Bronchial asthma takes first place in the world among diseases associated with hyperactivity of the immune system. A huge number of drugs are created for its treatment. One such remedy is Budesonide. Analogues of this drug are also often used to treat bronchial obstructive syndrome. So what is this medicine?
What is budesonide?
This drug belongs to the group of inhaled glucocorticoids. This tool is a synthetic analogue of hormones synthesized in our body (in the adrenal cortex). What is the effect of Budesonide?
Instructions for use of the drug suggests that this tool helps to increase the number of active beta-adrenergic receptors in the airways.
In addition, the drug blocks the effect of inflammatory leukotrienes and prostaglandins, thereby preventing the development of the inflammatory process in the mucous membrane of the bronchi.
It has an effect after daily intake for several days (usually about 5-7 days).
It is one of the main drugs for the treatment of severe bronchial asthma and chronic obstructive pulmonary disease. At the initial stages of development of these diseases is not applied.
How does Budesonide affect target cells?
Pharmacodynamics
The drug, due to inhalation use, is well absorbed from the surface of the lungs (from the surface of the nasal mucosa practically does not enter the systemic circulation).
The maximum concentration of the drug in blood plasma is observed 45 minutes after its inhalation. 85 percent of the drug received is bound to blood albumin, while the remaining part is excreted unchanged.
It is processed in the liver. It is excreted through the gastrointestinal tract (with bile) and in the urine.
Patients with pathology of these organs have a longer delay of the drug in the blood, which is associated with the development of most complications and an overdose of glucocorticoid hormones.
You can use the drug in tablet form for the treatment of systemic collagenoses (however, only 10 percent of the total amount of the drug that gets into the digestive tract can have a therapeutic effect).
It is also used to treat non-inflammatory diseases of the nasal mucosa due to prolonged local action.
Indications for use
In what cases can Budesonide be prescribed? Instructions for use lists the main diseases in which these drugs can be used:
- Bronchial asthma. The drug has spread due to its anti-inflammatory effect and ability to inhibit the activity of inflammatory mediators.
- Crohn's disease. For the treatment of this disease, a tablet form of the drug is used. The drug is prescribed to induce remission in mild and moderate forms of the disease.
- Rhinitis treatment. The purpose of the intranasal form of budesonide for the relief of symptoms of hay fever and allergic rhinitis is shown. An excellent treatment for this disease is Budesonide Formoterol.
- Prevention of relapse of the development of polyposis of the nasal mucosa. The drug is used in the early postoperative period. In almost 95 percent of cases, it prevents the re-development of polyposis.
These diseases are the main processes in which Budesonide is prescribed.
Sometimes this drug can be prescribed to prevent the development of obstructive pulmonary disease. Such cases include patients with occupational diseases or working in harmful working conditions. But it should be remembered that even when using medications for prevention, one should not forget about careful dosing of the drug, since otherwise there is a high risk of getting problems with the adrenal glands and glucocorticoid withdrawal syndrome .
In what cases is its use contraindicated?
Contraindications
Under what processes and diseases is it forbidden to use Budesonide? Instructions for use of the drug indicate the following diseases:
- Hypersensitivity to the drug or its components. Dangerous development of angioedema.
- Active form of pulmonary tuberculosis.
- Respiratory diseases of fungal nature.
- Acute infectious processes in the gastrointestinal tract.
- Severe liver failure.
- Childhood.
For all these diseases, the use of glucocorticoids is prohibited. This is due to the fact that the drug either contributes to an exacerbation of the process, or worsens its course. In children, this drug should not be used because the physiological production of glucocorticoid hormones may be impaired due to insolvency of the adrenal cortex.
There are some limitations under which Budesonide should be prescribed with extreme caution. Instructions for use warns that the drug should be used very carefully for people with arterial hypertension, diabetes mellitus, pheochromocytoma, a stomach ulcer and duodenal ulcer.
Side effect
At present, there is no drug that can cause a side effect to not develop. Unfortunately, Budesonide is also a drug with a rather large spectrum of side effects.
If Budesonide is used for inhalation, then the main side effects of its use will be speech disorders (dysphonia), hoarseness, dry mouth, cough, the development of paradoxical bronchospasm.
With oral administration, the development of depression, dizziness, irritability.
The cardiovascular system can respond to the introduction of Budesonide by the development of vasculitis, increased systemic blood pressure, and tachycardia.
The medicine can also cause exacerbation of gastrointestinal diseases - ulcers, pancreatitis. In addition, it stimulates the development of dyspeptic disorders.
It also negatively affects the musculoskeletal system. Perhaps the development of osteoporosis, myasthenia gravis, joint pain.
The most severe side effect is hypercorticism syndrome. It develops due to the fact that during the period of taking glucocorticoids, the synthesis of own hormones decreases. If corticoids have been used for quite some time, the adrenal glands may simply stop synthesizing physiological substances, which will necessarily affect the patient’s health. That is why it is important to carefully monitor the dose of incoming hormones, as well as correctly stop their intake.
