Select a medication above to begin.
Eohilia
budesonide
Adult Dosing .
Dosage forms: SUSPENSION: 2 mg per 10 mL
eosinophilic esophagitis
- [2 mg PO bid x12wk]
- Info: avoid food/drink during administration and for at least 30min after each dose
renal dosing
- [see below]
- renal impairment: no adjustment
- HD/PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class A or B: no adjustment; Child-Pugh Class C: avoid use; Info: caution advised if Child-Pugh Class B
Peds Dosing .
- Dosage forms: SUSPENSION: 2 mg per 10 mL
eosinophilic esophagitis
- [11 yo and older]
- Dose: 2 mg PO bid x12wk; Info: avoid food/drink during administration and for at least 30min after each dose
renal dosing
- [see below]
- renal impairment: no adjustment
- HD/PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class A or B: no adjustment; Child-Pugh Class C: avoid use; Info: caution advised if Child-Pugh Class B
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- hepatic impairment, Child-Pugh Class C
- systemic fungal infection
- Strongyloides infection
- cerebral malaria
- amebiasis, active
- amebiasis, latent
- ocular HSV infection
- abrupt withdrawal (long-term use)
- caution: hypersensitivity to corticosteroids
- caution: long-term systemic corticosteroid use, recent
- caution: peds patients
- caution: adolescent patients
- caution: hepatic impairment, Child-Pugh Class B
- caution: renal impairment
- caution: immunosuppressed patients
- caution: infection, active
- caution: infection risk
- caution: measles exposure (non-immune patients)
- caution: varicella exposure (non-immune patients)
- caution: HTN
- caution: pheochromocytoma risk
- caution: CHF
- caution: MI, recent
- caution: diabetes mellitus
- caution: diabetes mellitus family history
- caution: ulcerative colitis
- caution: PUD
- caution: diverticulitis
- caution: intestinal anastomosis, recent
- caution: GI perforation risk
- caution: seizure disorder
- caution: myasthenia gravis
- caution: psychiatric disorder
- caution: thyroid disorder
- caution: osteoporosis
- caution: osteoporosis risk
- caution: cataract
- caution: glaucoma
- caution: glaucoma risk
Drug Interactions .
Overview
budesonide
corticosteroid
- CYP3A4 substrate
- affects growth hormone diagnostic test results
- binds to anion exchange resin/polymer
- corticosteroid
- hyperammonemia
- hyperglycemic effects
- hypernatremia
- hypertensive effects
- hypokalemia
- immunomodulatory effects
- interferes w/ ACTH analog test
Contraindicated
- adenovirus vaccine, live
- BCG live intravesical
- chikungunya vaccine, live
- cholera vaccine, live
- dengue vaccine, live
- desmopressin
- influenza nasal vaccine, live
- measles/mumps/rubella vaccine, live
- rotavirus vaccine, live
- smallpox vaccine, live
- talimogene laherparepvec
- typhoid vaccine, live
- varicella vaccine, live
- yellow fever vaccine, live
Avoid/Use Alternative
- adagrasib
- afamitresgene autoleucel
- aldesleukin
- amphotericin
- arsenic trioxide
- atazanavir
- axicabtagene ciloleucel
- betamethasone
- brexucabtagene autoleucel
- budesonide
- ceritinib
- chloramphenicol
- ciltacabtagene autoleucel
- cladribine oral
- clarithromycin
- cobicistat
- cortisone
- deflazacort
- dexamethasone
- epinephrine inhaled
- fludrocortisone
- furosemide
- grapefruit
- hydrocortisone
- idecabtagene vicleucel
- idelalisib
- itraconazole
- ketoconazole
- levoketoconazole
- lifileucel
- lisocabtagene maraleucel
- lonafarnib
- lopinavir/ritonavir
- lutetium Lu 177 dotatate
- macimorelin
- methylprednisolone
- midodrine
- mifepristone
- natalizumab
- nefazodone
- nelfinavir
- obecabtagene autoleucel
- pimecrolimus topical
- posaconazole
- prednisolone
- prednisone
- rabies vaccine
- relacorilant
- ribociclib
- ritonavir
- tipranavir
- tisagenlecleucel
- triamcinolone
- tucatinib
- vamorolone
- voriconazole
Monitor/Modify Tx
- abiraterone acetate
