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Inhaled Glucocorticoid·Respiratory - Asthma & COPD
Asthma maintenance, COPD maintenance (in severe cases with frequent exacerbations)
Max Dose
800 mcg/day
Half-life
2-3 h
Thrush
HIGH RISK
Wash Mouth
MANDATORY
Overview
Inhaled Corticosteroid (ICS). The cornerstone of asthma prevention and chronic inflammation control in the airways.
Maximum Dose
Max 800 mcg/day (Doses > 800 mcg/day provide little extra local benefit but drastically increase systemic absorption/side effects).
Clinical Focus
Must rinse and spit after every use to prevent severe oropharyngeal candidiasis (oral thrush).
Bottom Line
Budesonide is a first-line inhaled corticosteroid for asthma and COPD with good local potency, but oral candidiasis requires mouth rinsing after every dose.
Brand Names
Pulmicort, Symbicort (combo)
Oral Routes
Dry powder inhaler (Turbuhaler 100 mcg, 200 mcg, 400 mcg). Nebules (1 mg/2 mL).
Prescribing & PBS
Unrestricted General Benefit (S4).
Primary
Asthma maintenance, COPD maintenance (in severe cases with frequent exacerbations).
Off-Label
Eosinophilic esophagitis, Croup.
Clinical Place
First-line preventative therapy for any patient requiring a SABA more than twice a month.