According to the instructions for use, Pulmicort is available in suspension. The main active substance is budesonide. The drug is quite expensive - from 700 rubles and more, which is explained to some extent by the manufacturer: the medicine is manufactured by the English pharmaceutical company AstraZeneca, which has a very good world-class reputation. However, if you need to save money, you can replace the product with analogues that are more affordable, but this fact will have to be agreed with the attending doctor.
Basic features
The instructions for use of Pulmicort indicate that the main compound is present in micronized form, which allows its use for inhalation. 0.25 mg of active substance per package. The manufacturer used auxiliary compounds. A complete list of all used substances is in the instructions for use. Pulmicort contains:
- sodium chloride and citrate;
- polysorbate;
- citric acid;
- water
- disodium edetate.
The medication belongs to the class of glucocorticoid. In the instructions for use, Pulmicort is recommended by the manufacturer as a drug for allergic reactions and inflammatory processes.
Drug dynamics
The manufacturer draws attention: in order to make the treatment as safe as possible, you must familiarize yourself with the instructions for use of Pulmicort before use. For inhalations, the drug is applicable because it is based on a special substance designed specifically for this route of administration into the patient's body. If you use the composition at a dosage recommended by the manufacturer, the effect will be pronounced in inflammatory processes localized in the bronchial tree. The manufacturer focuses on: using Pulmicort according to the instructions for use for inhalation, you can reduce the strength of asthma symptoms and make the frequency of attacks less.
Pulmicort differs from alternative options by the minimal probability of side effects. This is especially noticeable in comparison with GCS, which have a systemic effect. Proper use in accordance with the instructions for use "Pulmicort" 0.25 mg can reduce the swelling of the bronchial mucous membranes, slightly reduce the volume produced by the mucous compartments. Under the influence of the components of the drug, sputum is formed more slowly, hyperresponsiveness of the respiratory tract decreases.
Tests showed (and this is recorded in the instructions for use): Pulmicort, the price of which is quite high (from 700 rubles), is well tolerated with prolonged therapy, so the cost of it is completely justified. A distinctive feature of the active compound is the absence of a mineralocorticosteroid effect.
Application rules
The instructions for Pulmicort (0.25 and 0.5 mg) indicate that the medication is suitable for the treatment of people of different age groups. In this case, it is important to comply with dosage restrictions and all the recommendations that the doctor will give when writing the prescription for the medication.
After one inhalation, therapeutic efficacy is felt after several hours. The maximum result can be seen by the end of the first or second week of continuous use. The manufacturer recommends using the medication as a prophylactic. The active component mentioned in the instructions for use of Pulmicort (0.5 mg and 0.25 mg), has proven itself in the treatment of asthmatics. Especially in cases where it is necessary to prevent exacerbations of the disease.
Tests have shown that the dosage of Pulmicort used for inhalation (0.25 or 0.5 mg according to the instructions for use) affects the concentration of cortisol in urine and the circulatory system. If the composition is used in the amounts recommended by the manufacturer, a relatively weak effect on the function of the adrenal glands is observed from the side of the medication. The difference is especially pronounced in comparison with the use of preparations on prednisone containing 10 g of the active compound. To identify this fact, specialized clinical tests were performed.
Kinetics
Studies have shown that rapid absorption occurs if budesonide is administered by inhalation. Reviews of the instructions for use of Pulmicort mention that the manufacturer provides an understandable and clear description of what is happening in the patient’s body under the influence of the active compound. If a nebulizer is used to administer the drug, for adult patients the bioavailability of the basic compound reaches 15% of the total volume recommended by the doctor. Relative to substances trapped in organic tissues, bioavailability for adult patients is estimated at 40-70%. The maximum concentration in the blood plasma is observed within half an hour from the start of the procedure.
In some cases, the doctor recommends stopping on such a form of drug release as Pulmicort Turbuhaler. The instructions for using this option are similar, since the active component is the same as in the basic Pulmicort. Both drugs are produced by the same manufacturer.
