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budesonide

Generic Pulmicort Flexhaler
Used for Asthma

Pulmicort Flexhaler (budesonide) is an inhaled corticosteroid. It's used in adults and children for the maintenance treatment of asthma. It's a type of dry powder inhaler that's inhaled through the mouth twice per day. Side effects include the common cold and sore throat.

Reviewed by:Last reviewed on October 28, 2024
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What is Pulmicort Flexhaler (budesonide)?

What is Pulmicort Flexhaler (budesonide) used for?

  • Maintenance treatment of asthma in people ages 6 years and older

How Pulmicort Flexhaler (budesonide) works

Pulmicort Flexhaler (budesonide) is an inhaled corticosteroid. It lessens inflammation and swelling in the lungs, which helps you breathe better.

When does Pulmicort Flexhaler (budesonide) start working?Time passed since treatment started:
HOURS
Initial effect
DAYS
WEEKS
Full effect
MONTHS

Drug facts

Common BrandsPulmicort Flexhaler
Drug ClassInhaled corticosteroid (ICS)
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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Side effects of Pulmicort Flexhaler (budesonide)

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

Less Common Side Effects

  • Allergic rhinitis (hay fever) (2%)
  • Viral upper respiratory tract infection (2%)
  • Nausea (2%)
  • Stomach flu (2%)
  • Middle ear infection (1%)
  • Oral thrush (1%)

Pulmicort Flexhaler (budesonide) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

  • Serious allergic reaction: hives, swelling of your face, lips, or tongue, difficulty breathing
  • Sudden narrowing of your airways: difficulty breathing, wheezing, chest pain or tightness, cough
When do Pulmicort Flexhaler (budesonide) possible side effects begin and end?
Time passed since treatment started:
M
H
D
W
M
Sore throat
Stuffy nose
Risk of thrush
Risk of respiratory infections
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.

Source: DailyMed

The following Pulmicort Flexhaler (budesonide) 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

cough

diarrhea

dryness or soreness of the throat

fever

general feeling of discomfort or illness

headache

hoarseness

joint pain

loss of appetite

muscle aches and pains

nausea

pain or tenderness around the eyes and cheekbones

shivering

shortness of breath or troubled breathing

sneezing

sore throat

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

depression

dizziness

earache

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

dry mouth

ear congestion

headache, severe and throbbing

heartburn

indigestion

muscle cramping

neck pain

sleeplessness

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 Pulmicort Flexhaler (budesonide)

Pros

  • First-choice medication for controlling asthma symptoms
  • Inhaling into the lungs, which has fewer side effects than taking steroid pills by mouth
  • Possible option for children as young as 6 years old

Cons

  • Doesn't treat an asthma attack
  • Needs to be inhaled twice per day
  • Contains lactose, so not a good choice for people with a milk protein allergy
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Pharmacist tips for Pulmicort Flexhaler (budesonide)

pharmacist
  • Use Pulmicort Flexhaler (budesonide) twice per day at the same time every day to prevent asthma attacks. You can take Pulmicort Flexhaler (budesonide) at any time of the day. Take Pulmicort Flexhaler (budesonide) exactly as prescribed.
  • If you have sudden trouble breathing during an asthma attack, use your rescue inhaler (e.g., albuterol (Ventolin)). Pulmicort Flexhaler (budesonide) won't work quickly enough to treat an asthma attack.
  • Call your pulmonologist if your breathing or peak flow meter results worsen. Also contact your pulmonologist if you're using your rescue inhaler more often than usual. These could be signs that you need a dosage change or another long-acting medication to help manage your asthma.
  • Store Pulmicort Flexhaler (budesonide) at room temperature in a dry place away from heat or sunlight. Keep unused inhalers in the original foil pouch.

Tips for how to use Pulmicort Flexhaler (budesonide):

  • Pulmicort Flexhaler (budesonide) comes in 2 different strengths: 90 mcg/inhalation and 180 mcg/inhalation. Make sure you know which strength you have and what your dose of Pulmicort Flexhaler (budesonide) is. You might need to take multiple inhalations to get the full prescribed dose.
  • You don't need to shake the Pulmicort Flexhaler (budesonide) inhaler before using it. But you need to prime the inhaler if you're using a brand new Pulmicort Flexhaler (budesonide) for the first time.
  • When you're ready to take a dose, hold Pulmicort Flexhaler (budesonide) upright and remove the white cover by twisting it off. Then, hold the inhaler in the middle and twist the brown grip in the one direction as far as it will go. Twist it fully back again in the other direction. You will hear a "click" during one of the twists. Then, breathe out as long as you can away from the inhaler. Place your lips firmly around the mouthpiece and take a quick and deep breath.
  • After you inhale from the Pulmicort Flexhaler (budesonide) inhaler, try to hold your breath for 10 seconds, or for as long as you comfortably can. This allows the medication to reach deep into your lungs.
  • After you're done using Pulmicort Flexhaler (budesonide), rinse your mouth with water and spit. This helps prevent fungal infections in your mouth and throat (thrush).
  • Never wash the Pulmicort Flexhaler (budesonide) inhaler with water or any liquid. Instead, clean the mouthpiece every once in a while by wiping it with a dry tissue. Just make sure you don't get water or moisture on or near the inhaler. Moisture can make the dry powder medication clump together and clog the inhaler.
Common questions about Pulmicort

Common questions about Pulmicort

Yes, the active ingredient in Pulmicort Flexhaler is budesonide, which is an inhaled corticosteroid (or steroid). Steroids help you breathe better by lowering the inflammation in your airways.

