Budesonide-native, 0.25 mg/ml, solution for inhalation, 2ml, 10 pcs.
Inhalation.
The dosage of Budesonide-native should be individual. The initial dose in adults for the treatment of bronchial asthma and COPD is 1–2 mg/day. The dose for maintenance treatment is 0.5–4 mg/day.
After obtaining the effect, the dose is reduced to the minimum effective dose necessary to maintain a stable condition. In some cases, in patients whose treatment requires achieving a rapid therapeutic effect, the dose of the drug may be increased.
If the patient took GCS orally, transfer to treatment with Budesonide-native should be carried out when the patient’s health condition is stable; inhalations and GCS taken orally are combined for 10–14 days.
For 10 days, it is recommended to take high doses of Budesonide-native while taking oral corticosteroids in a selected dose. Subsequently, the dose of oral corticosteroids should be gradually reduced (for example, 2.5 mg of prednisolone) to the minimum possible level. In many cases, it is possible to completely stop taking oral corticosteroids. There are no data on the use of budesonide in patients with renal failure or impaired liver function. Since budesonide is eliminated through biotransformation in the liver, an increase in the duration of action of the drug can be expected in patients with severe liver cirrhosis. When prescribed to patients with liver cirrhosis, more careful monitoring is required.
Children over 16 years of age - initial dose 0.25–0.5 mg/day. If necessary, the dose can be increased to 1 mg/day. The maintenance dose is 0.25–2 mg/day.
The drug is administered using a nebulizer. The bottle contains 1 single dose.
Instructions for use
Open the bottle with the drug. Fill the nebulizer through the top hole with the required amount of the drug. Nebulization should be carried out in accordance with the instructions for the type of nebulizer used.
The volume of budesonide solution delivered to the patient's lungs by nebulizer is variable and depends on several factors, including the following:
— inhalation time;
— chamber filling level;
— technical characteristics of the nebulizer;
— the ratio of the volume during inhalation/exhalation and the tidal volume of the patient;
- use of a mouthpiece or mask.
Note.
1. After each inhalation, rinse your mouth with water.
2. If the patient uses a mask, he should make sure that the mask fits tightly to his face when inhaling. After inhalation, wash your face.
Cleaning
The nebulizer chamber should be cleaned after each use.
Wash the nebulizer chamber and mouthpiece or mask with warm water, using a mild detergent, or according to the manufacturer's instructions.
Budesonide (Budesonidum)
For inhalation use: dry or irritated mouth, dry or irritated throat, flu-like symptoms, pharyngitis, laryngitis, dysphonia (dose-dependent effect), cough, headache. Oropharyngeal candidiasis, bruising (high doses), fatigue, weakness, malaise, insomnia, dizziness, weight gain, abdominal pain, nausea or vomiting, constipation or diarrhea, chest pain, palpitations, tachycardia, arrhythmias, cystitis, allergic reactions, swelling of the face, fingers, ankles, feet, lower extremities, unpleasant taste. Esophageal candidiasis, gastroenteritis, slow growth in children, osteoporosis (more than 1500 mcg per day - a significant decrease in bone mineral density), cataracts (increased risk of developing posterior subcapsular cataracts with long-term treatment with high doses), hypertension, hypercortisolism, hyperglycemia, menstrual irregularities , fever, mental disorders (anxiety, aggressive reactions, depression, psychosis), bleeding from the rectum, nosebleeds, hemorrhagic rash and thinning of the skin (400-2000 mcg per day), fainting, adrenal insufficiency (suppression of adrenal function during therapy at a dose more than 1500 mcg per day, but sensitivity varies significantly among patients), pneumonia, bronchospasm, allergic reactions, decreased sense of smell and taste, increased risk of developing glaucoma or increased intraocular pressure with long-term treatment with high doses, suppression of the hypothalamic-pituitary-adrenal axis (minimal at a dose of more than 1500 mcg per day (400 mcg per day in children)).
For intranasal use: mild and transient burning sensation, dryness or other irritation in the nasal cavity and pharynx, sneezing attacks, headache.