Shortly after administration, the active component is distributed throughout the patient’s tissues and organs. On average, the possibility of binding to plasma proteins for budesonide is estimated at 90%, and the distribution volume reaches 3 l / kg. Shortly after absorption of the active component (as indicated in the instructions for use of the suspension) of Pulmicort, biological transformation reactions begin. Localization is the liver. The resulting metabolites have low activity as GCS. The main metabolites are 6-beta-hydroxy-budesonide, 16-alpha-hydroxy-prednisolone. Compared with the starting compound, they exhibit GCS activity, which is about a hundred times less.
Mostly elimination is provided by the enzyme CYP3A4. The metabolic reaction products leave the body with urine. An alternative is the conjugated form. Metabolites do not undergo changes. For the active compound of the drug, high levels of systemic clearance are characteristic, and kinetics is determined by the amount of medication entering the body. This obliges you to be especially careful in observing the dosages prescribed by the doctor and recommended by the manufacturer in the instructions for use of Pulmicort Turbuhaler and the basic Pulmicort.
Important nuance
According to the information about the experiments indicated in the instructions for use, Pulmicort for children was not tested for effectiveness and safety. No special studies have been conducted to identify the effectiveness of taking the drug by persons suffering from impaired renal function, impaired functioning of this body.
Clinical observations have shown that liver diseases can cause a longer stay of the active compound in the patient's body than is characteristic of individuals with a healthy organ.
When will it help?
In the instructions for the use of Pulmicort (0.5 mg and other release options), the manufacturer indicates that the composition is effective for bronchial asthma if the patient is prescribed maintenance treatment for GCS. Indications for use are:
- chronic obstructive pulmonary disease (COPD);
- false croup (laryngotracheitis accompanied by stenosis).
Special position
Observations were made of practicing inhalation with the described agent during the period of gestation by the mothers. The research results are recorded in the instructions for use "Pulmicort": for children there was no negative, toxic effect, the embryos developed completely normally.
The manufacturer indicates that there is no way to say absolutely precisely that against the background of using Pulmicort there will be no negative effects for the fetus. In order not to harm the nursing children, the instructions for the use of Pulmicort for inhalation are recommended for pregnant women in the minimum dosage effective for a particular patient. The drug is prescribed only if there is a risk of deterioration without the use of budesonide.
The study of breast milk showed the ability of the active component of the drug in question to penetrate into this substance. If the instructions for use by adults are followed, Pulmicort for inhalation in a therapeutic dose does not show an effect on the child if the mother feeds him with a natural product. Based on the studies, it was concluded that the product is suitable for breast-feeding women.
It is impossible!
The instructions for the use of Pulmicort for inhalation (the price of the drug is quite high, but according to the responses, the composition justifies it) indicates that the drug cannot be used if the patient has an increased sensitivity or susceptibility of any compound present in the medicine.
The medication is not intended for the treatment of children under six months of age. For persons over six months of age, the question of the therapeutic program is taken after consulting with the doctor and assessing the possible advantages and risks of such treatment.
Some groups of patients require special attention from the doctor, since Pulmicort may be more likely to provoke a negative body response. Patients belong to this category:
- active tuberculosis;
- infections provoked by fungi, germs, viruses;
- cirrhosis.
It is important to consider that GCS can show a systemic effect. Which imposes certain restrictions. The doctor takes this opportunity into account when prescribing the drug. The doctor warns which manifestations may indicate a systemic effect, what measures should be taken in this case. In general, if the patient follows the instructions for use developed for adults, Pulmicort for inhalation is not well tolerated, has a narrow list of restrictions, and possible side effects are evaluated by patients as relatively insignificant against the background of the benefits.
Negative body response
In the reviews and instructions for use for Pulmikort, it is noted that the drug can provoke side effects. Most often, they are disturbed by the respiratory tract. Many patients who used the drug complained of candidiasis of the oral cavity and pharynx, as well as irritation of the throat. Sometimes the voice becomes more hoarse, and dry mouth is felt. Very rarely Pulmicort provoked a bronchospasm.
The instructions for use of Pulmicort for inhalation (0.5 ml and other release options) indicate that in rare cases, against the background of the use of the composition, the head hurts, there is a risk of angioedema. Possible:
- hematomas;
- skin rashes;
- dermatitis;
- hives;
- nervousness;
- excited state;
- depression.
