Budesonide for inhalation

What is budesonide?

Budesonide is a corticosteroid medication, which is inhaled to control inflammation in your child’s lungs and help prevent asthma attacks. It may also be used to decrease cough, wheezing or shortness of breath from other respiratory conditions. This medicine keeps the airways of your child's lungs healthy when they use it regularly.

Budesonide is a preventer medicine. It does not stop the signs of an asthma attack or wheezing once they have started. Your child should use their reliever medicine for this. You may also hear budesonide called by its brand names, Pulmicort Nebuamp or Pulmicort Turbuhaler.

Budesonide comes as an inhaler or as a liquid to use in a nebulizer machine.

Before giving budesonide to your child?

Tell your child's health-care provider if your child has:

• an allergy to budesonide or any ingredient in the formulation

Talk with your child's health-care provider if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• an infection, such as chickenpox, measles or tuberculosis
• eye problems, such as cataracts or glaucoma
• weak bones or low bone density (osteopenia)
• liver disease

How should you give your child budesonide?

• Give your child budesonide exactly as your health-care provider tells you, even if your child seems better.
• Give your child budesonide for as long as your child's health-care provider tells you. Do not suddenly stop giving this medicine to your child. Talk with your child's health-care provider before you stop giving this medicine for any reason.
• Give your child budesonide at the same times every day. Pick times that are easy for you so that you do not miss doses.
• If your child uses a reliever medicine, such as salbutamol, make sure your child uses the reliever medicine five minutes before using the budesonide. The reliever medicine opens the airways, which helps budesonide enter deeper into the lungs.
• If your child uses a nebulizer machine to take the budesonide, you can mix the reliever medicine with the budesonide liquid immediately prior to administration.
• Your child needs to breathe the budesonide in through their mouth. If you are not sure how to give this medicine, ask the pharmacist or nurse to show you.
• If your child is using the Pulmicort Turbuhaler, they should follow these instructions:
1. Remove the cover from the mouthpiece of the inhaler.
2. Turn the bottom grip as far as it will go in the opposite direction until you hear a “click”.
3. Breathe out fully away from the inhaler.
4. Have your child close their lips around the mouthpiece and breathe in deeply and forcefully.
5. Have your child hold their breath for 10 seconds and then breathe out slowly through their nose.
• Have your child rinse their mouth with water and spit out after taking budesonide to reduce its side effects (e.g., oral thrush). If your child is too young to rinse, give water or juice to drink after every dose of budesonide.

What should you do if your child misses a dose of budesonide?

• Give the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
• Do not give your child two doses to make up for one missed dose.

How long does budesonide take to work?

It may take several weeks before you notice that your child's breathing is getting better with budesonide.

What are the possible side effects of budesonide?

Your child may have some of these side effects while they take budesonide. Check with your child's health-care provider if your child continues to have any of these side effects, if they do not go away or if they bother your child:

• Dry mouth or throat
• Sore throat
• A bad taste in the mouth
• Hoarseness
• Cough

Call your child's health-care provider during office hours if your child has any of these side effects:

• White patches in the mouth
• Pain while eating or swallowing
• Blurry vision or any changes in vision
• Changes in behaviour, such as increased restlessness or nervousness
• Symptoms of adrenal insufficiency, including tiredness, headaches, muscle or joint pain, nausea and vomiting

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's health-care provider right away or take your child to the Emergency Department if your child has any of these side effects:

• Wheezing, shortness of breath or trouble breathing that is not relieved by any medication
• Signs of an allergic reaction: rash; hives; itching; wheezing; swelling of the face, eyes or lips; trouble breathing or swallowing; chest tightness

What safety measures should you take when your child is using budesonide?

There are some medicines that should not be taken together with budesonide for inhalation, or, in some cases, the dose of budesonide or the other medicine may need to be adjusted. It is important that you tell your child’s health-care provider if your child takes any other medications (prescription, over the counter or herbal), including:

• certain azole antifungal medications (e.g., voriconazole, itraconazole)
• certain HIV medications (e.g., ritonavir)

Check with your child's health-care provider before giving your child any other medicines (prescription, non-prescription, herbal or natural products).

If your child's asthma is not getting better after two weeks of using inhaled budesonide, or if you feel it is getting worse, contact your child’s health-care provider.

Gargling and rinsing the mouth with water after each dose will help to prevent hoarseness, throat irritation and yeast infections in the mouth.

Before your child has any kind of surgery, including dental surgery or an emergency treatment, tell the doctor or dentist that your child is taking budesonide.

What other important information should you know about budesonide?

• Keep budesonide Turbuhaler at room temperature in a cool, dry place away from sunlight. Do NOT store it in the bathroom or kitchen.
• Keep liquid budesonide for nebulization in the unopened aluminum package to protect the medicine from light. After the package has been opened, the unused liquid should be stored in its original aluminum package. Any unused liquid should be thrown out three months after opening the aluminum pouch.
• Keep a list of all medications your child is on and show the list to their health-care providers.
• Do not share your child's medicine with others and do not give anyone else's medicine to your child.
• Make sure you always have enough budesonide to last through weekends, holidays and vacations. Call your pharmacy at least two days before your child runs out of medicine to order refills.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.

Keep budesonide for inhalation out of your child’s sight and reach and locked up in a safe place. If your child takes too much budesonide for inhalation, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.