Budesonide (Rhinocort) Nasal Spray Dosage for Allergic Rhinitis
For allergic rhinitis, budesonide (Rhinocort) nasal spray should be administered as 2 sprays per nostril twice daily (total 128 μg per day) or 4 sprays per nostril once daily in the morning for patients aged 6 years and older. 1
Approved Age and Formulation
- Budesonide (Rhinocort AQ) is FDA-approved for patients ≥6 years of age
- Available as an aqueous formulation containing 32 μg per spray
- Indicated for both allergic rhinitis and nonallergic rhinitis
Dosing Guidelines by Age
- Age ≥6 years: 2 sprays per nostril twice daily (128 μg total daily) OR 4 sprays per nostril once daily in the morning (128 μg total daily)
- Not approved for children under 6 years of age
Administration Technique
- Insert tip gently into the nostril
- Direct spray away from the nasal septum to prevent irritation
- Use the right hand to spray the left nostril and vice versa
- Breathe in slowly while spraying
- For optimal delivery in children, have them lie down with head tilted back
Common Side Effects
The most common side effects of budesonide nasal spray include:
- Epistaxis (nosebleed)
- Pharyngitis (sore throat)
- Bronchospasm
- Coughing
- Nasal irritation
Clinical Efficacy
Budesonide nasal spray has demonstrated effectiveness in treating allergic rhinitis with:
- Significant reduction in nasal symptoms compared to placebo 2
- Onset of action within 12 hours in children with perennial allergic rhinitis 3
- Effective reduction in nasal inflammation as shown by decreased eosinophils and basophils 2
Prescription Status
- Budesonide (Rhinocort AQ) is available by prescription only, unlike triamcinolone acetonide (Nasacort Allergy 24HR) which is available over-the-counter 1
Important Considerations
- Examine the nasal septum periodically to check for mucosal erosions
- Avoid sharing medication between individuals to prevent infection spread
- Regular use is more effective than intermittent use
- Contraindicated in patients with history of hypersensitivity to budesonide or its components
Comparison to Other Intranasal Corticosteroids
While all intranasal corticosteroids are effective for allergic rhinitis, budesonide has been shown to:
- Have comparable efficacy to fluticasone propionate but with different sensory attributes 4
- Be superior to intranasal antihistamines like azelastine in relieving symptoms of perennial allergic rhinitis 5
For optimal outcomes in treating allergic rhinitis, consistent daily use of budesonide nasal spray at the recommended dosage is essential for symptom control and improved quality of life.