Occasionally, behavioral disorders are noted against the background of using the drug (the possibility of such a side effect is also indicated in the Pulmicort application instructions). Reviews about the price and quality of the drug mostly agree that the negative responses of the body are quite rare, and it’s not difficult to tolerate them, while the benefits of the substance are pronounced. At the same time, patients note that the drug is frankly expensive.
Mutual influence
At the moment, it is not known about the interaction of the active component of Pulmicort and other drugs used in the therapeutic program of bronchial asthma.
If you use both Pulmicort and 200 mg ketoconazole preparations (the entire dose was taken at a time as part of the experiment), the concentration of budesonide in the blood plasma increases. Pulmicort was used in an amount of 3 mg daily, the entire volume was taken at a time. On average, the figures were six times higher than the standard ones.
If you use the drug with ketoconazole 12 hours after Pulmicort, the concentration in the plasma component of the blood of budesonide increases on average three times. The manufacturer warns: it is likely that other CYP3A4 inhibitors can also be the cause of an increased content of the active substance of the composition in question in the blood plasma.
It is allowed to dilute Pulmicort with sodium chloride, solutions of sodium cromoglycate, ipratropium bromide, as well as liquids containing:
Terms of use
Pulmicort is intended for inhalation. The doctor chooses the dosage, evaluating the patient's condition - everything is strictly individual. If the doctor recommended a day to a milligram, the entire volume is used in one procedure. If necessary, use Pulmicort in a larger dosage, it is reasonable to divide the prescribed volumes into two approaches.
For children six months of age and older, Pulmicort is shown in the amount of 0.25-0.5 mg per day, but it is possible to increase volumes to a milligram.
For adult patients and the elderly, Pulmicort is recommended in an amount of 1-2 mg per day.
If therapy aims to maintain the patient’s condition, for children the drug is shown in the amount of 0.25-2 mg per day, and for adults the optimal volume is 0.5-4 mg. An increase in dosage is allowed if the disease worsens.
Too much!
There will be no clinical manifestations, even if the patient used Pulmicort in a very high dose. Prolonged use of the drug in a dosage significantly higher than recommended may cause a systemic effect on the body, characteristic of GC drugs.
Nuances
When deciding on the appointment of Pulmicort inhalation drug, you need to remember that there is a risk of a systemic effect of GCS.
Nebulizers and inhalations
The manufacturer recommends using Pulmicort using a nebulizer, a device that can turn a suspension into a suspension in the air that the patient inhales. The nebulizer is equipped with a mouthpiece, through which it is necessary to inhale the composition. A smooth, late breath allows the substance to penetrate into all parts of the respiratory system, fill the lungs. If inhalation is necessary for the child, a mask should be used.
Ultrasonic devices are not suitable for using Pulmicort.
Before starting the procedure, you need to carefully read the instructions for use of the drug. The manufacturer's recommendations must be observed very clearly.
Immediately after inhalation, rinse the mouth with clean water. This reduces the likelihood of candidiasis of the mucous membranes. In addition, wash thoroughly to minimize irritation of the skin.
After diluting the suspension, you should use it in the next half hour - after this time, the medication loses its effectiveness. At the end of the procedure, rinse the nebulizer. For cleaning, use a mild detergent, and then dry the device.
A distinctive feature of modern devices is the formation of a saturated air flow that delivers from five to eight liters of treated air every minute. The amount of drug used for such a procedure is chosen by the doctor.
Application features
Studies have shown that Pulmicort does not affect a person’s ability to concentrate. No special restrictions are required during the therapeutic course; vehicles and devices requiring increased reaction and attention can be controlled.
Analogues of Pulmicort: reviews and prices
Instructions for use of the drug in question indicate that the active component is budesonide. It is based on several other means:
- Symbicort.
- "Tafen Nasal."
- "Foradil Combi."
Of the above, the drug Tafen Nazal is least worth it, but it is far from suitable in every case. The price of packaging is about 300 rubles. But for the popular "Symbicort" in pharmacies ask about 2,500 rubles.
The Pulmicort analogs similar in some paragraphs of the instructions for use are more affordable at the price than the composition under consideration:
It is sometimes possible to replace the composition prescribed by the doctor with:
The medicines “Novopulmon” and “Budoster” have a good reputation.