You'll know Pulmicort is working when you start to have less asthma symptoms, such as wheezing, cough, and shortness of breath. Also, when your asthma is well-controlled, you're less likely to need your rescue inhaler. You can measure how well your breathing is improving by using a peak flow meter. Pulmicort is a long-acting medication that works over time to lower inflammation in your lungs. You might notice some symptoms getting better after a day. But it can take at least 1 to 2 weeks to notice the maximum effect of Pulmicort. Contact your pulmonologist if you're concerned with how well Pulmicort might be working for you.

The most common side effect of Pulmicort seen in clinical studies is symptoms of the common cold, such as runny nose, sore throat, or cough. A cold usually lasts about a week, but you can try medications or self-care methods to help yourself feel better in the meantime. Contact your prescriber if these symptoms don't improve over time.

People who used Pulmicort in clinical studies didn't experience weight gain as a side effect. While oral corticosteroids are known to cause weight gain, inhaled steroids are less likely to get absorbed into the rest of your body and cause this side effect. Talk with your primary care provider if you notice weight gain after starting Pulmicort. They can examine you to see if the increase in body weight might be caused by the medication or by other factors.

It might take about 10 to 15 hours for most of budesonide to leave your body after an inhalation of Pulmicort. This time frame is estimated based on the half-life of the medication in Pulmicort. But keep in mind that you need to take Pulmicort twice daily for it to work well to control asthma.

No, Pulmicort is still available. An older product called Pulmicort Turbuhaler, has been discontinued.

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Risks and warnings for Pulmicort Flexhaler (budesonide)

Pulmicort Flexhaler (budesonide) 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.

Not for use in asthma attack or for worsening breathing

Don't use Pulmicort Flexhaler (budesonide) if you're experiencing an asthma attack because this medication won't provide immediate relief. Use a rescue inhaler, such as albuterol (Ventolin HFA), if you're having trouble breathing.

If you're using your rescue inhaler more often than usual, let your pulmonologist know because this could be a sign that your condition is getting worse. Don't use more doses of Pulmicort Flexhaler (budesonide) than recommended because this won't improve your breathing. Rather, this can raise your risk for serious side effects, such as heart problems, tremors, and dizziness.

Fungal infection in the mouth

  • Risk factors: Not rinsing and spitting after using Pulmicort Flexhaler (budesonide) | Weakened immune system from medical conditions or medications

Pulmicort Flexhaler (budesonide), like all inhaled steroids, can cause a fungal infection in your mouth and throat called thrush. To lower your risk for thrush, rinse your mouth with water and spit after each inhalation of Pulmicort Flexhaler (budesonide). If you develop thrush, your pulmonologist might prescribe you a medication to treat this infection and ask you to temporarily stop using Pulmicort Flexhaler (budesonide). Let your pulmonologist know if you notice symptoms of thrush, such as white patches in your mouth, cotton-like feeling in your mouth, pain while eating or swallowing, or loss of taste.

Narrowing of your airways (bronchospasm)

Inhaled medications, including Pulmicort Flexhaler (budesonide), can sometimes cause a muscle spasm in your lungs. This can lead to difficulty breathing, wheezing, cough, and chest discomfort. If you have a hard time breathing after inhaling Pulmicort Flexhaler (budesonide), use your rescue inhaler and get medical attention right away.

Higher risk of infections

Like all corticosteroid-containing medications, Pulmicort Flexhaler (budesonide) can weaken your immune system and raise your risk for infections, including upper respiratory infections and pneumonia. Your risk for infections is higher if you're also taking other medications that also weaken your immune system. If you're currently being treated for a serious infection, such as tuberculosis, let your pulmonologist know. They might need to consider a different medication for your condition until you get better. Let your pulmonologist or primary care provider know right away if you have symptoms of infections, such as fever, chills, or body aches.

Changes in stress hormone levels

  • Risk factors: Using Pulmicort Flexhaler (budesonide) for a long time | Using too much Pulmicort Flexhaler (budesonide)

Use Pulmicort Flexhaler (budesonide) only as directed. Don't use more than the maximum number of inhalations each day. Doing so can cause more steroids to be absorbed into the body and raise your risk for symptoms of too much stress hormones, such as higher blood sugar or blood pressure.

