Budesonide (Pulmicort, Uceris): Uses, Forms, Safety

What is budesonide?

Budesonide is an active ingredient used in different medicines and dosage forms. The original content describes it as a local anti-inflammatory glucocorticosteroid.

It is listed in the source material for use in inflammatory conditions affecting the bowel and liver, and it also appears in inhaled products used for respiratory conditions.

Brand names mentioned in the United States

The original content lists these U.S. brand names:

• Uceris
• Pulmicort Turbuhaler
• Pulmicort Flexhaler
• Pulmicort Respules

Brand names can vary by country and by dosage form, so it is important to confirm the exact product on the package or prescription label.

How budesonide works

According to the source content, budesonide acts as a local anti-inflammatory glucocorticosteroid. It inhibits the release of inflammatory mediators and immune responses mediated by cytokines.

In practical terms, this means it is used to help reduce inflammation in the condition for which it is prescribed.

Therapeutic indications listed in the source

The original content lists the following uses:

Oral budesonide

• Induction of remission in mild to moderate active Crohn’s disease involving the ileum and/or ascending colon
• Induction of remission in active collagenous colitis
• Autoimmune hepatitis
• Induction of remission in adults with mild to moderate active ulcerative colitis when 5-ASA treatment is not sufficient

Rectal budesonide

• Ulcerative colitis affecting the rectum and the sigmoid and descending colon

Dosage information from the original content

The dose depends on the product and the condition being treated. The source content includes the following examples:

Important: The exact dose, timing, and duration depend on the specific budesonide product. Check the prescription label and official leaflet for the medicine you have.

How it is taken

Oral use

The source says capsules should be taken about half an hour before meals and swallowed whole with plenty of liquid.

For people with swallowing difficulties, the source notes that some capsules may be opened and the contents swallowed with applesauce, but the contents should not be crushed or chewed.

Granules should be swallowed whole and not chewed or crushed. Prolonged-release tablets should be swallowed with water and not broken, crushed, or chewed.

Rectal use

The source describes rectal foam as being used once daily, usually before bedtime, for the listed ulcerative colitis indication.

Contraindications listed in the source

• Hypersensitivity
• Cirrhosis of the liver

Warnings and precautions

The original content includes several cautions. These are important to review with a clinician or pharmacist, especially if you have other medical conditions or take other medicines.

• Limited experience in the elderly and children
• Caution in kidney failure and liver failure
• Not indicated for Crohn’s disease of the upper gastrointestinal tract
• Extra caution with infections, tuberculosis, BPH, diabetes, osteoporosis, peptic ulcer, glaucoma, cataracts, or a family history of diabetes or glaucoma
• Risk of worsening bacterial, fungal, amoebic, or viral infections, including chickenpox and measles
• High doses over time may cause systemic corticosteroid effects, including adrenal suppression and other steroid-related effects listed in the source
• When replacing a stronger systemic glucocorticoid, monitoring is needed because adrenal suppression may occur
• The source says treatment should be suspended gradually
• Additional systemic glucocorticoids may be needed during surgery or stress
• Live vaccines should not be given during treatment, according to the source
• Visual symptoms such as blurred vision should be checked promptly
• Children on long-term treatment should have growth monitored

Kidney and liver impairment

Liver failure

The source advises caution because liver failure can increase the systemic bioavailability of budesonide.

Kidney failure

The source also advises caution in kidney failure.

Drug and food interactions listed in the source

The original content highlights several interactions. A pharmacist can help check whether any of these apply to your medicine list.

• Ketoconazole and other CYP3A4 inhibitors may increase exposure
• Ritonavir, itraconazole, and clarithromycin are also listed as CYP3A4 inhibitors
• Grapefruit juice should be avoided in the source content
• CYP3A4 inducers such as carbamazepine and rifampicin may decrease plasma levels
• Estrogens or oral contraceptives may increase plasma levels
• Cholestyramine and antacids may reduce effect; the source advises spacing doses by at least 2 hours
• Cardiac glycosides and saluretic diuretics are listed as interaction concerns
• The ACTH stimulation test may be affected

Pregnancy and breastfeeding

Pregnancy

The source says animal studies were associated with fetal development anomalies and that the relevance in humans is unknown, so it advises avoidance.

If you are pregnant or planning pregnancy, the safest next step is to review the official leaflet and discuss the medicine with your clinician.

Breastfeeding

The source states that budesonide is excreted in breast milk after inhalation use, but that only minor effects are predictable in the infant after oral therapeutic use. It also says exposure after oral and rectal administration is expected to be low in the infant.

The original content concludes that these data support continued use of oral and rectal budesonide during lactation, while weighing the benefits for mother and infant.

Effects on driving and using machines

No studies were conducted, according to the source. It notes that dizziness or fatigue may occasionally occur, so caution is advised when driving or using machines.

Side effects listed in the source

The original content lists the following adverse reactions.

Oral use

• Cushing syndrome and other steroid-related effects
• Dyspepsia
• Increased risk of infection
• Muscle and joint pain
• Muscle weakness and cramps
• Osteoporosis
• Headache
• Depression, irritability, and euphoria
• Allergic rash, petechiae, delayed wound healing, and contact dermatitis

Rectal use

• Burning and pain in the rectum

What to verify in the official leaflet

If you have a budesonide product at home, check the package insert or ask a pharmacist to confirm:

• The exact brand and dosage form
• Whether it is oral, rectal, or inhaled
• The approved use for that specific product
• How it should be taken or administered
• Whether any food, drink, or medicine interactions apply
• What symptoms should prompt urgent medical advice

Frequently asked questions

Source and reference links

The original content cites FDA and USP-based ingredient information and recommends reviewing the FDA medication guide for the specific drug product.

• FDA Medication Guide search
• UNII: Q3OKS62Q6X
• ChemIDplus
• DrugPortal
• NCI Thesaurus: C1027