If it is necessary to replace the prescribed composition with analogues, it is important to consult a doctor, otherwise the drug may be ineffective or provoke unpredictable side effects that worsen the patient's condition. The negative experience of self-medication can be concluded from the reviews of patients.
What is bronchial asthma?
The disease is one of the immuno-allergic, provoked by inflammatory processes of non-infectious origin. The area of ​​localization of inflammation is the respiratory organs, bronchial tree. The disease is usually chronic, gradually progresses, from time to time it bothers with attacks accompanied by suffocation, bronchial obstruction.
Asthma is provoked by a whole range of factors - external, internal: stress, mental, emotional stress, increased physical activity, poor climate, chemical, toxic components, allergens. More likely, asthma is experienced by people suffering from problems in the functioning of the endocrine system, weakened immunity. Asthma is often diagnosed against the background of bronchial hyperreactivity.
Where did the trouble come from?
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- exogenous factors, due to which mediators are produced, while a general allergic reaction is not formed;
- swelling of the bronchial mucosa, leading to poor patency;
- lesions of small bronchial elements;
- a small amount of secretion produced by the glands of the bronchi;
- destructive changes in lung tissue due to inadequate ventilation of the organ.
Doctors say that asthma often develops due to the dustiness of a person’s habitat. Dust is rich in ticks, the chitin of which is a strong allergen.
Stages and forms of the disease
Asthma is divided into four stages:
- intermittent;
- easy persistence;
- average persistence;
- severe persistence.
The early stages are rarely accompanied by seizures, and the manifestations themselves are easily eliminated. The more actively the disease develops, the more severe the exacerbations, and the medications show an increasingly weaker result.
The origin of asthma:
- exogenous;
- endogenous;
- combined.
Specific forms are known:
- against the background of salicylates (aspirin);
- reflux induced;
- physical;
- professional;
- nightly.
Atopic asthma is more common than others. The cause of the disease is hypersensitivity of the respiratory system to allergens. Immunity, trying to protect itself from harmful agents, provokes a spasm of the muscles of the bronchial tree. Such asthma belongs to the class of exogenous, but in modern medicine it is considered separately. This is largely due to a hereditary factor affecting the likelihood of developing a pathology.
Symptomatology
During exertion, and often even at rest, asthma suffers from shortness of breath, possibly suffocation. Symptoms occur if you inhale pollen or find yourself in conditions of a sharp change in temperature. At an early stage, an asthma attack usually develops completely unpredictably. The patient breathes shallowly, the exhalation is longer than the inhalation, and it is not possible to completely release air from the lungs, and this gives rise to a feeling of anxiety.
Asthmatics are tormented by a strong, unproductive cough against the background of shortness of breath. It is not possible to cough up with asthma, but at the end of the attack, small volumes of sputum can go away. At the same time, wheezing is noticeable during breathing, often loud enough to be heard from a distance.
Asthmatics are characterized by orthopnea, that is, a specific position of the body (sitting, legs down, hands holding on to a support). This makes breathing easier.
In the early stages of asthma, only some of the symptoms from the listed “bouquet” may occur. Attacks are short-term at first, rarely. This time period was called in medicine "imaginary well-being." Over time, symptoms become more pronounced. Treatment will bring the best results if you can notice the disease at the beginning and consult a doctor on time.
The onset of the disease is not accompanied by systemic health problems, but the situation worsens over time. Patients note that the head hurts and is spinning - this indicates a lack of activity of the respiratory system. The patient feels weak, and when trying to actively move during an attack, he is faced with an acute shortage of air. But between the attacks, the condition is usually normal, you can easily cope with physical activity (within reasonable limits).
During an asthmatic attack, the heartbeat becomes more frequent, its rhythm goes astray. The average frequency reaches 130 beats per minute. If the disease has reached a severe stage, even between attacks, tachycardia is disturbing.
Often with asthma of the extremities, the skin acquires a bluish tint. This symptom is explained by respiratory failure, indicates that asthma is difficult. The terminal finger phalanges, nail plates change, signs appear that make it possible to suspect pulmonary emphysema. All these manifestations require an early visit to the doctor. Only a doctor can choose the appropriate treatment - perhaps it will be the Pulmicort drug discussed above, perhaps something else.