Formation of scabs in the nasal cavity, nosebleeds, persistent rhinorrhea and nasal congestion, watery eyes, sore throat, hoarseness, cough, lethargy, dizziness, nausea or vomiting, stomach pain, loss of sense of taste or smell. Candidiasis of the nasal cavity and pharynx, atrophic rhinitis, ulceration of the nasal mucosa, perforation of the nasal septum, conjunctivitis, increased intraocular pressure, glaucoma, cataracts, muscle pain, shortness of breath, allergic reactions, tinnitus.
When used orally: the incidence and severity of side effects depend on the duration of use, the size of the dose used and the ability to comply with the circadian rhythm of the prescription.
From the endocrine system: decreased glucose tolerance, “steroid” diabetes mellitus or manifestation of latent diabetes mellitus, suppression of adrenal function, Itsenko-Cushing syndrome (moon face, pituitary type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, myasthenia, stretch marks ), delayed sexual development in children.
From the digestive system: nausea, vomiting, pancreatitis, “steroid” ulcer of the stomach and duodenum, erosive esophagitis, bleeding and perforation of the gastrointestinal tract, increased or decreased appetite, flatulence, hiccups. In rare cases, increased activity of liver transaminases and alkaline phosphatase.
From the cardiovascular system: arrhythmias, bradycardia (up to cardiac arrest); development (in predisposed individuals) or increased severity of chronic heart failure, changes in the electrocardiogram characteristic of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction - the spread of necrosis, slowing down the formation of scar tissue, which can lead to rupture of the heart muscle.
From the nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudotumor of the cerebellum, headache, convulsions.
From the senses: posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, a tendency to develop secondary bacterial, fungal or viral eye infections, trophic changes in the cornea, exophthalmos.
From the metabolic side: increased excretion of Ca2+, hypocalcemia, increased body weight, negative nitrogen balance (increased protein breakdown), increased sweating.
Caused by mineralocorticoid activity: fluid and Na+ retention (peripheral edema), hypernatremia, hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue).
From the musculoskeletal system: slowing of growth and ossification processes in children (premature closure of the epiphyseal growth plates), osteoporosis (very rarely - pathological bone fractures, aseptic necrosis of the head of the humerus and femur), rupture of muscle tendons, steroid myopathy, decreased muscle mass (atrophy).
From the skin and mucous membranes: delayed wound healing, petechiae, ecchymosis, thinning of the skin, hyper- or hypopigmentation, steroid acne, stretch marks, tendency to develop pyoderma and candidiasis.
Allergic reactions: generalized (skin rash, itching, anaphylactic shock), local allergic reactions.
Other: development or exacerbation of infections (the appearance of this side effect is facilitated by jointly used immunosuppressants and vaccination), leukocyturia, withdrawal syndrome.
With intravenous administration: arrhythmias, hot flashes, convulsions. Locally - burning, numbness, pain, paresthesia at the injection site, infection at the injection site, rarely - necrosis of surrounding tissues, scar formation at the injection site; atrophy of the skin and subcutaneous tissue when administered intramuscularly (injection into the deltoid muscle is especially dangerous).
When administered parenterally, crystals of the drug may be deposited in the head, neck, nasal turbinates, and scalp, and sudden loss of vision may occur in the vessels of the eye.
With intracranial administration - nosebleeds (during neurosurgical operations).
For external use: steroid acne, purpura, telangiectasia, burning and itching of the skin, irritation and dry skin. With long-term use and/or when applied to large surfaces, systemic side effects are possible.
Budesonide Easyhaler, 1 piece, 2.5 g, 200 mcg/dose, dosed powder for inhalation
To minimize the risk of fungal infection of the oropharynx, the patient should be instructed to thoroughly rinse the mouth with water after each inhalation of the drug.
Co-administration of budesonide with ketoconazole, itraconazole or other potential CYP3A4 inhibitors should be avoided. If budesonide and ketoconazole or itraconazole or other potential CYP3A4 inhibitors have been prescribed, the time between doses should be increased to the maximum possible.
