Pulmicort Respules
Budesonide (Pulmicort Respules) is a prescription medication used to prevent and treat asthma in children. It's an inhaled steroid, which means it lowers lung inflammation to help your child breathe better. Budesonide (Pulmicort Respules) is used with a nebulizer, which turns the inhalation solution into a mist that your child breathes through their mouth and into the lungs. Common side effects include lung infections, stuffy nose, and cough.
What is Budesonide (Pulmicort Respules)?
What is Budesonide (Pulmicort Respules) used for?
- Prevention and maintenance treatment of asthma in children 1 year to 8 years old
How Budesonide (Pulmicort Respules) works
Budesonide (Pulmicort Respules) is a corticosteroid. It reduces chemicals in your body that cause swelling and inflammation. Inflammation in your lungs can lead to difficulty breathing. By lowering inflammation, budesonide (Pulmicort Respules) makes it easier for you to breathe.
Drug facts
Side effects of Budesonide (Pulmicort Respules)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Lung infection (fever, shortness of breath; 34-38%)
- Stuffy nose (7-12%)
- Coughing (5-8%)
- Ear infection (ear pain, rubbing or tubbing at an ear; 2-12%)
- Stomach flu (diarrhea, belly pain; 5%)
- Viral infection (chills, sore throat, body pain; 3-5%)
- Thrush (yeast infection in your mouth or throat; 3-4%)
Less Common Side Effects
- Vomiting
- Nosebleed
- Pink eye
- Rash
- Feeling tired
- Appetite loss
- Muscle pain
- Feeling restlessness
- Mood changes
- Trouble speaking
- Noisy breathing
- Dry skin
Budesonide (Pulmicort Respules) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe allergic reaction: swelling, rash, trouble breathing
The following Budesonide (Pulmicort Respules) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Body aches or pain
chills
congestion
dryness or soreness of the throat
general feeling of discomfort or illness
headache
hoarseness
joint pain
loss of appetite
muscle aches and pains
pain or tenderness around the eyes and cheekbones
shivering
shortness of breath or troubled breathing
stuffy or runny nose
sweating
tender, swollen glands in the neck
tightness of the chest or wheezing
trouble with sleeping
trouble with swallowing
unusual tiredness or weakness
voice changes
vomiting
Less common
Bruising
darkening of the skin
dizziness
excessive muscle tone
fainting
fractures
large, flat, blue, or purplish patches in the skin
lower back or side pain
muscle stiffness
muscle tension or tightness
painful or difficult urination
redness or swelling in the ear
skin rash
sore mouth or tongue
white patches in the mouth or on the tongue
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Back pain
Less common
Acid or sour stomach
belching
change in taste or bad, unusual, or unpleasant (after) taste
difficulty with breathing
difficulty with moving
ear congestion
headache, severe and throbbing
indigestion
muscle cramping
neck pain
stomach discomfort, upset, or pain
swollen joints
unable to sleep
unexplained runny nose or sneezing
weakness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Budesonide (Pulmicort Respules)
Pros
- Available as a lower-cost generic medication
- Typically inhaled once a day
- Safe for children 1 year to 8 years old
- Works directly in the lungs to prevent asthma
Cons
- Not safe for use in asthma attacks
- Possible bone loss if used long term
- Can cause thrush in mouth or throat as a side effect
- Takes 4-6 weeks before the full effects of the medication kicks in
Pharmacist tips for Budesonide (Pulmicort Respules)
- After using budesonide (Pulmicort Respules), rinse your child's mouth with water and spit it out right away. This can help lower the chances of developing a fungal infection in their mouth and throat (thrush). If your child develops white patches or a cotton-like feeling in the mouth, let their healthcare provider know. Your child might need to take antifungal medication(s) for this side effect.
- Budesonide (Pulmicort Respules) isn't used to treat symptoms of an asthma attack. If your child has wheezing, cough, shortness of breath, chest pain or tightness, let their provider know right away. Make sure your child has a rescue inhaler, such as albuterol (Ventolin) in case of an asthma flare-up.
- Budesonide (Pulmicort Respules) should only be inhaled through a jet nebulizer. Avoid using this medication with an ultrasonic nebulizer.
