Budesonide Clinical data Trade names Pulmicort, Rhinocort, Entocort, others AHFS/ Drugs.com Monograph MedlinePlus a608007 License data
US: B (No risk in non-human studies) Routes of administration By mouth, nasal, tracheal, rectal ATC code Legal status Legal status
AU: S2 (Pharmacy only)
: CA ?-only
UK: POM (Prescription only) US: OTC and Rx-only Pharmacokinetic data Bioavailability 10-20% (first pass effect) Protein binding 85-90% Metabolism Hepatic CYP3A4 Elimination 2.0-3.6 hours Excretion Urine, feces Identifiers
11?,21-Dihydroxy-16?,17?-[butane-1,1-diylbis(oxy)]pregna-1,4-diene-3,20-dione CAS Number PubChem CID DrugBank ChemSpider UNII KEGG ChEMBL PDB ligand ECHA InfoCard 100.051.927 Chemical and physical data Formula C 25 H 34 O 6 Molar mass 430.534 g/mol 3D model ( JSmol)
(what is this?) (verify) Budesonide ( BUD), sold under the brand name Pulmicort among others, is a medication of the corticosteroid type. It is available as an  inhaler, pill, nasal spray, and rectal forms.  The inhaled form is used in the long-term management of  asthma and chronic obstructive pulmonary disease (COPD).   The nasal spray is used for  allergic rhinitis and nasal polyps.  The pills in a delayed release form and rectal forms may be used for  inflammatory bowel disease including Crohn's disease, ulcerative colitis and microscopic colitis.   
Common side effects with the inhaled form include respiratory infections, cough, and headaches.
Common side effects with the pills include feeling tired, vomiting, and joint pains.  Serious side effects include an increased risk of infection, loss of bone strength, and  cataracts. Long-term use of the pill form may cause  adrenal insufficiency. Stopping the pills suddenly following long-term use may therefore be dangerous.  The inhaled form is generally safe in  pregnancy. Budesonide is mainly acting as a  glucocorticoid. 
Budesonide was initially patented in 1973.
Commercial use as an asthma medication began in 1981.  It is on the  World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. Some forms are available as a  generic medication. The wholesale price in the  developing world for an inhaler containing 200 doses is about US$5 to US$7 as of 2014. As of 2015 the cost for a typical month of the inhaler medication in the United States is US$100 to US$200.  
nebulized for maintenance and prophylactic treatment of asthma including patients who require oral corticosteroids and those who may benefit from a systemic dose reduction. 
Inflammatory bowel disease
Formulations of delayed-release Budesonide are an effective treatment for mild-to-moderately active
Crohn's disease involving the ileum and/or ascending colon. A Cochrane review found evidence for up to 3 months (but not longer) of maintenance of remission Crohn's disease.  
Budesonide assists in the induction of remission in people with active
ulcerative colitis. 
Budesonide is highly effective and recommended as the drug of choice in
microscopic colitis, for induction and maintenance of remission, and for both the lymphocytic colitis and collagenous colitis forms. 
Nasal spray budesonide is a treatment for
allergic rhinitis. 
Budesonide may cause:
 Nose irritation or burning
Bleeding or sores in the nose
Bad taste in mouth Change in
mucus Blurred vision 
In addition, the following symptoms should be reported immediately:
Difficulty breathing or swelling of the face
White patches in the throat, mouth, or nose
Irregular menstrual periods
On rare occasions, behavioral changes (mostly affecting children) 
Budesonide is contraindicated as a primary treatment of
status asthmaticus or other acute episode of asthma where intensive measures are required. It is also contraindicated for patients who have hypersensitivity to budesonide.  
Those taking tablets or capsules orally should avoid grapefruit juice and
Also, high fat meals delay absorption but do not impede absorption.
Budesonide is an agonist of glucocorticoid receptors. Among its effects are:
Controls the rate of protein synthesis.
Depresses the migration of polymorphonuclear leukocytes and fibroblasts.
Reverses capillary permeability and lysosomal stabilization at the cellular level to prevent or control inflammation.
Has a potent glucocorticoid activity and weak mineralocorticoid activity.