Due to the possible risk of weakening pituitary-adrenal function, special attention should be paid to patients who are transferred from oral corticosteroids to taking Pulmicort®. Also, special attention should be paid to patients who have taken high doses of GCS, or who have been receiving the highest recommended doses of inhaled GCS for a long time. In stressful situations, these patients may exhibit signs and symptoms of adrenal insufficiency. In case of stress or in cases of surgical intervention, it is recommended to carry out additional therapy with systemic corticosteroids.
Particular attention should be paid to patients who are transferred from systemic to inhaled GCS (Pulmicort® Turbuhaler®), or in cases where a violation of the pituitary-adrenal function can be expected. In such patients, the dose of systemic corticosteroids should be reduced with extreme caution and the hormonal function of the adrenal glands should be monitored. Patients may also need to be prescribed oral corticosteroids during stressful situations, such as trauma, surgery, etc.
When switching from oral corticosteroids to Pulmicort® Turbuhaler®, patients may experience previously observed symptoms such as muscle pain or joint pain. In such cases, a temporary increase in the dose of oral corticosteroids may be necessary. In rare cases, symptoms such as fatigue, headache, nausea and vomiting may occur, indicating systemic insufficiency of GCS.
Replacing oral corticosteroids with inhaled ones sometimes leads to the manifestation of existing allergies (for example, rhinitis and eczema), which were previously treated with systemic drugs.
In children and adolescents receiving treatment with corticosteroids (regardless of the method of delivery) for an extended period, it is recommended to regularly monitor growth parameters.
Patients should be instructed to contact their physician if the effectiveness of therapy with short-acting bronchodilators decreases, because An independent increase in the frequency of use of the drug may lead to a delay in the prescription of adequate treatment. In case of sudden deterioration of the condition, it is necessary to consider the possibility of a course of treatment with oral corticosteroids.
Impact on the ability to drive a car or use other machinery.
Pulmicort® Turbuhaler® does not affect the ability to drive a car or use other machinery.
Instructions for the correct use of Turbuhaler®
The drug contained in Turbuhaler® enters the patient's respiratory tract along with air flows when active inhalation is performed through the Turbuhaler® mouthpiece.
Attention:
it is important to convince the patient to carefully read the instructions for using Pulmicort® Turbuhaler®.
To be sure that the optimal dose of the drug has reached the lungs, you need to inhale deeply and forcefully through the Turbuhaler® mouthpiece.
Under no circumstances should you exhale through the mouthpiece.
After inhaling the required dose of the drug, rinse your mouth with water in order to minimize the risk of fungal infection of the oropharynx.
How to use Pulmicort® Turbuhaler®
Turbuhaler® is a multi-dose inhaler that allows you to dose and inhale the drug in very small doses. When the patient inhales, Turbuhaler® powder is delivered to the lungs. Therefore, it is important that the patient inhales forcefully and deeply through the mouthpiece.
Turbuhaler® is very easy to use. You just need to follow the instructions given below:
1. Unscrew and remove the cap.
2. Keep the inhaler upright
, dispenser down. Load the dose into the inhaler by turning the dispenser counterclockwise until it stops, and then turn the dispenser to its original position until it clicks.
3. Exhale
.
Do not exhale through
the mouthpiece.
Before exhaling, remove the inhaler from your mouth.
4. Gently squeeze the mouthpiece between your teeth, purse your lips and inhale deeply and forcefully
through the mouth. The mouthpiece should not be chewed or squeezed tightly with your teeth.
If inhalation of more than one dose is required, repeat steps 2–5.
5. Close the inhaler with the cap.
6. Rinse your mouth with water.
IMPORTANT!
Never exhale through the mouthpiece. Always cap the inhaler tightly after use.
Since the amount of powder inhaled is very small, the patient may not be able to taste the powder after inhalation. However, if he followed the instructions, he can be sure that he inhaled the required dose of the drug.
Cleaning
Clean the outside of the mouthpiece regularly (once a week) with a dry cloth.
Do not use water or other liquids to clean the mouthpiece.
