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 :430.5

%Protein binding :85–90

%Excreted unchanged in urine : 0

Volume of distribution (L/kg) :3

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

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

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

HD :Unlikely to be dialysed. Dose as in normal renal function

HDF/high flux :Unlikely to be dialysed. Dose as in normal renal function

CAV/VVHD :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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