Budesonide

Overview
Budesonide is a glucocorticoid steroid for the treatment of asthma, non-infectious rhinitis (including hay fever and other allergies), and for treatment and prevention of nasal polyposis. Additionally, it is used for inflammatory bowel disease. It is marketed by AstraZeneca as a nasal inhalation with the brand name Rhinocort (in Denmark, as Rhinosol), as an oral inhalation with the brand name Pulmicort, and as an enema and a modified-release capsule with the brand name Entocort. It is also sold in combination with formoterol (Oxis) in a single inhaler, with the brand name Symbicort.

Pharmacology
Budesonide has a high first pass metabolism. It has efficacy in the terminal ileum and the right colon. Budesonide in comparison with prednisolone has been associated with fewer bone density losses and unlike other corticosteroids has little influence on the hypothalamic-pituitary-adrenal axis which also limit the need of tapering before discontinuation. Overall, it has a lower incidence of systemic manifestations than similar medications.

Side Effects
Budesonide may cause:
 * nose irritation or burning
 * bleeding or sores in the nose
 * lightheadedness
 * upset stomach
 * cough
 * hoarseness
 * dry mouth

In addition the following should be reported:
 * Immediately if difficulty breathing or swelling of the face
 * white patches in the throat, mouth, or nose
 * irregular menstrual periods
 * severe acne

Recall
Pulmicort inhalers were recalled in 2002 because there was concern that they may not always have provided the full dosage.