How do you know if your inhaler is empty?
When a red indicator appears in the dose window, it means there are approximately 20 doses left in the inhaler. The inhaler is empty when the red mark reaches the bottom edge of the dose indicator window.
The sound heard when the inhaler is shaken is produced by the drying agent, not the medication.
Budesonide Easyhaler (portable d/ing dosage 0.2 mg/dose 200 doses inhalation 2.5 g)
A country
The country of production may vary depending on the batch of goods. Please check with the operator for detailed information when confirming your order.
Active substance
Budesonide
Compound
Powder 2.5 g
Budesonide 200 mcg per 1 dose. Excipients: lactose monohydrate - 7.8 mg. Powder for inhalation, dosed, white or almost white, homogeneous.
pharmachologic effect
GKS. When used inhalation, it has anti-inflammatory, anti-allergic and anti-exudative effects, which leads to a reduction in bronchial obstruction. The mechanism of action is to inhibit the release of inflammatory and allergic mediators, as well as to reduce the reactivity of the respiratory tract to their action. During the treatment, respiratory function improves, the severity and frequency of shortness of breath, attacks of suffocation, and cough are significantly reduced. The maximum clinical effect develops after 1-2 weeks of therapy. The exact mechanism of action of budesonide in the treatment of ulcerative colitis has not been fully established. Budesonide inhibits many inflammatory processes, including cytokine production, activation of inflammatory cells, and expression of adhesion molecules on endothelial and epithelial cells. At doses that are clinically equivalent to prednisolone, budesonide causes significantly less suppression of the hypothalamic-pituitary-adrenal axis and has less effect on inflammatory markers. Data from clinical pharmacological and pharmacokinetic studies indicate that the mechanism of action of oral budesonide is based on local action in the intestine.
Indications for use
Bronchial asthma requiring maintenance therapy with glucocorticoids. For induction of remission in patients with mild to moderate active ulcerative colitis.
Mode of application
Budesonide is intended for inhalation use. To ensure an optimal response to drug therapy, it is recommended to take it regularly. When switching to the use of Budesonide Easyhaler from other inhaled agents, the treatment regimen is selected individually, based on the characteristics of the course of the disease. At the same time, attention is also paid to the features of previously prescribed drugs, treatment regimens and method of drug administration. The initial dose is also adjusted according to the severity or level of control of the disease. The visible therapeutic effect is observed, as a rule, a few days after the start of the course of treatment, and it reaches its maximum several weeks after the first dose of the drug. The dose of Budesonide is adjusted until complete control of the disease is achieved, after which it is gradually reduced to the minimum at which effective control over the course of bronchial asthma will be maintained. The initial dose of Budesonide is calculated as follows: - 200-400 mcg per day - for adult patients diagnosed with mild bronchial asthma (not higher than stage 2), including the elderly and adolescents over twelve years of age (according to doctor's indications, allowed increasing the dose to 800 mcg per day); - 200-400 mcg per day - for children aged six to twelve years (according to doctor’s indications, the dose can be increased to 800 mcg per day); - up to 1600 mcg per day - for adult patients diagnosed with moderate and severe bronchial asthma (stage 3 and 4, respectively). The dose during the period of maintenance therapy is selected based on the severity of the disease and the clinical response to the treatment prescribed to the patient. After achieving control of asthma, the dose is reduced to the minimum acceptable, at which the required clinical effect is maintained. When dosing the drug twice a day, a single maintenance dose of the drug ranges from 200 to 400 mcg for adult patients diagnosed with mild bronchial asthma (not higher than stage 2), including the elderly and adolescents over the age of twelve. According to the doctor's indications, during periods of exacerbation of the disease, it is allowed to increase the daily dose of the drug to 1600 mcg per day. It is divided into two doses and reduced after the patient’s condition