On the other hand, if you're transitioning to Pulmicort Flexhaler (budesonide) from oral steroids, you might experience symptoms of low steroid hormone, such as stomach pain, loss of appetite, and nausea. When you transition to Pulmicort Flexhaler (budesonide), your pulmonologist will work with you to lower your dose of oral steroids slowly over time to prevent these side effects.

Delayed growth in children

Children who use inhaled steroids, like Pulmicort Flexhaler (budesonide), might experience a delay in growth. To lower the risk of growth problems, your child's pulmonologist will only prescribe the lowest dose needed to help their condition. Your child's care team will check your child's growth regularly while your child is using this medication. If you're concerned about how Pulmicort Flexhaler (budesonide) might affect your child's growth, discuss with your child's pulmonologist to see if this medication is right for them.

Weakening bones

  • Risk factors: Older age | Bed rest for a long time | Family members who have osteoporosis | Females who've gone through menopause | Using tobacco

People who use inhaled steroids, like Pulmicort Flexhaler (budesonide), have reported lower bone mineral density (BMD) over time. It's unclear whether this leads to higher risk of bone fractures. But you're more likely to experience a fracture if you're an older adult, have family members who have osteoporosis, or are taking other medications that raise the risk of fractures.

Eye and vision problems

  • Risk factors: History of glaucoma or cataracts

Although rare, people using inhaled steroids over a long period of time have reported having higher pressure in the eyes, glaucoma, and cataracts. Talk to your optometrist before using Pulmicort Flexhaler (budesonide) if you have glaucoma or cataracts because they might ask you to come in more often for eye exams. Also speak with them if you notice any changes to your vision while using the medication.

Allergic reactions

  • Risk factors: Allergy to milk proteins (lactose)

Allergic reactions to Pulmicort Flexhaler (budesonide) are possible. These reactions can include life-threatening facial swelling, shock, and anaphylaxis (closing of the throat). Get medical attention right away if you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after you use Pulmicort Flexhaler (budesonide).

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Pulmicort Flexhaler (budesonide) dosage

The average cost for 30 ampules of 0.5mg/2ml of Pulmicort Flexhaler (budesonide) is $55.50 with a free GoodRx coupon. This is 56.58% off the average retail price of $127.83.

Typical dosage for Pulmicort Flexhaler (budesonide)

Pulmicort Flexhaler (budesonide) comes in two different strengths. Each inhalation can contain 90 mcg or 180 mcg of budesonide.

  • Adults: The typical starting dose is 360 mcg inhaled by mouth twice daily. The maximum dose is 720 mcg inhaled twice daily.
  • Children (ages 6 years and older): The typical starting dosage is 180 mcg twice daily. The maximum dose is 360 mcg inhaled twice daily.
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Interactions between Pulmicort Flexhaler (budesonide) and other drugs

Pulmicort Flexhaler (budesonide) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Pulmicort Flexhaler (budesonide). Please note that only the generic name of each medication is listed below.

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.

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.

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How much does Pulmicort Flexhaler (budesonide) cost?

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Pulmicort Flexhaler (budesonide) 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 Pulmicort Flexhaler (budesonide) will not be safe for you to take.

  • Treatment of sudden, severe asthma attack
  • Allergy to lactose or milk proteins
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What are alternatives to Pulmicort Flexhaler (budesonide)?

There are a number of medications that your doctor can prescribe in place of Pulmicort Flexhaler (budesonide). Compare a few possible alternatives below.
Pulmicort Flexhaler (budesonide)
Used for:
  • Maintenance treatment of asthma in people ages 6 years and older
$39.30Lowest GoodRx priceView prices
Used for:
  • Maintenance treatment of asthma
$46.55Lowest GoodRx priceView prices
Used for:
  • Maintenance treatment of asthma in people ages 5 years and older
$102.23Lowest GoodRx priceView prices
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Pulmicort Flexhaler (budesonide) images

This medicine is Colorless Ampule.
This medicine is Colorless Ampule.
This medicine is Colorless Ampule.
This medicine is Colorless Ampule.
This medicine is Colorless Ampule.
This medicine is Colorless Ampule.
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white - Budesonide 0.5mg/2mL Suspension for Inhalation
This medicine is White Ampule.white - Budesonide 0.5mg/2mL Suspension for Inhalation
white - Budesonide 0.5mg/2mL Suspension for Inhalation
This medicine is White Ampule.white - Budesonide 0.5mg/2mL Suspension for Inhalation
This medicine is Colorless Ampule.
This medicine is Colorless Ampule.

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References

Best studies we found

American Lung Association. (2022). How to use a flexhaler dry powder inhaler.

American Lung Association. (2024). How to use a flexhaler asthma inhaler.

American Lung Association. (2024). Measuring your peak flow rate.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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