- The jet nebulizer turns budesonide (Pulmicort Respules) into a mist that's then inhaled into your child's lungs. Don't swallow this medication or mix it with any other medications in the nebulizer. If you have questions about which type of nebulizer to use, ask your child's pharmacist or provider.
- If your child was taking oral steroids on a regular basis in the past, make sure they carry a warning card with them if they're switching from oral steroids to budesonide (Pulmicort Respules). The warning card should state that your child might need oral steroids during an asthma attack.
- Make sure your child gets their routine tests done on time while they’re taking budesonide (Pulmicort Respules). This helps your child's provider make sure this medication is working for them and not causing side effects. Typically the provider will check your child's blood works, breathing, and eye exams.
- Before starting any new medications, speak with your child's provider first. Some medications can interact with budesonide (Pulmicort Respules) and lead to more side effects.
- Store budesonide (Pulmicort Respules) in an upright position at room temperature in a place away from direct sunlight or light, as this can potentially damage the medication. You should never refrigerate or freeze this medication. When your child isn't using budesonide (Pulmicort Respules), keep the ampules in the protective aluminum foil. Once you open the foil package, the ampules can be stored and used for up to 2 weeks. If the ampules aren't used within 2 weeks, throw them away as they might not work as well anymore.
Common questions about Budesonide (Pulmicort Respules)
Yes, budesonide (Pulmicort Respules) is an inhaled steroid. It lowers swelling and inflammation in your lungs to help you breathe better and control symptoms of asthma.
Don't mix albuterol nebulizing solution with budesonide (Pulmicort Respules) until after you've checked in with your child's provider. The two medications can be mixed, but only if your child is using a specific kind of nebulizer (jet nebulizer). If your child's provider says it's okay to mix albuterol and budesonide (Pulmicort Respules), ask them to show you how to do so safely.
You might notice your child's breathing improving after 2-8 days of using budesonide (Pulmicort Respules) regularly. But it can take up to 4-6 weeks of treatment for your child's asthma symptoms to be much better controlled. Make sure your child has a rescue inhaler (e.g., albuterol (Ventolin)) on hand in case they have an asthma attack during this time. If your child's asthma symptoms worsen or don't get better after 6 weeks, let their provider know.
In children between 4-6 years of age, it typically takes about 12 hours for most of budesonide (Pulmicort Respules) to leave your body after a single dose. This time frame is estimated based on the half-life of budesonide (Pulmicort Respules). It can also be affected by your health conditions and genetics, so it can be different for each individual person. Even though budesonide (Pulmicort Respules) only lasts 12 hours in the body, certain side effects can linger after your child stops this medication. For example, although rare, your child can develop thrush (yeast infection of the mouth) or pneumonia from using budesonide (Pulmicort Respules). To prevent these side effects, rinse your child's mouth after using this medication and make sure to use the lowest prescribed dose as directed by their provider. If your child's side effects are severe and don't go away, talk to their provider immediately.
Typically, your child's provider will prescribe budesonide (Pulmicort Respules) to be used once or twice a day. Using this medication more often than directed can raise the risk of side effects, such as lung or ear infections. If your child continues to experience symptoms of asthma or need to use their rescue inhaler more than 2 times a week while also using budesonide (Pulmicort Respules), talk to their provider.
To use budesonide (Pulmicort Respules), remove one ampule from the sealed aluminum foil. If there're multiple ampules in the foil, record the date that you first opened the foil and place the remaining unopened ampules back into the foil. Then, shake the medication gently by rotating the ampule in a circular direction. To open the ampule, hold the ampule upwards and twist off the top without squeezing the ampule, as this can potentially cause the medication to spill out. Place the open end of the budesonide (Pulmicort Respules) ampule into the nebulizer cup. Use your fingers to squeeze the ampule to allow the medication to flow into the nebulizer cup. Once you're done, throw the empty ampule away in a trash can and start your child's nebulizer treatment as directed by the provider.
