From the FDA Drug Label
Patients who are on drugs that suppress the immune system are more susceptible to infection than healthy individuals. Chicken pox and measles, for example, can have a more serious or even fatal course in susceptible children or adults using corticosteroids In children or adults who have not had these diseases, or been properly immunized, particular care should be taken to avoid exposure. If exposed to measles, prophylaxis with pooled intramuscular immunoglobulin (IG) may be indicated.
The interaction between Budesonide (a corticosteroid) and measles is that corticosteroids may increase the risk of severe or fatal measles infection. If a patient taking budesonide is exposed to measles, prophylaxis with pooled intramuscular immunoglobulin (IG) may be indicated 1 1. Particular care should be taken to avoid exposure to measles in patients who have not had the disease or been properly immunized.
From the Research
Budesonide should generally be continued during measles infection for patients who are already using it for conditions like asthma or inflammatory bowel disease, as it helps reduce inflammation and is not known to specifically worsen measles outcomes when used at prescribed therapeutic doses. For patients with asthma using inhaled budesonide, maintaining control of respiratory symptoms is particularly important during a measles infection, as measles can cause respiratory complications, as noted in a study published in the Lancet in 2022 2. For those with inflammatory bowel disease using oral budesonide, abrupt discontinuation could lead to disease flares. However, high-dose systemic corticosteroids might potentially affect immune response during active measles infection, so consultation with a healthcare provider is recommended to assess individual risk-benefit, as suggested by a review of measles management in the Journal of Emergency Medicine in 2020 3. Patients with measles should focus on supportive care including rest, adequate hydration, fever management with acetaminophen or ibuprofen, and vitamin A supplementation in certain cases as recommended by a healthcare provider. If respiratory symptoms worsen while on budesonide during measles infection, medical attention should be sought promptly.
Some key considerations in managing measles infection include the potential for complications such as otitis media, laryngotracheobronchitis, pneumonia, stomatitis, and diarrhoea, as outlined in a study published in the Lancet in 2022 2. Additionally, neurological complications can occur, although they are uncommon, and include acute disseminated encephalomyelitis, measles inclusion body encephalitis, and subacute sclerosing panencephalitis. The use of early measles vaccination at 4 months of age could be an effective strategy to prevent severe morbidity and death from both measles and RSV infections in many low-income and middle-income countries, as discussed in a viewpoint published in the Lancet Global Health in 2022 4.
In terms of the interaction between budesonide and measles, there is no specific evidence to suggest that budesonide worsens measles outcomes, and the medication can be continued as prescribed, with careful monitoring of the patient's condition and adjustment of the treatment plan as needed, based on guidance from studies such as those published in the Journal of Emergency Medicine in 2020 3 and the Lancet in 2022 2.
The management of measles is mainly supportive, and patients should be closely monitored for complications and treated promptly if they occur, as recommended by studies such as those published in the Lancet in 2022 2 and the Journal of Emergency Medicine in 2020 3. Vitamin A supplementation is recommended in certain cases, and antibiotics may be prescribed if bacterial superinfections occur, as noted in a study published in Annali di igiene in 2009 5. Overall, the key to managing measles infection is prompt recognition, supportive care, and prevention of complications, with the use of medications such as budesonide continued as prescribed and monitored closely.