Pharmacokinetics Onset of action: Nebulization: 2-8 days; Inhalation: 24 hours
Peak effect: Nebulization: 4-6 weeks; Inhalation: 1-2 weeks
Distribution: 2.2-3.9 L/kg
Protein binding: 85% to 90%
Metabolism: Hepatic via CYP3A4 to two metabolites: 16 alpha-hydroxyprednisolone and 6 beta-hydroxybudesonide; minor activity
Bioavailability: Limited by high first-pass effect; Capsule: 9% to 21%; Nebulization: 6%; Inhalation: 6% to 13%
Half-life elimination: 2-3.6 hours
Time to peak: Capsule: 0.5-10 hours (variable in Crohn's disease); Nebulization: 10-30 minutes; Inhalation: 1-2 hours; Tablet: 7.4-19.2 hours
Excretion: Urine (60%) and feces as metabolites.
Budesonide, also known as 11?,21-dihydroxy-16?,17?-(butylidenebis(oxy))pregna-1,4-diene-3,20-dione, is a
synthetic pregnane steroid and non- halogenated cyclic ketal corticosteroid.  It is the C16?  hydroxyl, C16?,17? cyclic ketal with butyraldehyde derivative of prednisolone (11?,17?,21-trihydroxypregna-1,4-diene-3,20-dione).  
Budesonide (2 stereoisomers)
Society and culture
Inhaler for a powder based in budesonide and
Aeronide (TH); Aquacort (DE); B Cort (CO); Bronex (PH); Budair (MY); Budecort DP (MY); Budenofalk (DE, GB, HK, KP, PH, SG); Budeson (AR); Budeson Aqua (AR); BudeSpray (TH); Budiair (KP); Budicort Respules (IL); Budinide (KSA); Bunase (TH); Clebudan (CN); Cycortide (HK); Denecort (PH); Duasma (TW); Eltair (MY); Entocort (AR, AT, BE, BR, CH, CZ, DK, FI, FR, GB, HK, IE, IL, IT, KP, NL, NO, PL, PT, SE, TR); Giona Easyhaler (MY, SG, TH); Inflammide (PE); Miflonid (CZ); Miflonide (BE, DE, IL, IT, NZ, PT); Neumocort (PY); Novopulmon (DE, FR); Pulmicon Susp for Nebulizer (KP); Pulmicort (AT, BE, BG, BR, CH, CL, CN, CO, CR, CZ, DE, DK, DO, EE, FI, FR, GB, GR, GT, HN, ID, IN, NI, NL, NO, PA, PK, PL, PT, RU, SE, SV, TR, TW, UY, VE, ZA); Pulmicort Nasal Turbohaler (CL, KE, MU, NG); Pulmicort Turbuhaler (KE, MU, NG); Rafton (FR); Rhinocort (AU); Rhinocort Aqua (HK); Rhinoside (GR); Symbicort (FR, US, ZA) Uceris (US)
^ a b c d e f g h i j
"Budesonide". The American Society of Health-System Pharmacists. Archived from the original on 2015-11-28 . Retrieved 2015.
^ a b
"Budesonide eent". The American Society of Health-System Pharmacists. Archived from the original on 2015-12-08 . Retrieved 2015.
De Coster, DA; Jones, M (2014). "Tailoring of corticosteroids in COPD management". Current Respiratory Care Reports. 3 (3): 121-132. doi: 10.1007/s13665-014-0084-2. PMC . 4113685 PMID 25089228.
Christophi, GP; Rengarajan, A; Ciorba, MA (2016). "Rectal budesonide and mesalamine formulations in active ulcerative proctosigmoiditis: efficacy, tolerance, and treatment approach". Clinical and Experimental Gastroenterology. 9: 125-30. doi: 10.2147/CEG.S80237. PMC . 4876845 PMID 27274301.
Rudmik, L; Schlosser, RJ; Smith, TL; Soler, ZM (July 2012). "Impact of topical nasal steroid therapy on symptoms of nasal polyposis: a meta-analysis". The Laryngoscope. 122 (7): 1431-7. doi: 10.1002/lary.23259. PMID 22410935.