Budesonide (Pulmicort Respules) is only FDA-approved for kids from 1 to 8 years old. But according to the [National Asthma Education
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Risks and warnings for Budesonide (Pulmicort Respules)
Budesonide (Pulmicort Respules) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Fungal infection in the mouth (oral thrush)
- Risk factor: Not rinsing mouth after using budesonide (Pulmicort Respules)
There's a chance of fungal infections, such as thrush in the mouth and throat, while using budesonide (Pulmicort Respules). The risk is higher if your child doesn't rinse their mouth right after using this medication. Symptoms of oral thrush include white patches on the inside of the mouth, mouth redness or soreness, and pain while eating or swallowing. If your child develops thrush in their mouth, let their provider know right away. Your child will need to take an antifungal medication to treat the infection.
Risk of worsening of asthma
- Risk factor: Using budesonide (Pulmicort Respules) during asthma attacks or severe episodes of asthma
Although rare, budesonide (Pulmicort Respules) can worsen symptoms of asthma by tightening the airways. This medical condition is called paradoxical bronchospasm and can be life-threatening if not treated quickly. If your child feels more wheezing, shortness of breath, or coughing after using budesonide (Pulmicort Respules), stop this medication right away and speak to your child's provider.
In addition, budesonide (Pulmicort Respules) shouldn't be used to treat asthma attacks or any severe episodes of asthma. Your child should only use a rescue inhaler, such as albuterol (ProAir), to treat asthma attacks. If your child's rescue inhaler isn't working well to control their symptoms, let the provider know because your child might need additional medications, such as steroid pills.
Serious allergic reaction
- Risk factor: History of allergy to medications containing budesonide
In some rare cases, budesonide (Pulmicort Respules) can cause allergic reactions, which can be life-threatening. Don't use this medication if your child has a history of allergy to medications containing budesonide. Watch out for signs and symptoms of allergic reactions, such as wheezing, dizziness, fainting, rash, itching, trouble breathing, and swelling of the tongue or throat. Get medical attention right away if your child has any of these reactions.
Higher risk of infection
- Risk factors: Active, chronic (long-term), or recurrent infection | Medical conditions that weaken the immune system | Taking other medications that can weaken the immune system
Budesonide (Pulmicort Respules) can lower your child's ability to fight infections. Infections, such as tuberculosis (TB), chickenpox, and measles, can be more serious in people who use budesonide (Pulmicort Respules). If your child has any of the risk factors listed above, discuss with their provider about how they can safely use this medication. Don't use budesonide (Pulmicort Respules) if your child has an active infection or an infection that keeps coming back without speaking with their provider first. Budesonide (Pulmicort Respules) can make these infections worse. Let your child's provider know right away if they have signs or symptoms of an infection, such as fever, cough, white patches in your mouth, or sore throat.
Switching from oral to inhaled steroids
- Risk factors: Long-term use of oral steroids | Suddenly stopping prednisone 20 mg or equivalent dose of steroid for treatment of asthma | History of asthma
When switching from an oral to an inhaled steroid, your child's provider might closely observe your child for withdrawal symptoms, such as nausea, tiredness, weakness, or muscle and joint pain. This is because switching between different forms of steroids can affect the cortisol levels in your child's body. Cortisol is a steroid hormone that controls blood sugar, blood pressure, and other important functions in your child's body. It also helps the body respond to stressful situations, such as trauma, surgery, and infection. Don't switch between steroids without proper guidance from your child's provider. Let their provider know if your child develops any symptoms, such as tiredness, weakness, loss of energy, nausea, vomiting, or low blood pressure.
If your child has used oral steroids for long periods of time and has asthma, it's important to carry a warning card with you that states that your child might need steroid pills during an asthma attack. In these cases, a rescue inhaler alone might not be enough to treat their asthma attack. So it's important that those taking care of your child are aware of their situation. Your child's provider might also perform tests to monitor your child's lung function and breathing more closely.
Reduced adrenal gland function
- Risk factors: Using high potency steroids | Using steroids for a long period of time | Using oral steroids | Stressful events (e.g., surgery) | Young children
In very rare cases, using inhaled budesonide (Pulmicort Respules) for a long time can cause a medical condition called adrenal suppression. This happens when your adrenal gland doesn't make enough of steroid hormones for your body, which creates a dependence on steroid medication. If you suddenly stop the medication, it can be dangerous to your body. In adults, symptoms of withdrawal include fever, joint or muscle pain, and low energy. In children, symptoms often include stunted growth, weight gain, and headaches. To prevent adrenal suppression from happening, your child's provider will prescribe the lowest possible dose of budesonide (Pulmicort Respules) that works well for your child for the shortest amount of time. If your child needs to use budesonide (Pulmicort Respules) for a long period of time, their provider might ask them to do some lab work to test how well their adrenal gland works. Let your child's provider know if your child has symptoms of withdrawal. Don't suddenly stop using budesonide (Pulmicort Respules) without talking to their provider first.
