Budesonide: The Good, the Bad, and the Ugly

Last Updated: September 17, 2022By Tags: , ,

Budesonide is a steroid medication commonly used to treat asthma, chronic obstructive pulmonary disease (COPD), and nasal polyps in patients who have either allergic or non-allergic rhinitis. It’s also sometimes prescribed as an alternative treatment to oral prednisone, which can cause unpleasant side effects like insomnia, mood swings, anxiety, or even depression and fatigue. But this alternative comes with its own set of risks and side effects that you should be aware of before taking the medication.

What is Budesonide

In the United States, budesonide is a corticosteroid drug that is prescribed for treating asthma. It reduces inflammation in a number of ways by blocking certain white blood cells from entering your lungs. This reduces some swelling as well as protecting your lungs from damage. Budesonide can also be used to treat certain types of skin disorders such as psoriasis or atopic dermatitis.
When you take budesonide, it doesn’t just stay in your lungs; it spreads to other parts of your body through your bloodstream. One of these areas is bone marrow where there are developing blood cells.

Side Effects

Budesonide is an anti-inflammatory nasal spray for sinusitis, nasal polyps, and allergic rhinitis. While most of its side effects are common to any corticosteroid use (such as skin thinning or bone loss), it can also cause mental confusion in older adults or children.

Dosage Adjustments

Budesonide is an inhaled corticosteroid that has been widely used for over twenty years. It is available in two types of inhalers: a metered-dose bronchodilator (MDI) inhaler or a dry powder inhaler (DPI).
For patients with asthma or COPD, budesonide decreases the intensity of flare-ups. For those with allergic rhinitis or perennial nonallergic rhinitis, budesonide decreases nasal congestion and nasal itching. Though not everyone will have side effects from using it, there are some minor to severe side effects reported by some users including burning nose after use and throat irritation following use.

Toxicity, Contraindications and Interactions

According to PubMed.gov, Budesonide is a steroid. Some of the most common side effects for this medication are an increased chance of stomach ulcers and high blood pressure, decreased bone density as well as muscle weakness, mood swings and depression in some people. In addition to these side effects there can be increased risk of infections with Budesonide usage; however this risk decreases with use of other medications including HIV medications. There is no information on potential cancer risks or reproductive issues on any level so it’s good to know that there are not long-term risks from Budesonide but rather immediate reactions. One other possible side effect noted was menstrual irregularity or amenorrhea but this has only been observed in female children taking it for asthma.

Cost vs. Benefit Analysis

If you suffer from bronchitis or mild asthma symptoms it might be best to try the medications in the DMARD family such as Azithromycin (Zithromax) or Trimethoprim/Sulfamethoxazole (Septra). Those have fewer side effects, but don’t have as good of an effect on reducing inflammation. You may also want to try an oral steroid like Prednisone if a bacteria is not suspected. That’s because Prednisone has less systemic side effects than Budesonide. Unfortunately if none of those treatments work you will need to go to steroids inhalers like Budesonide which will stop any bronchial spasms and help open up your airways.

How long does it last?

It is active for 12 hours when taken at the recommended dose of twice daily. Budesonide nasal spray can be used up to 3 times a day with doses spaced out evenly throughout the day. If you take it 4 times a day, then its effects are halved since each time you take it, you’re dividing what’s left in your body into smaller segments.
Common side effects may include headache or dizziness which is likely because your dosage is too high or because there’s an insufficient interval between dosing intervals. On rare occasions you may also feel flu-like symptoms (body aches, fever). One less common but serious side effect that only about 1% of people experience is oral thrush in infants and children.