- acarbose
- acebutolol
- acetazolamide
- albuterol
- albuterol inhaled
- aliskiren
- almotriptan
- aloe
- alogliptin
- amiloride
- amlodipine
- amphetamine
- angiotensin II
- anthrax vaccine
- aprepitant
- aprocitentan
- arformoterol inhaled
- armodafinil
- asciminib
- asparaginase
- atenolol
- atogepant
- atomoxetine
- atropine ophthalmic
- avacopan
- axitinib
- azilsartan medoxomil
- bempedoic acid
- benazepril
- benzphetamine
- berotralstat
- betaxolol
- bevacizumab
- bexagliflozin
- bismuth subsalicylate
- bisoprolol
- brigatinib
- bromocriptine
- bumetanide
- bupropion
- cabozantinib
- caffeine
- caffeine citrate
- canagliflozin
- candesartan cilexetil
- cannabis
- captopril
- carfilzomib
- carglumic acid
- carvedilol
- celecoxib
- cetuximab
- chikungunya vaccine
- chlorothiazide
- chlorthalidone
- cholestyramine
- ciprofloxacin
- cisplatin
- clevidipine
- clofazimine
- clonidine
- cocaine
- colesevelam
- colestipol
- conivaptan
- copanlisib
- corticotropin
- cosyntropin
- COVID-19 vaccine
- crizotinib
- cyclosporine
- danazol
- dapagliflozin
- darbepoetin alfa
- darunavir
- decitabine
- desvenlafaxine
- dexmethylphenidate
- dextroamphetamine
- dichlorphenamide
- diclofenac
- diclofenac topical
- diethylpropion
- diflunisal
- digoxin
- dihydroergotamine
- diltiazem
- dinutuximab
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- dobutamine
- dopamine
- doxapram
- doxazosin
- dronabinol
- dronedarone
- droxidopa
- dulaglutide
- duvelisib
- ebola vaccine, live
- eletriptan
- emapalumab
- empagliflozin
- enalapril
- enalaprilat
- ephedra
- ephedrine injection
- ephedrine oral
- epinephrine
- eplerenone
- epoetin alfa
- eptinezumab
- erenumab
- ergotamine
- ertugliflozin
- erythromycin
- esketamine
- esmolol
- estetrol (contraceptive)
- estradiol (contraceptive)
- ethacrynic acid
- ethanol (alcoholic beverage)
- ethinyl estradiol (contraceptive)
- etodolac
- etrasimod
- everolimus
- exenatide
- fedratinib
- felodipine
- fenfluramine
- fenoldopam
- fenoprofen
- fingolimod
- fluconazole
- flurbiprofen
- formoterol inhaled
- foscarnet
- fosfomycin injection
- fosinopril
- fostamatinib
- fremanezumab
- frovatriptan
- fruquintinib
- galcanezumab
- glimepiride
- glipizide
- glyburide
- glycerol phenylbutyrate
- guanfacine
- Haemophilus b vaccine
- hepatitis A vaccine
- hepatitis B vaccine
- hoodia
- human papillomavirus vaccine
- hydralazine
- hydrochlorothiazide
- hydroxocobalamin IV
- ibrutinib
- ibuprofen
- imatinib
- indapamide
- indomethacin
- influenza H5N1 vaccine
- influenza vaccine
- insulin
- irbesartan
- isavuconazonium
- isoproterenol
- isradipine
- Japanese encephalitis vaccine
- ketamine
- ketoprofen
- ketorolac
- labetalol
- lanreotide
- lefamulin
- leflunomide
- lenacapavir
- lenalidomide
- lenvatinib
- letermovir
- levalbuterol inhaled
- levomilnacipran
- licorice
- linagliptin
- liraglutide
- lisdexamfetamine
- lisinopril
- lixisenatide
- lorlatinib
- losartan
- lumacaftor/ivacaftor
- luspatercept
- magnesium citrate
- magnesium salicylate
- mannitol
- meclofenamate
- mefenamic acid
- meloxicam
- meningococcal vaccine
- metformin
- methamphetamine
- methazolamide
- methoxy polyethylene glycol-epoetin beta
- methyldopa
- methylergonovine
- methylphenidate
- methyltestosterone
- metoclopramide
- metolazone
- metoprolol
- metyrapone
- miglitol
- milnacipran
- minoxidil
- mirabegron
- mitomycin
- mitotane
- modafinil
- moexipril
- motixafortide
- nabumetone
- nadolol
- naproxen
- naratriptan
- nateglinide
- naxitamab
- nebivolol
- necitumumab
- netupitant
- nicardipine
- nicotine
- nifedipine
- nilotinib
- nimodipine
- niraparib
- nirogacestat
- nisoldipine
- norepinephrine
- obinutuzumab
- olmesartan medoxomil
- olodaterol inhaled
- osilodrostat
- oxaprozin
- oxymetazoline nasal
- oxytocin
- ozanimod
- pamidronate
- panitumumab
- pazopanib
- perindopril
- pexidartinib
