Budesonide, sold under the brand name Pulmicort among others, is a medication of the corticosteroid type. It is available as an inhaler, nebulization solution, 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.
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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. Some forms are available as a generic medication. In 2019, generic budesonide was listed as involved in Teva’s price fixing scheme in the United States. In 2019, it was the 201st most commonly prescribed medication in the United States, with more than 2 million prescriptions.
Budesonide is given by metered-dose inhaler or nebulizer 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 three months (but not longer) of maintenance of remission in 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.
Budesonide in the form of nasal sprays is a treatment for allergic rhinitis.
Topical budesonide has considerable effects in eosinophilic esophagitis. For this use, it is formulated as a tablet that disperses in the mouth, and sold under the trade name Jorveza.
Budesonide (Tarpeyo) is indicated to reduce proteinuria (increased protein levels in the urine) in adults with primary immunoglobulin A (IgA) nephropathy (Berger’s disease) at risk of rapid disease progression.