Budesonide Nebuliser Suspension

Indications (নির্দেশনা)

This suspension is indicated for:

• Treatment of persistent bronchial asthma in patients where a pressurized inhaler or dry powder formulation is unsatisfactory or inappropriate.

• Very serious pseudocroup (laryngitis subglottica) where hospitalization is indicated.

• Note: It is not indicated for the treatment of acute dyspnoea or status asthmaticus.

Pharmacology (ঔষধবিজ্ঞান)Budesonide is a synthetic corticosteroid with potent glucocorticoid activityand a high affinity for the glucocorticoid receptor.¹ 

Corticosteroids inhibit a wide range of multiple cell types (e.g., mast cells, eosinophils) and inflammatory mediators (e.g., histamine, leukotrienes), thereby controlling allergic-mediated inflammation.

Dosage & Administration (ডোজ ও ব্যবহারবিধি)

The dose should be given twice daily, but once daily may be considered for mild to moderate stable asthma. The maximum effect is typically obtained after 2−4 weeks of treatment.

• Administration:Must be administered with a jet Nebuliserdevice (ultrasonic nebulisers should not be used). 

• Important:Rinse the mouth with water after inhaling to minimize the risk of oropharyngeal Candida infection. Wash the face after using a face mask to prevent skin irritation.

   

Precautions & Warnings (সাবধানতা ও সতর্কতা)

• Systemic Effects: May occur with high doses for long periods, including adrenal suppression, growth retardation in children, and risk of cataract/glaucoma. The lowest effective dose should always be sought.

• Oral Corticosteroid Withdrawal: Special care is needed when transferring patients from oral steroids to inhaled Budesonide. Supplemental systemic steroids may be needed during periods of stress (e.g., surgery, infection).

• Paradoxical Bronchospasm:May occur immediately after dosing; treat with a rapid-acting bronchodilator and discontinue Budesonide immediately. 

• Infections: Close observation is needed for patients with pulmonary tuberculosis or fungal/viral infections of the airways.

Interactions & Safety

• Inhibitors: Concomitant use with strong inhibitors (e.g., ketoconazole, itraconazole) should be avoided as it can significantly increase systemic exposure to Budesonide, increasing the risk of systemic side effects.

• Pregnancy & Lactation:It is crucial to maintain adequate asthma treatment during pregnancy.Budesonide can be used during breastfeedingat therapeutic doses, as infant exposure is anticipated to be low. 

Therapeutic Class: Respiratory corticosteroids.