What is the usage of Pulmicort (Budesonide)?

From the Guidelines

Pulmicort (budesonide) should be used at a dose of 1 mg, twice daily for 7 days at the first sign of respiratory tract infection–associated symptoms in children aged 0 to 4 years, as recommended by the 2020 focused updates to the asthma management guidelines 1.

Key Considerations

• The typical adult dosage ranges from 180-720 mcg twice daily, while children usually receive 180-360 mcg twice daily, depending on age and condition severity.
• When using Pulmicort, rinse your mouth with water after each use to prevent oral thrush, a common side effect.
• The medication should be used regularly as prescribed, even when symptoms improve, as it works by gradually reducing airway inflammation rather than providing immediate relief.
• Pulmicort is considered a controller medication, not a rescue inhaler, and it may take 1-2 weeks of consistent use before you notice significant improvement in symptoms.
• Common side effects include hoarseness, throat irritation, and cough.
• If you're also using a bronchodilator inhaler, use it 15 minutes before Pulmicort to help the medication reach deeper into your lungs.

Important Guidelines

• Clinicians should carefully monitor length or height in children treated with the recommended regimen, as data regarding effects on growth are conflicting 1.
• Caregivers can initiate intermittent ICS treatment at home without a visit to a health care provider when they have clear instructions, and clinicians should review the plan with the caregiver at regular intervals 1.
• The dose of Pulmicort may be administered 2 times daily, and budesonide suspension is compatible with albuterol, ipratropium, and levalbuterol nebulizer solutions in the same nebulizer 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.

Pulmicort Usage:

• Indication: Pulmicort (budesonide) is used for the maintenance treatment of asthma and as prophylactic therapy in children 12 months to 8 years of age.
• Administration: It should be used with a jet nebulizer machine connected to an air compressor, and not with an ultrasonic nebulizer.
• Important Information: Patients should be advised to use Pulmicort at regular intervals twice a day, and to always have a short-acting beta2-agonist medicine (rescue inhaler) with them to treat sudden symptoms. 2

From the Research

Pulmicort Usage

• Pulmicort, also known as budesonide, is an inhaled corticosteroid used to treat asthma and chronic obstructive pulmonary disease (COPD) 3.
• Studies have compared the efficacy and safety of budesonide with other inhaled corticosteroids, such as fluticasone, in combination with long-acting beta-agonists (LABAs) like formoterol and salmeterol 4, 5, 6, 7.
• A systematic review found that budesonide/formoterol and fluticasone/salmeterol combinations were effective in improving lung function and reducing exacerbations in patients with asthma, with no significant differences in tolerability profiles between the two combinations 4.
• Another study found that budesonide/formoterol was associated with a lower incidence of serious pneumonia events and oral candidiasis compared to other LABA/ICS combinations in COPD patients 6.
• A real-world analysis in an Italian setting found that treatment with budesonide/formoterol was associated with fewer exacerbations and lower healthcare costs compared to fluticasone/salmeterol in COPD patients 7.
• A long-term study found that budesonide inhalation powder (Pulmicort Turbuhaler) was effective and well-tolerated in adults and children with persistent asthma, with no evidence of hypothalamic-pituitary-adrenal axis function suppression 3.