What is the use of Budesonide (Pulmicort) inhaler?

From the Guidelines

Budesonide inhaler is recommended for patients with mild persistent asthma at a dosage of 200 μg twice daily, as it has been shown to improve pre-bronchodilator FEV1 and asthma control, although its effect on quality of life is not significant 1. The medication works by reducing inflammation in the airways, making breathing easier. When using the inhaler, patients should rinse their mouth afterward to prevent oral thrush, a common side effect. Some key points to consider when prescribing budesonide inhaler include:

• The typical adult dosage ranges from 180-720 mcg twice daily, depending on the severity of the condition and specific formulation.
• For maintenance therapy in asthma, 360 mcg twice daily is common, while children often receive lower doses based on age and weight.
• Budesonide does not provide immediate relief for acute symptoms and should be used regularly as prescribed, even when feeling well.
• It may take 1-2 weeks to notice full benefits.
• Side effects can include hoarseness, throat irritation, and oral fungal infections.
• Budesonide is considered a controller medication and should be paired with a rescue inhaler like albuterol for emergency symptom relief.
• Patients should not abruptly stop using budesonide without medical guidance, as symptoms may worsen. The results of the IMPACT study suggest that patients with mild persistent asthma may not need to take daily anti-inflammatory therapy, and that an action plan-based approach may be sufficient 1. However, the use of budesonide inhaler at a dosage of 200 μg twice daily is still recommended for patients with mild persistent asthma, as it has been shown to improve pre-bronchodilator FEV1 and asthma control 1.

From the FDA Drug Label

Budesonide inhalation suspension is an inhaled corticosteroid indicated for: Maintenance treatment of asthma and as prophylactic therapy in children 12 months to 8 years of age 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 budesonide inhaler is used for the maintenance treatment of asthma and as prophylactic therapy in children 12 months to 8 years of age. It is a long-term maintenance medicine used to control and prevent asthma symptoms in this age group.

• The indicated age range for budesonide inhaler is 12 months to 8 years.
• It is not indicated for the relief of acute bronchospasm 2.
• Patients should be advised to use budesonide inhalation suspension at regular intervals twice a day 2.

From the Research

Budesonide Inhaler Efficacy

• The efficacy of budesonide inhalers in controlling mild-to-moderate asthma has been investigated in several studies 3, 4, 5, 6, 7.
• A study published in 2001 found that both high and standard initial doses of budesonide were equally effective in controlling symptoms and improving lung function in mild-to-moderate asthma 3.
• Another study published in 2010 compared the efficacy and safety of budesonide/formoterol pressurized metered-dose inhaler administered once or twice daily in patients with asthma, and found that twice-daily dosing was more effective than once-daily dosing 4.

Dosage and Administration

• The optimal dosage and administration schedule for budesonide inhalers has been explored in several studies 4, 5, 6.
• A study published in 2004 found that once-daily administration of budesonide achieved clinical efficacy comparable to twice-daily regimens in patients with mild-to-moderate asthma 5.
• Another study published in 2007 found that once-daily administration of budesonide was more effective than twice-daily administration in controlling symptoms and improving bronchial hyperresponsiveness in asthmatic children 6.

Patient Outcomes

• The use of budesonide inhalers has been associated with significant improvements in patient outcomes, including peak expiratory flow rates and forced expiratory volume in one second values 7.
• A study published in 2002 found that budesonide therapy was effective in reducing the risk of exacerbations and the number of days with poorly controlled asthma in patients with mild persistent asthma 7.
• The simplification of treatment regimens through once-daily dosing may also improve patient compliance and adherence to treatment 5, 6.