- phendimetrazine
- phenoxybenzamine
- phentermine
- phentolamine
- phenylephrine
- phenylephrine injection
- phenylephrine nasal
- phenylephrine ophthalmic
- phenylephrine rectal
- pindolol
- pioglitazone
- piroxicam
- pneumococcal vaccine
- poliovirus vaccine
- polyethylene glycol
- polyethylene glycol/electrolytes
- ponatinib
- ponesimod
- pralsetinib
- pramlintide
- prazosin
- propranolol
- pseudoephedrine
- quetiapine
- quinapril
- ramipril
- ramucirumab
- regorafenib
- repaglinide
- respiratory syncytial virus vaccine
- rilzabrutinib
- rimegepant
- ripretinib
- rizatriptan
- ropinirole
- rosiglitazone
- rotigotine transdermal
- sacituzumab govitecan
- salmeterol inhaled
- salsalate
- saxagliptin
- selinexor
- selpercatinib
- semaglutide
- siponimod
- sipuleucel-T
- sirolimus albumin-bound
- sitagliptin
- smallpox/mpox vaccine, live
- sodium acid phosphate
- sodium benzoate
- sodium phenylacetate
- sodium phenylbutyrate
- sodium polystyrene sulfonate
- sodium thiosulfate
- solriamfetol
- somatrogon
- sorafenib
- spironolactone
- sulfate bowel prep
- sulindac
- sumatriptan
- sunitinib
- tacrolimus
- tafasitamab
- tagraxofusp
- telmisartan
- terazosin
- terbutaline
- teriflunomide
- testosterone
- tick-borne encephalitis vaccine
- timolol
- tirzepatide
- tivozanib
- tolmetin
- topiramate
- torsemide
- trametinib
- trandolapril
- triamterene
- typhoid vaccine
- ubrogepant
- vadadustat
- valsartan
- vandetanib
- vasopressin
- venlafaxine
- verapamil
- vilanterol inhaled
- viloxazine
- voclosporin
- yohimbe
- zavegepant
- ziv-aflibercept
- zolmitriptan
- zonisamide
Caution Advised
- abatacept
- abemaciclib
- abrocitinib
- acalabrutinib
- adalimumab
- alemtuzumab
- anakinra
- anifrolumab
- anti-thymocyte globulin
- apalutamide
- artemether/lumefantrine
- atidarsagene autotemcel
- azacitidine
- azathioprine
- baricitinib
- beclomethasone inhaled
- beclomethasone nasal
- belatacept
- belimumab
- belinostat
- belzutifan
- bendamustine
- bexarotene
- bimekizumab
- blinatumomab
- bortezomib
- bosentan
- brentuximab vedotin
- brodalumab
- budesonide inhaled
- budesonide nasal
- budesonide rectal
- busulfan
- butalbital
- cabazitaxel
- canakinumab
- carbamazepine
- carboplatin
- carmustine
- cenobamate
- certolizumab pegol
- chlorambucil
- ciclesonide
- cladribine injection
- clobazam
- clobetasol ophthalmic
- clofarabine
- coccidioides immitis skin test antigen
- crovalimab
- cyclophosphamide
- cytarabine
- dabrafenib
- dactinomycin
- danicopan
- danshen
- daratumumab
- darolutamide
- daunorubicin
- delgocitinib topical
- deucravacitinib
- deuruxolitinib
- dexamethasone ophthalmic
- dicloxacillin
- difluprednate ophthalmic
- dimethyl fumarate
- diroximel fumarate
- docetaxel
- doxorubicin
- dupilumab
- echinacea
- eculizumab
- efavirenz
- efgartigimod alfa
- elafibranor
- elagolix
- eleuthero
- elivaldogene autotemcel
- elotuzumab
- elranatamab
- enasidenib
- encorafenib
- enzalutamide
- epcoritamab
- epirubicin
- eribulin
- eslicarbazepine acetate
- etanercept
- etoposide
- etravirine
- etuvetidigene autotemcel
- felbamate
- fexinidazole
- floxuridine
- fludarabine
- flunisolide nasal
- fluocinolone intravitreal
- fluorometholone ophthalmic
- fluticasone furoate
- fluticasone propionate
- fosamprenavir
- fosphenytoin
- garlic
- gemtuzumab ozogamicin
- ginkgo
- ginseng, Asian
- glofitamab
- golimumab
- griseofulvin
- guselkumab
- hydrocortisone ophthalmic
- hydroxyurea
- ibritumomab tiuxetan
- icotrokinra
- idarubicin
- ifosfamide
- inebilizumab
- infliximab
- inotuzumab ozogamicin
- iptacopan
- irinotecan
- isatuximab
- isotretinoin
- ivosidenib
- ixabepilone
- ixekizumab
- lebrikizumab
- linvoseltamab
- lomustine
- loncastuximab tesirine
- loteprednol ophthalmic
- lymphocyte immune globulin, anti-thymocyte globulin
- marnetegragene autotemcel
- mavacamten
- melphalan
- mercaptopurine
