Budesonide

CLINICAL USE

  • Asthma
  • Allergic and vasomotor rhinitis
  • Inflammatory skin disorders

    DOSE IN NORMAL RENAL FUNCTION

    Inhaler/Turbohaler: 200–1600 micrograms daily in divided doses
  • Respules: 1–2 mg twice daily; half doses for maintenance
  • Nasal spray: 100 micrograms each nostril twice daily or 200 micrograms each nostril once daily; reduce to 100 micrograms each nostril once daily when symptoms controlled
  • Topical preparations: apply 1–2 times daily
  • Capsules: 3 mg, 3 times a day, CR: 9 mg once dailycinEnema: 2 mg/100 mL at bedtime

    PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :430.5
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :85–90
  • %Excreted unchanged in urine &nbsp &nbsp : 0

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :3

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :1.8–2.2 (inhaled), 3–4 (oral)/–

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in normal renal function

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Unlikely to be dialysed. Dose as in normal renal function
  • HDF/high flux &nbsp :Unlikely to be dialysed. Dose as in normal renal function
  • CAV/VVHD &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Antifungals: concentration of inhaled budesonide increased by itraconazole and ketoconazole
  • Antivirals: concentration of inhaled and intranasal budesonide increased by ritonavir

    ADMINISTRATION

    Reconstition

    Respules: may be diluted up to 50% with sterile sodium chloride 0.9%

    Route

    Inhalation, topical, oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    Special care is needed in patients with quiescent lung tuberculosis, fungal and viral infections in the airways.
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