From the Guidelines
Budesonide is recommended as the first-line treatment for inducing clinical remission in patients with symptomatic microscopic colitis, due to its strong recommendation and moderate quality of evidence 1.
Key Points
- Budesonide has a strong recommendation and moderate quality of evidence for inducing clinical remission in patients with symptomatic microscopic colitis 1.
- The recommended dose of budesonide for induction of clinical remission is 9 mg daily, with a treatment duration of up to 8 weeks 1.
- Budesonide has fewer systemic side effects compared to other corticosteroids, due to its extensive first-pass metabolism in the liver 1.
- Common side effects of budesonide include throat irritation, nasal dryness, and mild digestive issues 1.
- Patients should rinse their mouth after using inhaled budesonide to prevent oral thrush and should not abruptly stop taking the medication without medical guidance 1.
- Budesonide MMX has been shown to be effective in inducing remission in patients with mild to moderate ulcerative colitis, particularly those with left-sided disease 1.
Treatment Considerations
- Budesonide should be considered as first-line therapy for the treatment of microscopic colitis, due to its favorable risk/benefit profile and convenience of once-daily dosing 1.
- Alternative therapies, such as mesalamine, may be considered if cost is a determining factor or if budesonide is not feasible 1.
- Maintenance therapy with budesonide may be necessary for patients who have had a clinical relapse after cessation of induction therapy, with a recommended dose of 6 mg daily 1.
- Osteoporosis prevention and screening should be considered in patients who require maintenance therapy with budesonide, due to the potential risk of bone loss with prolonged use 1.
From the FDA Drug Label
Budesonide inhalation suspension is an inhaled corticosteroid medicine Budesonide inhalation suspension is a long-term maintenance medicine used to control and prevent asthma symptoms in children ages 12 months to 8 years. The main use of budesonide is as an inhaled corticosteroid for the treatment of asthma in children aged 12 months to 8 years, and also as an oral medication for the treatment of ulcerative colitis.
- Key points about budesonide include:
- It is used to control and prevent asthma symptoms
- It is not used to treat sudden symptoms of asthma
- It may cause systemic corticosteroid effects, such as hypercorticism and adrenal suppression
- Patients should be advised to use it at regular intervals, twice a day 2
- It is also used to induce remission in patients with active, mild to moderate ulcerative colitis 3 3
From the Research
Budesonide Overview
- Budesonide is a glucocorticoid with high topical activity and low systemic bioavailability, resulting in reduced systemic effects compared to other glucocorticoids 4.
- It has been evaluated for use in patients with inflammatory bowel disease, asthma, and chronic obstructive pulmonary disease (COPD).
Inflammatory Bowel Disease
- Budesonide has been shown to be effective in treating active distal ulcerative colitis and/or proctitis, with endoscopic remission or improvement in 46-84% of patients 4.
- Oral treatment with controlled-release budesonide has produced clinical remission in 42-67% of patients with active Crohn's disease of the ileum, ileocaecal region, and/or ascending colon 4.
- Budesonide has similar efficacy to prednisolone and causes less suppression of plasma cortisol levels than other glucocorticoids 4.
Asthma
- Budesonide is a widely used inhaled corticosteroid (ICS) with a favorable therapeutic ratio, available via a dry powder inhaler or as a suspension for nebulization 5.
- Once-daily administration of budesonide achieves clinical efficacy comparable to twice-daily regimens in patients with mild-to-moderate asthma 5.
- Budesonide is effective and well-tolerated in the control of mild-to-moderate persistent asthma in patients aged 12 months and older 6.
Chronic Obstructive Pulmonary Disease (COPD)
- Budesonide is a potent, non-halogenated ICS that has been developed for its anti-inflammatory properties 7.
- Inhaled budesonide has a rapid and high airway efficacy due to its balanced relationship between water solubility and lipophilicity 7.
- The combination of budesonide/formoterol can be used as an as-needed reliever with anti-inflammatory properties, with or without regular maintenance for asthma 7.