- meropenem
- methotrexate
- mirikizumab
- mitapivat
- mitoxantrone
- mobocertinib
- mogamulizumab
- momelotinib
- mometasone implant
- mometasone inhaled
- mometasone nasal
- monomethyl fumarate
- mosunetuzumab
- mycophenolate mofetil
- mycophenolic acid
- nadofaragene firadenovec intravesical
- nafcillin
- narsoplimab
- nelarabine
- nevirapine
- nipocalimab
- ocrelizumab
- odevixibat
- ofatumumab
- olutasidenib
- omaveloxolone
- oxaliplatin
- oxcarbazepine
- paclitaxel
- pacritinib
- pegcetacoplan
- pentobarbital
- pentostatin
- perampanel
- phenobarbital
- phenytoin
- pirtobrutinib
- polatuzumab vedotin
- pomalidomide
- pozelimab
- prednisolone ophthalmic
- primidone
- procarbazine
- ravulizumab
- repotrectinib
- rifabutin
- rifampin
- rifapentine
- rilonacept
- risankizumab
- ritlecitinib
- rituximab
- romidepsin
- ropeginterferon alfa-2b
- rozanolixizumab
- rufinamide
- ruxolitinib
- ruxolitinib topical
- sarilumab
- satralizumab
- secukinumab
- sibeprenlimab
- siltuximab
- sirolimus
- sotorasib
- spesolimab
- St. John's wort
- stiripentol
- sulfasalazine
- sunvozertinib
- sutimlimab
- suzetrigine
- talquetamab
- tarlatamab
- tazemetostat
- teclistamab
- tecovirimat
- telotristat ethyl
- temozolomide
- temsirolimus
- teplizumab
- teriparatide
- tezepelumab
- thioguanine
- thiotepa
- tildrakizumab
- tocilizumab
- tofacitinib
- topotecan
- tovorafenib
- trabectedin
- tralokinumab
- tuberculin purified protein derivative
- ublituximab
- upadacitinib
- ustekinumab
- vaborbactam
- vedolizumab
- vemurafenib
- venetoclax
- vilobelimab
- vinblastine
- vincristine
- vinorelbine
- vorasidenib
- zanubrutinib
- zilucoplan
Adverse Reactions .
Serious Reactions
- anaphylaxis
- intracranial HTN
- HTN
- infection
- GI obstruction
- diabetes mellitus
- adrenal insufficiency
- Cushing syndrome (long-term use)
- immunosuppression (long-term use)
- Kaposi sarcoma (long-term use)
- glaucoma (long-term use)
- cataracts (long-term use)
- osteoporosis (long-term use)
- withdrawal symptoms if abrupt D/C (long-term use)
- growth suppression (long-term use in peds patients)
Common Reactions
- URI
- candidiasis, oral
- candidiasis, esophageal
- headache
- gastroenteritis
- throat irritation
- adrenal suppression
- erosive esophagitis
Safety/Monitoring .
Monitoring Parameters
TB, HBV screening at baseline; electrolytes; 2h postprandial glucose; BP; weight; height (peds); consider BMD, chest x-ray, endoscopic evaluation, ophthalmic exam; consider upper GI x-ray if PUD history or significant dyspepsia
Look/Sound-Alike Drug Names
budesonide confused with: bumetanide
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy, especially in 1st trimester or if long-term use; inadequate human data available, though possible risk of orofacial cleft, low birth wt, and premature birth based on conflicting human data with other systemic corticosteroids; possible risk of fetal harm, including teratogenicity and fetal death, based on animal data with SC route at 0.03-1.2x recommended human dose; possible risk of fetal adrenal suppression based on drug's mechanism of action
Lactation
Clinical Summary
weigh risk/benefit if prolonged high-dose use, otherwise may use while breastfeeding; inadequate human data available, though risk of infant harm not expected based on limited drug excretion into milk; no human data available to assess effects on milk production
Pharmacology .
Metabolism: for budesonide: liver extensively; CYP450: 3A4 substrate
Excretion: for budesonide: urine 60% (none unchanged), feces; Half-life: 3.3h
Subclass: Corticosteroids, Systemic
Mechanism of Action
for budesonide: exact mechanism of anti-inflammatory action unknown; inhibits multiple inflammatory cytokines; produces multiple glucocorticoid and mineralocorticoid effects
Formulary .
No Formulary Selected
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