Budesonide Dosages for Allergies and Asthma: Your GoodRx Guide

Budesonide is a versatile medication that can treat different inflammatory health conditions. It comes in a variety of dosage forms and both over-the-counter (OTC) and prescription products. For allergies or asthma, it’s available in nasal and inhaled forms.

You can find budesonide as an OTC nasal spray for allergies (Rhinocort Allergy). But for asthma, it comes as an inhaler (Pulmicort Flexhaler) and an inhalation suspension (Pulmicort Respules). These require a prescription, and are meant for maintenance treatment only, not rescue treatment.

Below, we’ll look at the different budesonide dosages for adults and children when it’s used for allergies and asthma. Budesonide is also available in oral and rectal dosage forms, but they’re not typically used for allergies and asthma, so we won’t be reviewing those.

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Budesonide dosage forms

For allergies or asthma, budesonide is available as a nasal spray, inhaler, and inhalation suspension.

Nasal spray

When budesonide is used for allergies, it comes as a nasal spray. Each spray contains 32 mcg of budesonide. Budesonide nasal spray used to be prescription (Rx) only. But in 2015, the FDA approved an Rx-to-OTC switch. This means you can purchase it OTC without a prescription.

Before you use budesonide nasal spray for the first time, you’ll need to prime it. You’ll need to prime it again if you haven’t used it for 2 days or longer. The instructions on your product explain how to prime it. Shake well before using.

Inhaled forms

For asthma, budesonide comes as a prescription-only dry powder inhaler and an inhalation suspension. The inhaler is approved for people age 6 and older. But the inhalation suspension is approved only for children ages 1 to 8.

The budesonide inhaler comes in 90 mcg and 180 mcg doses. The budesonide inhalation suspension must be used with a nebulizer. It comes in three different doses:

• 0.25 mg/2 mL

• 0.5 mg/2 mL

• 1 mg/2 mL

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If you’re using the budesonide inhaler, you’ll also need to prime it before use. Inhale deeply and forcefully with each dose. You may not feel anything while you inhale the powder — this doesn’t mean you didn’t get your dose. The inhalation suspension, on the other hand, is poured into a nebulizer cup and inhaled over about 5 minutes.

Make sure to rinse out your mouth with water and spit after each inhaled budesonide dose. This can help prevent a fungal infection in your mouth and throat (oral thrush).

Keep in mind: If you’re experiencing asthma symptoms, use your rescue inhaler. Budesonide is meant to prevent asthma attacks from happening. But in some cases, your prescriber may ask you to take a dose of budesonide at the same time as your rescue inhaler. Be sure to follow their instructions to best prevent and treat asthma attacks.

What’s the typical budesonide dosage for adults?

Below are the typical nasal and inhaled budesonide dosages for adults. This information may be different from your prescribed dosage. Be sure to follow the instructions from your prescriber.

Allergies

The typical budesonide nasal spray dosage for allergy symptoms in adults is 2 sprays into each nostril once a day. When your allergy symptoms are better, try using 1 spray in each nostril once a day.

Remember to sniff gently as you spray budesonide into your nostril. If your allergy symptoms don’t improve after 2 weeks of using budesonide nasal spray, stop using it and ask your primary care provider for guidance.

Asthma

The typical budesonide inhaler dosage for asthma in adults ranges from 180 mcg to 360 mcg inhaled by mouth twice a day. For most people, the starting dosage is 360 mg twice daily. The maximum dosage is 720 mcg inhaled twice a day.

What’s the typical budesonide dosage for children?

Children age 6 and older may use budesonide nasal spray for allergies and the budesonide inhaler for asthma. Children ages 1 to 8 can use the budesonide inhalation suspension.

Allergies

The typical budesonide nasal spray dosage for children ages 6 to 11 is 1 spray in each nostril once a day. If your child’s allergy symptoms aren’t improving, they can use 2 sprays in each nostril once a day. Once they’re feeling better, reduce the dose to 1 spray in each nostril once a day.

Children age 12 and older should use the adult dose. Start with 2 sprays in each nostril once a day. Once symptoms improve, lower the dose to 1 spray in each nostril once a day.

If your child’s symptoms aren’t improving after 2 weeks, stop using budesonide and contact their pediatrician.

Asthma

Your child may be prescribed the budesonide inhaler or inhalation suspension for asthma. This will depend on their age and which dosage form they’re more comfortable using.

The typical budesonide inhaler dosage for children ages 6 to 17 is to inhale 180 mcg by mouth twice a day. Your child’s pediatrician may recommend a starting dosage of 360 mcg twice a day if they need more help managing their symptoms. The maximum recommended dosage in this age group is 360 mcg twice daily.

The typical budesonide inhalation suspension dosage for children ages 1 to 8 depends on their prior asthma treatments:

• Bronchodilators alone: 0.5 mg once a day or 0.25 mg twice a day

• Inhaled corticosteroids: 0.5 mg once a day or 0.25 mg to 1 mg once a day or 0.5 mg twice a day

• Oral corticosteroids: 0.5 mg twice a day or 1 mg once a day

If your child’s symptoms aren’t managed with a once-daily dosage, their prescriber might recommend giving budesonide in doses split up throughout the day.

Can budesonide be used during pregnancy or while nursing?

If you’re pregnant or nursing, you may be wondering whether budesonide is safe to use. Experts consider budesonide nasal spray to be safe to take during pregnancy. It can help lower the need for oral allergy medications, which tend to have more side effects.

Of all the inhaled corticosteroids, budesonide has been studied the most. This is why it’s considered the safest option to manage your asthma during pregnancy.

Not much budesonide is expected to get into breast milk from the nasal spray or inhaler. But it’s best to check with your OB-GYN or pediatrician before taking any medications while nursing.

What happens if you miss a dose of budesonide?

If you miss a dose of budesonide, just skip that dose. Take the next dose at your usual time. Don’t double up on your dose to make up for a missed dose. This could lead to side effects such as nose or throat irritation. It could also expose your body to too much medication.

To help you remember to take your doses on time, try setting an alarm. You could also try a medication reminder app on your smartphone. Talk to your prescriber if you’re having trouble remembering to take it. Consistency is key to get the most from budesonide.

What should you do if you take too much budesonide?

Taking an extra dose of budesonide by mistake isn’t likely to cause serious harm. But using too much repeatedly can cause more serious problems, since more medication can get absorbed into your body. For children, this can slow their growth. Other problems include high blood pressure, high blood glucose (sugar), and weak bones.

Tell your prescriber if your symptoms aren’t being managed by your budesonide dose. They may adjust your dose or recommend a different medication.

If you took too much budesonide, call Poison Control immediately at 1-800-222-1222 for guidance. You should also tell your prescriber.

Why trust our experts?

Written by:

Kristianne Hannemann, PharmD

Kristianne Hannemann, PharmD, is a licensed pharmacist in California. She has been a retail pharmacy manager and staff pharmacist for over 7 years and has contributed drug information content to different health companies.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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