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.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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