has stabilized. The dosage regimen of the drug once a day when prescribing maintenance therapy involves use by adult patients diagnosed with mild bronchial asthma (not higher than stage 2), including the elderly and adolescents over the age of twelve: - 200-400 mcg once a day day, if they have not previously taken glucocorticosteroid drugs; - up to 800 mcg once a day, if the course of the disease was previously controlled by glucocorticosteroid inhaled drugs prescribed for dosing twice a day. Children from six to twelve years of age diagnosed with mild or moderately severe bronchial asthma are prescribed 200 to 400 mcg of budesonide as a maintenance daily dose if: - patients in this category have not previously received steroid therapy; — previously prescribed twice-daily inhaled glucocorticosteroid drugs made it possible to completely control the course of the disease. After transferring the patient to a single daily dose, which varies from 200 to 400 mcg, the dose is reduced to the minimum possible, at which effective control over the course of the disease will be maintained. It is considered optimal to take the drug once a day at the same time in the evenings. It is important that it be regular. To date, there is no sufficient data to develop an optimal scheme for transferring patients who have not previously undergone a course of inhaled therapy with glucocorticosteroid drugs to Budesonide Easyhaler once a day. If the course of the disease worsens and the condition of a patient taking the drug once a day worsens, the instructions recommend doubling the daily dose by transferring the patient to inhalation twice a day while maintaining the previously established single dose. In this case, patients are recommended to immediately contact their doctor. Patients are also advised to keep short-acting bronchodilators on hand at all times, which are intended to relieve symptoms of acute attacks of bronchial asthma. For patients with chronic obstructive pulmonary disease (COPD), the dose of Budesonide is selected individually based on the severity of the disease. The initial dose recommended by the drug instructions is from 100 to 400 mcg of the substance twice a day. The highest permissible dose is 800 mcg of Budesonide twice a day.
Interaction
Cimetidine and omeprazole do not have a clinically significant effect on the pharmacokinetic parameters of budesonide when taken orally. However, under the influence of cimetidine, the metabolism of budesonide in the liver may slow down. Budesonide has lower systemic bioavailability compared to other corticosteroids, so drug interactions may be less pronounced compared to many other drugs in this class. The risk of drug interactions may be increased in the elderly and patients with impaired renal or hepatic function.
Side effect
When used inhalation, irritation of the mucous membranes of the pharynx, oral cavity, nose, and candidiasis is possible; with increased sensitivity - bronchospasm. When taken orally, side effects typical of systemic corticosteroids may occasionally occur. These side effects depend on the dose, duration of treatment, concomitant or previous treatment with other corticosteroids and individual sensitivity. Side effects of the steroid class include: Skin: allergic exanthema, red striae, petechiae, ecchymosis, steroid acne, delayed wound healing, contact dermatitis. From the musculoskeletal system: aseptic necrosis of bone (femur and head of the humerus). From the organs of vision: glaucoma, cataract. Mental disorders: depressive syndrome, irritability, euphoria. From the digestive system: discomfort in the stomach, duodenal ulcer, pancreatitis. From the endocrine system: Cushing's syndrome, moon face, trunk obesity, decreased glucose tolerance, diabetes mellitus, adrenal insufficiency, growth retardation in children, impaired secretion of sex hormones (for example, amenorrhea, hirsutism, impotence). Metabolism: sodium retention with the formation of edema, increased potassium excretion. From the cardiovascular system: arterial hypertension, increased risk of thrombosis, vasculitis (withdrawal syndrome after long-term therapy). From the immune system: impaired immune response (for example, increased risk of infections).
Contraindications
For inhalation use: hypersensitivity to budesonide. For oral administration: - liver cirrhosis; - infectious intestinal diseases; - lactation period (breastfeeding); - children and adolescents up to 18 years of age; - hypersensitivity to budesonide.