Silverman J, Otley A (2011). "Budesonide in the treatment of inflammatory bowel disease". Expert Rev Clin Immunol. 7 (4): 419-28. doi: 10.1586/eci.11.34. PMID 21790284.
Pardi DS, Tremaine WJ, Carrasco-Labra A (2016). "American Gastroenterological Association Institute Technical Review on the Medical Management of Microscopic Colitis". Gastroenterology. 150 (1): 247-274.e11. doi: 10.1053/j.gastro.2015.11.006. PMID 26584602.
British national formulary : BNF 58 (58 ed.). British Medical Association. 2009. pp. 56-57. ISBN 9780857111562.
Domeij, Bengt (2000). . The Hague: Kluwer Law International. p. 278. Pharmaceutical patents in Europe ISBN 9789041113481. Archived from the original on 2015-12-08.
Hamley, Peter (2015). . John Wiley & Sons. p. 390. Small Molecule Medicinal Chemistry: Strategies and Technologies ISBN 9781118771693. Archived from the original on 2015-12-08.
"WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016 . Retrieved 2016.
^ a b
Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 451. ISBN 9781284057560.
"Budesonide". International Drug Price Indicator Guide . Retrieved 2015.
^ Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2011. Available at
http://www.ginasthma.org Archived 2013-10-14 at the Wayback Machine.
Lichtenstein GR, Hanauer SB, Sandborn WJ (2009). "Management of Crohn's Disease in Adults". Am J Gastroenterol. 104 (2): 465-83. doi: 10.1038/ajg.2008.168. PMID 19174807.
Kuenzig ME, Rezaie A, Seow CH, Otley AR, Steinhart AH, Griffiths AM, et al. (2014). "Budesonide for maintenance of remission in Crohn's disease". Cochrane Database Syst Rev. 8 (8): CD002913. doi: 10.1002/14651858.CD002913.pub3. PMID 25141071.
Habal FM, Huang VW (2012). "Review Article: A Decision-Making Algorithm For the Management of Pregnancy in the Inflammatory Bowel Disease Patient". Aliment Pharmacol Ther. 35 (5): 501-15. doi: 10.1111/j.1365-2036.2011.04967.x. PMID 22221203.
Pardi, Darrell (2016). "American Gastroenterological Association Institute Technical Review on the Medical Management of Microscopic Colitis". www.gastrojournal.org.
Stanaland, BE (April 2004). "Once-daily budesonide aqueous nasal spray for allergic rhinitis: a review". Clinical Therapeutics. 26 (4): 473-92. doi: 10.1016/s0149-2918(04)90050-1. PMID 15189745.
^ a b
BUDESONIDE - NASAL AEROSOL INHALER (Rhinocort) side effects, medical uses, and drug interactions Archived November 6, 2008, at the Wayback Machine.
"Budesonide: CMDh scientific conclusions and grounds for variation, amendments to the product information and timetable for the implementation - PSUSA/00000449/201604" (pdf). European Medicines Agency (EMA). March 10, 2017. Archived (PDF) from the original on 8 September 2017 . Retrieved 2017.
Todd GR, Acerini CL, Buck JJ, Murphy NP, Ross-Russell R, Warner JT, McCance DR (2002). "Acute Adrenal Crisis in Asthmatics Treated With High-Dose Fluticasone Propionate". Eur Respir J. 19 (6): 1207-9. doi: 10.1183/09031936.02.00274402. PMID 12108877.
Todd GR, Acerini CL, Ross-Russell R, Zahra S, Warner JT, McCance D (2002). "Survey of Adrenal Crisis Associated With Inhaled Corticosteroids in the United Kingdom". Arch Dis Child. 87 (6): 457-61. doi: 10.1136/adc.87.6.457. PMC . 1755820 PMID 12456538.
^ a b
J. Elks (14 November 2014). . Springer. pp. 186, 1011. The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies ISBN 978-1-4757-2085-3. Archived from the original on 8 September 2017.
^ a b
Thomas L. Lemke; David A. Williams (2008). . Lippincott Williams & Wilkins. pp. 1253-. Foye's Principles of Medicinal Chemistry ISBN 978-0-7817-6879-5. Archived from the original on 2017-09-08.