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What Factors Affect a Sufficient Budesonide Dose?

By Maggie J. Hall
Updated Feb 11, 2024
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A sufficient dose of budesonide varies depending on administration method, liver health, and possible interacting medications. Pharmaceutical companies manufacture budesonide as a suspension or a powder, administered as an inhalant. The dosage from these two forms varies. Patients might also take the medication orally in capsule form, which delivers a different dose than the inhalers. Hepatic, or liver, malfunction and certain medications increase blood levels of budesonide, requiring dose adjustment. Inhibition of the inflammatory processes associated with asthma and Crohn's disease symptoms are common reasons for prescribing budesonide.

Using the medication in suspension form requires a budesonide dose of 0.5 to 1 milligram daily, usually administered as 0.25 to 0.5 milligrams every 12 hours. Patients typically take the suspension as an inhalant from a nebulizer device. When inhaled in aerosol powder form, the budesonide dose ranges from 180 to 360 micrograms, administered twice a day. Patients using the capsule form for relief of symptoms associated with Crohn's disease, typically start on a budesonide dose of 9 milligrams every morning. After symptom reduction occurs, physicians usually drop the budesonide dose to 6 milligrams every morning.

Commonly reported budesonide side effects include an increased susceptibility to infection. Patients using inhalant forms of the medication must rinse their mouths following administration to prevent the development of oral yeast infections. Headaches, nausea, and back pain are other possible adverse reactions. Studies indicate that patients diagnosed with existing infections, diabetes mellitus, hypertension, or osteoporosis should not use budesonide, as the drug typically exacerbates these conditions.

The liver metabolizes budesonide, and patients diagnosed with hepatic malfunction cannot sufficiently eliminate the medication from the body, and require a dosage adjustment. After using the anti-inflammatory for extended lengths of time, patients may exhibit signs of hypercorticism, which include a moon-shaped face and extra fat deposits on the trunk of the body while the limbs remain slender. The syndrome may also decrease bone mineral density and increase clotting time, causing a tendency to bruise or bleed easily. Patients with these symptoms require a decrease in the usual budesonide dose or gradual weaning from the medication.

Budesonide interactions include grapefruit juice and certain antibiotic and antifungal medications. These substances generally inhibit the enzymes necessary for the liver to properly metabolize and eliminate the compound from the body, resulting in increased blood levels of the drug. If a patients is taking an antibiotic, the budesonide dose may require reduction. Omeprazole interacts with the formulation by decreasing levels of budesonide, which may also require a dosage adjustment. Budesonide safety concerns include research that indicates the medication stunts growth in children.

The medication displays strong properties of a corticosteroid and, to a lesser degree, the properties of a mineral corticoid. Researchers believe that budesonide produces anti-inflammatory effects by minimizing the action of eosinophils, macrophages, mast cells, and neutrophils, along with the chemicals responsible for creating irritation. Simultaneously, the medication encourages cytokine and the release of other chemicals that aid in inhibiting inflammation.

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