Overdose
The incidence of acute toxic reactions to budesonide is characterized as rare. Long-term use of increased doses of the drug can provoke the development of systemic reactions to glucocorticosteroid drugs, including: - increased susceptibility to various types of infections; - the occurrence of symptoms of hyper- or hypocortisolism; - suppression of normal adrenal function. In rare cases, the patient may begin the process of atrophy of the adrenal cortex. If symptoms of acute overdose appear, no specific treatment is required. Treatment with Budesonide is continued using therapeutic doses recommended to control the course of the disease. As a rule, it takes several days to restore the function of the hypothalamus, pituitary gland and adrenal cortex. In stressful situations, systemic administration of glucocorticosteroids (for example, high doses of hydrocortisone) may be necessary as a preventive measure. Patients who exhibit symptoms of adrenal cortical atrophy are classified as steroid-dependent and, until their condition is completely stabilized, are transferred to adequate maintenance therapy using systemic glucocorticosteroids.
special instructions
For inhalation use Use with caution in patients with pulmonary tuberculosis, as well as chickenpox. Budesonide is not intended for the relief of acute attacks of asthma in bronchial asthma. Use is not recommended for intermittent disease. The replacement of systemic corticosteroids with inhalations is carried out gradually. The effectiveness and safety of budesonide in children under 7 years of age have not been studied. For oral administration Use with caution in patients with diagnosed liver and kidney dysfunction, with diabetes mellitus, arterial hypertension, gastrointestinal diseases, osteoporosis, glaucoma or cataracts, with concomitant verified mental disorders or in the presence of mental illness in first-degree relatives. The use of budesonide can lead to an exacerbation of the inflammatory reaction in patients with infectious pathology and a decrease in the immune response to vaccines.
Dispensing conditions in pharmacies
On prescription
Instructions for use BUDESONIDE-INTELI
Particular caution is required if it is necessary to use the drug in patients with asymptomatic pulmonary tuberculosis, fungal, bacterial and viral infections of the respiratory system.
Patients who did not take GCS:
The therapeutic effect is usually achieved within 7 days. However, for selected patients with excess secretion of the bronchial mucosa, short-term (about 2 weeks) additional oral corticosteroids may be prescribed initially. Exacerbation of bronchial asthma caused by a bacterial infection requires antibiotic therapy and a possible increase in the dose of budesonide or, if necessary, the use of systemic corticosteroids.
Patients taking GCS:
when switching from oral corticosteroids to budesonide, the patient's condition should be in a relatively stable phase. High dose budesonide is used in combination with a previously used dose of an oral steroid for about 10 days.
After this, the dose of oral corticosteroids should be gradually reduced (for example, every month by 2.5 mg of prednisolone or equivalent) to the minimum effective level. In many cases, it is possible to completely replace oral GCS with Budesonide Intel. The transition from oral corticosteroid treatment to inhaled budesonide treatment should be carried out with special precautions, mainly due to the slow normalization of the function of the hypothalamic-pituitary-adrenal axis, previously impaired by oral corticosteroid use. It may take several months to achieve this normalization. During this substitution of oral corticosteroids, patients may experience rhinitis, eczema or fatigue, headache, muscle or joint pain, and rarely nausea and vomiting. In such cases, it is necessary to begin additional symptomatic treatment.
Patients who have previously received systemic corticosteroids for a long time or in high doses may develop symptoms of adrenal suppression. In such patients, adrenal function should be regularly monitored, and the dose of systemic corticosteroids should be reduced with caution.
Budesonide-Inteli is not intended for the relief of an acute attack of bronchial asthma.
Treatment with budesonide should not be stopped suddenly. It is very important that the dose of the drug is reduced to the minimum value at which effective control of bronchial asthma is maintained.
In vivo studies have shown that oral administration of ketoconazole and itraconazole (known inhibitors of CYP3A4 activity in the liver and intestinal mucosa) increases the systemic effect of budesonide. Concomitant treatment with ketoconazole and itraconazole or other strong CYP3A4 inhibitors should be avoided. If this is not possible, the time interval between administration of interacting medicinal products should be as long as possible. It is also necessary to consider the possibility of reducing the dose of budesonide.
The use of these inhaled corticosteroids, incl. the drug Budosonide-Intel in athletes can give a positive result of a doping test.
Impact on the ability to drive vehicles and operate machinery
Budesonide does not affect the ability to drive vehicles or operate machinery.
Budesonide
The drug is intended for inhalation use. The drug is not intended for oral administration!
