Budicort Suspension 0.5

Indications

• Asthma: For persistent bronchial asthma when pressurized inhalers or dry powder formulations are ineffective.
• Pseudocroup: Very serious cases requiring hospitalization.

Use as directed by a registered physician.

Pharmacology

Budesonide is a synthetic corticosteroid with:

• Potent glucocorticoid activity and weak mineralocorticoid activity.
• Higher affinity for glucocorticoid receptors (200-fold) and greater anti-inflammatory potency (1000-fold) than cortisol.
• Inhibits various cell types and mediators involved in allergic inflammation (e.g., mast cells, eosinophils, histamine).

Dosage

Asthma:

• Initial Dosage:
  • Children (6 months+): 0.25–1.0 mg daily; higher (up to 2.0 mg) for maintenance therapy with oral steroids.
  • Adults/Adolescents (12+): 0.5–2 mg daily; may increase in severe cases.
• Maintenance Dosage:
  • Adjust according to individual needs.
  • Children: 0.25–1.0 mg daily.
  • Adults/Adolescents: 0.5–2.0 mg daily; may further increase in severe cases.
• Once Daily Administration: For mild to moderate stable asthma, consider administering 0.25–1 mg once daily. If worsening occurs, increase to twice daily.

Pseudocroup:

• Infants/Children: 2 mg nebulized budesonide, given as a single dose or two 1 mg doses separated by 30 minutes; repeat every 12 hours for up to 36 hours if necessary.

Use as directed by a registered physician.

Administration

• Mix with 0.9% saline to a volume of 2 ml.
• Administer using a jet nebulizer connected to an adequate airflow compressor (5–8 l/min).

Instructions for Use:

• Shake container before use.
• Rinse mouth post-inhalation to prevent candida infection.
• Wash face after using a nebulizer with a mask.
• Clean nebulizer after each use as per manufacturer’s instructions.

Use as directed by a registered physician.

Interactions

• Increases the efficacy of inhaled beta-2 sympathomimetics.
• CYP3A inhibitors (e.g., ketoconazole, itraconazole) may increase systemic side effects; avoid combinations unless necessary.

Contraindications

• Not indicated for acute dyspnea or status asthmaticus; treat with short-acting β-sympathomimetics.

Side Effects

• Common: Facial irritation (especially with masks), candida infections, and coughing.
• Systemic Effects: Adrenal suppression, growth retardation, decreased bone mineral density, and increased infection susceptibility.

Pregnancy & Lactation

• Pregnancy: Use only if benefits outweigh risks.
• Breastfeeding: Minimal transfer to breast milk; considered safe at therapeutic doses.

Precautions & Warnings

• Caution when transferring patients from oral to inhaled corticosteroids; monitor for adrenal insufficiency.
• Patients with prior high-dose corticosteroid therapy may require additional systemic steroids during stress.