"2026-08-27"},{"id":"nhs_bud_who","url":"https://www.nhs.uk/medicines/budesonide-inhalers/who-can-and-cannot-use-budesonide-inhalers/","label":"NHS Medicines A-Z — Budesonide inhalers: who can and cannot use","quote":"tell a doctor or nurse if you: have ever had an allergic reaction to budesonide or any other medicine; have ever had TB (tuberculosis); are taking or have recently taken other steroid medicines; are pregnant or trying to get pregnant","accessed":"2026-08-27"},{"id":"fda_bud_ind","url":"https://api.fda.gov/drug/label.json?search=openfda.generic_name:%22budesonide%22&limit=5","label":"US FDA label — PULMICORT FLEXHALER (budesonide), Indications and Usage, via openFDA drug/label.json","quote":"PULMICORT FLEXHALER is a corticosteroid indicated for: Maintenance treatment of asthma as prophylactic therapy in adult and pediatric patients six years of age or older. Limitations of Use: Not indicated for the relief of acute bronchospasm","accessed":"2026-08-27"},{"id":"fda_bud_dose","url":"https://api.fda.gov/drug/label.json?search=openfda.generic_name:%22budesonide%22&limit=5","label":"US FDA label — PULMICORT FLEXHALER (budesonide), section 2.1 Asthma dosing, via openFDA drug/label.json","quote":"For patients 18 years of age and older, the recommended starting dosage is 360 mcg twice daily. The maximum dosage should not exceed 720 mcg twice daily … Patients 6 to 17 … should not exceed 360 mcg twice daily","accessed":"2026-08-27"},{"id":"fda_bud_rinse","url":"https://api.fda.gov/drug/label.json?search=openfda.generic_name:%22budesonide%22&limit=5","label":"US FDA label — PULMICORT FLEXHALER (budesonide), section 2 administration, via openFDA drug/label.json","quote":"PULMICORT FLEXHALER should be administered twice daily by the orally inhaled route only. After inhalation, the patient should rinse the mouth with water without swallowing.","accessed":"2026-08-27"},{"id":"fda_bud_ci","url":"https://api.fda.gov/drug/label.json?search=openfda.generic_name:%22budesonide%22&limit=5","label":"US FDA label — PULMICORT FLEXHALER (budesonide), section 4 Contraindications, via openFDA drug/label.json","quote":"Primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required. Severe hypersensitivity to milk proteins or any ingredients of PULMICORT FLEXHALER","accessed":"2026-08-27"},{"id":"fda_bud_di","url":"https://api.fda.gov/drug/label.json?search=openfda.generic_name:%22budesonide%22&limit=5","label":"US FDA label — PULMICORT FLEXHALER (budesonide), section 7 Drug Interactions, via openFDA drug/label.json","quote":"Strong Cytochrome P450 3A4 Inhibitors (e.g., ritonavir): Use with caution. May cause increased systemic corticosteroid effects … ketoconazole, a strong inhibitor of CYP3A4 … increased … clarithromycin, indinavir, itraconazole","accessed":"2026-08-27"},{"id":"fda_sym_dose","url":"https://api.fda.gov/drug/label.json?search=openfda.generic_name:%22budesonide%22&limit=5","label":"US FDA label — budesonide and formoterol fumarate dihydrate inhalation aerosol, section 2 Dosage and Administration, via openFDA drug/label.json","quote":"More frequent administration or a higher number of inhalations (more than 2 inhalations twice daily) of the prescribed strength … is not recommended as some patients are more likely to experience adverse effects with higher doses of formoterol.","accessed":"2026-08-27"},{"id":"fda_sym_di","url":"https://api.fda.gov/drug/label.json?search=openfda.generic_name:%22budesonide%22&limit=5","label":"US FDA label — budesonide and formoterol fumarate dihydrate, section 7 Drug Interactions, via openFDA drug/label.json","quote":"Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution … Beta-blockers: Use with caution. May block bronchodilatory effects of beta-agonists and produce severe bronchospasm. Diuretics: Use with caution.","accessed":"2026-08-27"},{"id":"fda_bud_oral_dose","url":"https://api.fda.gov/drug/label.json?search=openfda.generic_name:%22budesonide%22&limit=5","label":"US FDA label — budesonide delayed-release capsules (oral), section 2 Dosage and Administration, via openFDA drug/label.json","quote":"Mild to moderate active Crohn's disease: Adults: 9 mg once daily for up to 8 weeks … Maintenance of clinical remission … Adults: 6 mg once daily for up to 3 months","accessed":"2026-08-27"}],"brand_certs":null,"updated_at":"2026-08-29T16:16:14.713299+08:00"},"disclaimer":"kozen-x is not a medical device and does not give medical advice. it lists what published sources have written down. absence of a record is not the same as safe."}