The dose of the drug is selected individually.
The recommended doses of the drug in case of initiation of inhaled glucocorticosteroid therapy during severe exacerbations of bronchial asthma, as well as against the background of dose reduction or discontinuation of oral glucocorticosteroids, are as follows:
Children over 6 years old
: 100-800 mcg/day (the total daily dose of the drug can be divided into 2-4 inhalations). If the recommended dose does not exceed 400 mcg/day, the entire dose of the drug can be taken at one time (at one time).
In children, the transition to a single dose of the drug should be carried out under the supervision of a pediatrician.
Adults
: the usual dose is 200-800 mcg/day (the total daily dose of the drug can be divided into 2-4 inhalations). For the treatment of severe exacerbation of bronchial asthma, the daily dose can be increased to 1600 mcg.
If the recommended dose does not exceed 400 mcg/day, the entire dose of the drug can be taken at one time (one time).
When selecting a maintenance dose, it is necessary to strive to prescribe the minimum effective dose.
The time for the onset of the therapeutic effect after inhalation of one dose of the drug is several hours. The maximum therapeutic effect is achieved 1-2 weeks after treatment. Budesonide has a preventive effect on the course of bronchial asthma and does not affect the acute manifestations of the disease.
The effectiveness of budesonide has been demonstrated to be better when using an inhaler compared to a similar dose of budesonide in the form of a metered-dose aerosol. If a stable patient is transferred from aerosol formulation to inhalation capsules, a reduction in the daily dose of budesonide should be considered.
To enhance the therapeutic effect, it is possible to recommend increasing the daily dose of the drug instead of combining the drug with oral glucocorticosteroids, due to the lower risk of developing systemic effects.
Patients receiving oral corticosteroids
Cancellation of oral glucocorticosteroids should be carried out against the background of a stable health condition of the patient. For 10 days, it is recommended to take a high dose of budesonide while taking oral glucocorticosteroids in a selected dose. Subsequently, the dose of oral glucocorticosteroids should be gradually reduced (for example, 2.5 mg of prednisolone or its analogue) to the minimum possible level. In many cases, it is possible to completely stop taking oral glucocorticosteroids.
There are no data on the use of budesonide in patients with renal failure or impaired liver function. Taking into account the elimination of budesonide due to biotransformation in the liver, an increase in the duration of action of the drug can be expected in patients with severe liver cirrhosis.
Instructions for using the inhaler
:
1. Remove the protective cap from the inhaler.
2. Grasp the middle of the mouthpiece and the base of the inhaler, rotate the mouthpiece in the direction indicated by the arrow on the body, and open the capsule compartment in the base of the inhaler.
3. With dry hands, take one capsule and place the capsule into the capsule compartment.
Attention
! Do not insert capsules directly into the mouthpiece opening. Do not swallow!
4. Close the mouthpiece by rotating it in the opposite direction of the arrow, keeping the inhaler upright.
5. While holding the inhaler upright, press the buttons at the base of the inhaler and puncture the capsule. Release the buttons.
6. Exhale completely, place the inhaler in your mouth, tightly wrapping your lips around the mouthpiece. Take a deep breath.
Attention
! Do not press buttons or block air inlets.
7. Remove the mouthpiece from your mouth and hold your breath as long as possible. Then exhale.
Attention
! Do not exhale through the mouthpiece!
8. Open the capsule compartment: grab the middle of the mouthpiece and the base of the inhaler, turn the mouthpiece in the direction indicated by the arrow on the body.
9. Remove the capsule shell and visually check for punctures and powder inside the capsule.
If the capsule is not punctured and contains powder, repeat the procedure starting from step 3.
If the capsule is punctured but not empty, reinsert the capsule into the capsule compartment and repeat the procedure from step 6. Do not press the button again!
If the capsule is empty, throw it away.
10. After use, if necessary, wipe the mouthpiece with a dry cloth, close the mouthpiece and put on the protective cap.
11. To reduce the risk of developing candidiasis of the pharynx and oral cavity, it is recommended to rinse your mouth with water after inhalation.
