Pulmicort

ATTENTION:
If you are switching (or have recently switched) from an oral corticosteroid such as budesonide, betamethasone, dexamethasone, methylprednisolone, prednisolone, or prednisone to budesonide inhalation and suffer an injury, infection, or a severe asthma attack, take a full dose of the oral corticosteroid (even if you have been gradually decreasing the dose) and Call your physician for more directions.Always carry an identification card that says you may need supplementary doses of an oral corticosteroid during periods of stress (injuries, infections, and severe asthma attacks). Ask your pharmacist or physician how to get this card. List your name, medical problems, drugs and dosages, and physician's name and telephone number on the card. Include the name of the oral corticosteroid and the full dose you took before decreasing it.

General Information and Indications:

Budesonide, Pulmicort, is used to prevent wheezing, shortness of breath, and troubled breathing caused by severe asthma and other lung diseases. It belongs to a class of drugs called corticosteroids.

Information For Users:

Budesonide comes as a powder to inhale by mouth. Budesonide is usually inhaled once or twice a day. Follow the directions on your prescription label carefully, and ask Your physician or pharmacist to explain any part you do not understand. Use budesonide exactly as directed. Do not use more or less of it or use it more often than prescribed by Your Health provider.

Budesonide controls symptoms of asthma and other lung diseases but does not cure them. Improvement in your asthma may occur as soon as 24 hours after taking the medication, but full effects may not be seen for 1 to 2 weeks after taking it regularly. Continue to use budesonide even if you feel well. Do not stop using budesonide without talking to Your physician. Call your physician if your symptoms do not improve during the first 2 weeks or if they get worse.

Do not use budesonide for rapid relief of asthma attacks. If you do not have another inhaler for prompt relief of breathing difficulties, ask Your Health provider to prescribe one. If Your Health provider has prescribed a bronchodilator (a drug to be inhaled for rapid relief of difficult breathing such as albuterol [Proventil, Ventolin]), use it several minutes before you use your budesonide. This helps the budesonide get into the deeper parts of your lungs. Call your physician immediately if your asthma is not responding to usual treatment.

Before you use budesonide the first time, read the written directions that come with it. Ask Your Health provider, pharmacist, or respiratory therapist to show you the right way to use the inhaler. Practice using the inhaler in front of him or her, so you are sure you are doing it the right way.

To use the inhaler, follow these steps:

Turn the protective cover and lift it off.
The first time you use a new budesonide inhaler you must prime it. To do this, hold the inhaler upright (with mouthpiece up), then twist the brown grip fully to the right as far as it will go, then back again fully to the left. You will hear a click. Repeat. The unit is now primed and ready to load the first dose. You do not have to prime the inhaler again after this, even if you do not use it for a long time.
Holding the inhaler upright, load the first dose by turning the grip fully to the right and fully to the left until it clicks.
Turn your head away from the inhaler and breathe out. Do not blow or exhale into the inhaler. Do not shake the inhaler after loading it.
Hold the inhaler in the upright (mouthpiece up) or horizontal position. Place the mouthpiece between your lips well into your mouth, past your front teeth. Tilt your head slightly back. Close your lips tightly around the mouthpiece and inhale deeply and forcefully. Be sure that the mist goes into your throat and is not blocked by your teeth or tongue. Adults giving the treatment to young children may hold the child's nose closed to be sure that the medication goes into the child's throat.
Remove the inhaler from your mouth and hold your breath for about 10 seconds. Do not exhale through the inhaler.
If you take 2 puffs (inhalations), wait 2 minutes before taking the second puff.
For the next puff and all other puffs, you do not have to prime the inhaler. However, it must be loaded in the upright position right before its use. Turn the grip fully to the right and then fully to the left until it clicks.
Replace the protective cap on the inhaler. After each treatment, rinse your mouth with water, but do not swallow the water.
Keep the inhaler clean and dry at all times. Do not bite or chew the mouthpiece. Do not use Pulmicort Turbuhaler with a spacer.

special precautions:

Call your physician or pharmacist if you are allergic to budesonide or any other drugs.
Call your physician or pharmacist what prescription and nonprescription medications you are taking, especially arthritis medications; aspirin; cimetidine (Tagamet); digoxin (Lanoxin); diuretics ('water pills'); estrogen (Premarin); ketoconazole (Nizoral); oral contraceptives (birth control pills); oral corticosteroids; phenobarbital (Donnatal, others); phenytoin (Dilantin); rifampin (Rifadin); theophylline (Theo-Dur); and vitamins or herbal products.
if you have a fungal infection (other than on your skin), or any other type of infection, do not use budesonide without talking to Your physician.
Call your physician if you have or have ever had diabetes; thyroid problems; high blood pressure; mental illness; myasthenia gravis; osteoporosis; herpes eye infection; seizures; tuberculosis; ulcers; or liver, kidney, intestinal, or heart disease.
Call your physician if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using budesonide, Call your physician.
if you are having surgery, including dental surgery, tell the physician or dentist that you aretaking budesonide.
avoid exposure to chicken pox and measles. If you are exposed to them while using budesonide, Call your physician. Do not have a vaccination or other immunization unless directed to by Your Health provider.

Possible Adverse Effects:

Although adverse effects from budesonide are not common, they can occur. Call your physician if any of the following symptoms are severe or long lasting:

dry or irritated mouth or throat
cough
difficult or painful speech
dizziness
difficulty falling asleep or staying asleep
neck pain
stomach pain
If you experience any of the following symptoms, Call your physician immediately:

vision problems
white spots or sores in your mouth
swollen face, lower legs, or ankles
cold or infection that lasts a long time
muscle weakness
increased difficulty in breathing
skin rash
unusual bleeding or bruising
fever
sore throat
pain during urination
muscle aches
If you have been switched from oral corticosteroids to budesonide and are slowly tapering off your dose of the oral medication and you experience any of the following symptoms, Call your physician immediately:

joint or muscle pain
increased difficulty in breathing
tiredness