Drug dosage
In what doses should "Budesonide be prescribed? The instructions for prescribing the drug provide for the following dosage regimen.
The use of the inhaled form of Budesonide is based on the severity of the disease. The optimal dose for an adult is 200-800 mcg per day. The maximum daily dose should not exceed 1.5 mg. In children, the drug is contraindicated for use, and its analogues are prescribed according to the severity of the clinical case.
The oral form of the drug is used 30-60 minutes before a meal. Use up to 3 mg 3 times a day. The course of treatment with an oral drug is about 2 months. Refusal of the drug is carried out gradually in order to prevent withdrawal.
"Budesonide Isheiler" is usually prescribed intranasally. Its dose is selected for each person individually, depending on the severity of the process. On average, use 2-3 drops of the drug in each nostril twice a day. In children, this form of the drug is contraindicated. The course of treatment is designed for 2 weeks.
Interaction with other drugs
Some drugs when used together with Budesonide can worsen its digestibility. These medicines include cytochrome P450 inhibitors. For example, if you use both Budesonide (Pulmicort as an analogue) and drugs such as Ketoconazole and Erythromycin, it is possible to slow the removal of glucocorticoid from the blood, which is fraught with the development of hormonal intoxication and the appearance of undesirable effects of the drug.
The concomitant use of Budesonide and some diuretics (Indap) promotes the development of hypokalemia in the patient’s body, which will undoubtedly affect the work of the heart.
Some drugs (for example, antacids - "Almagel") when used simultaneously with "Budesonide" have an antagonistic effect on each other, i.e. do not allow each other to exert their therapeutic effect. Because of this, it is recommended to use these drugs with an interval of at least two hours (applicable only to the oral form of the drug).
Use of the drug for inhalation
Since this medicine was created primarily for the treatment of respiratory tract diseases, it is worthwhile to understand how they should be prescribed.
Quite a lot of inhalation forms of the drug have been created, but their use usually converges in many ways.
Firstly, these drugs are usually administered using a nebulizer. This device allows you to enter into the respiratory tract a strictly selected dose of the drug. Usually, one serving of inhalation powder is sufficient to relieve symptoms of asthma or COPD.
For this purpose, "Budesonide native" is usually used. This drug is patented by a Russian company. In its composition, the medicine carries a suspension (or powder) of Budesonide. The cassette with the drug is loaded into the nebulizer, after which, when inhaled, the drug enters the bronchi and lungs.
Some drugs come in the form of an aerosol, which also contains Budesonide. Their trade name may differ from each other, however, the active substance will be the same glucocorticoid. If you take such a drug, you should remember that one dose of aerosol contains 0.05 ml of active budesonide (it is important to know so as not to cause an overdose of glucocorticoids).
Drug cost
Given the size of the current market for medications, it is not difficult to choose Budesonide for inhalation. The price for it and its analogues may vary, however, it should be remembered that all the same, in their composition, the main active ingredient will be budesonide. The cost of the drugs will depend only on who produces the drug and whether it is a proprietary drug or generic.
The drug is purchased purely in pharmacies. How much will Budesonide cost? The price of it and its analogues is on average from 300 to 2000 rubles. It all depends on who the manufacturer is, and what form of release of the drug. For example, a drug like Benacort is available in the form of capsules with powder for inhalation. On average, it costs 400 rubles. English drugs are much more expensive. For example, British-made Budesonide Formoterol costs around 2,000 rubles, which not everyone can afford. It is easier to purchase Slovenian drugs, which do not differ in effectiveness, but are much cheaper.
In studies, it was proved that more expensive drugs are almost inferior to their budget counterparts. Therefore, what kind of drug to buy is an individual choice of each, depending on his needs and security.
Drug Reviews
Glucocorticoid drugs have long been used by many patients with chronic obstruction or asthma syndrome. Almost all patients with a severe form of one of these diseases are prescribed Budesonide. Its analogs occupy a rather wide cell in the register of medicines against these diseases, therefore they also often remain on hearing. These are such medicines as, for example, Apulein, Benacap, Buderin, Pulmicort and Benacort already mentioned above, etc.
According to many patients, these drugs are the best in the treatment of respiratory tract diseases. Quite a few people who would not benefit from the inhaled form of glucocorticoid or its combination with beta-adrenergic agonists.
With the right dosage of the drug, it was possible to achieve a significant improvement in these patients. Currently, many simply can not imagine life and normal life without the use of these drugs.
However, despite numerous positive reviews, there is also a dark side to a drug like Budesonide - the price.
For a long time, there was a tendency to prescribe anti-asthma drugs for needy patients for free. All patients could come to the pharmacy and, upon presentation of the relevant document, receive a free medication for their own needs.
Currently, this is also practiced, however, the contingent, which is given these drugs for free, has significantly narrowed. Now, such medicines are given free of charge only to disabled people of groups 2 and 1, as well as to children; other people are forced to buy medicine for their own money. Given that the drug requires quite a lot, not every person can afford such a treatment.