Risk of bone loss and poor growth
- Risk factors: Using budesonide (Pulmicort Respules) long term | Unable to move for a long period of time | Family history of osteoporosis | Poor diet | Using medications that can cause bone loss
People taking budesonide (Pulmicort Respules) for a long time might be at risk of bone loss or poor growth. If your child has any of the risk factors listed above, they might be more likely to experience weaken bones or slowed growth after using budesonide (Pulmicort Respules) long-term. Your child's provider might measure your child's bone density regularly to make sure their bones are healthy. If your child has had bone fractures before, talk to your child's provider about their risk before using this medication.
Eye problems
- Risk factors: Long-term use of budesonide (Pulmicort Respules) | History of eye problems like glaucoma or cataracts
Using budesonide (Pulmicort Respules) for a long time can raise eye pressure, worsen glaucoma, and cause cataracts (cloudiness in the eyes). Talk to your child's provider right away if they experience blurry vision, eye discomfort, or other changes in their vision after using budesonide (Pulmicort Respules). Your child might need an eye exam.
Budesonide (Pulmicort Respules) dosage
Ampule| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 0.25mg/2ml | 30 ampules | $55.50 | $1.85 |
| 0.5mg/2ml | 30 ampules | $55.50 | $1.85 |
| 1mg/2ml | 30 ampules | $155.28 | $5.18 |
Typical dosage for Budesonide (Pulmicort Respules)
Your child's provider will determine their dose of budesonide (Pulmicort Respules) based on what medications they were taking previously treat asthma.
- The typical dose for budesonide (Pulmicort Respules) ranges from 0.5 mg to 1 mg daily inhaled by mouth through a nebulizer, all at once or split into 2 divided doses.
Interactions between Budesonide (Pulmicort Respules) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aceclofenac
- Acemetacin
- Amtolmetin Guacil
- Balofloxacin
- Bemiparin
- Besifloxacin
- Boceprevir
- Bromfenac
- Bufexamac
- Bupropion
- Celecoxib
- Ceritinib
- Choline Salicylate
- Ciprofloxacin
- Clonixin
- Cobicistat
- Conivaptan
- Darunavir
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Dipyrone
- Droxicam
- Duvelisib
- Enoxacin
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Fleroxacin
- Floctafenine
- Flufenamic Acid
- Flumequine
- Flurbiprofen
- Fosnetupitant
- Gatifloxacin
- Gemifloxacin
- Ibuprofen
- Idelalisib
- Indomethacin
- Ivosidenib
- Ketoprofen
- Ketorolac
- Larotrectinib
- Lefamulin
- Levofloxacin
- Lomefloxacin
- Lorlatinib
- Lornoxicam
- Loxoprofen
- Lumacaftor
- Lumiracoxib
- Lutetium Lu 177 Dotatate
- Macimorelin
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Morniflumate
- Moxifloxacin
- Nabumetone
- Nadifloxacin
- Nadroparin
- Naproxen
- Nepafenac
- Netupitant
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Norfloxacin
- Ofloxacin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Pazufloxacin
- Pefloxacin
- Phenylbutazone
- Piketoprofen
- Piroxicam
- Pranoprofen
- Proglumetacin
- Propyphenazone
- Proquazone
- Prulifloxacin
- Ritonavir
- Rofecoxib
- Rufloxacin
- Salicylic Acid
- Salsalate
- Sargramostim
- Sodium Salicylate
- Sparfloxacin
- Sulindac
- Telaprevir
- Tenoxicam
- Tiaprofenic Acid
- Tolfenamic Acid
- Tolmetin
- Tosufloxacin
- Valdecoxib
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Auranofin
- Erythromycin
- Ketoconazole
How much does Budesonide (Pulmicort Respules) cost?
Budesonide (Pulmicort Respules) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Budesonide (Pulmicort Respules) will not be safe for you to take.
- Asthma attacks or severe episodes of asthma
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