Types of Asthma Inhalers and How to Choose the Best One for You
If you have asthma, you probably use an inhaler — and you may need more than one. Learn the different types of asthma inhalers and which one you need.
budesonide
Used for Asthma
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.
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:
Drug facts
| Common Brands | Pulmicort Flexhaler |
|---|---|
| Drug Class | Inhaled corticosteroid (ICS) |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
More on Pulmicort Flexhaler (budesonide) essentials
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
- Common cold (9%)
- Stuffy nose (3%)
- Sore throat (3%)
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.
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
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 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
Pharmacist tips for Pulmicort Flexhaler (budesonide)
- 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.
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).
Pulmicort Flexhaler (budesonide) dosage
The average cost for 30 ampules of 0.5mg/2ml of Pulmicort Flexhaler (budesonide) is $48.30 with a free GoodRx coupon. This is 61.97% off the average retail price of $127.01.
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.
More on Pulmicort Flexhaler (budesonide) dosage
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.
- 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 Pulmicort Flexhaler (budesonide) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
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
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.
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Pulmicort Flexhaler (budesonide) images
