Pulmicort Turbuhaler

Generic name: Budesonide inhalation powder

What is Pulmicort Turbuhaler?

Pulmicort Turbuhaler is an anti-inflammatory steroid medication. Inhaled on a regular basis, Pulmicort helps prevent asthma attacks. It is sometimes prescribed in addition to oral steroids, and may reduce or eliminate the need for them.

Pulmicort Turbuhaler is a preventive medicine used to treat asthma in adults and children over age 6. It will not relieve an acute or life-threatening episode of asthma.

What is the most important information I should know about Pulmicort Turbuhaler?

If you are switching to Pulmicort from an oral steroid medication, your doctor will reduce your oral dosage very gradually. Taking oral steroids suppresses the natural production of steroids by the adrenal gland; it takes months for production to return to normal after oral steroids are stopped. In the meantime, the body will be unusually vulnerable to stress.

There have been reports of death during and immediately after transfer from oral steroids to inhaled steroids; your doctor will monitor you carefully during this period. People who have been taking high doses of oral steroids for an extended period of time are especially at risk, particularly when the oral steroids have been almost completely stopped. At that point, any stress from trauma, surgery, or infection (especially stomach or intestinal inflammation) is more likely to trigger adverse events.

If you experience a period of stress or a severe asthma attack during your switch to Pulmicort, begin taking your oral medication again (in large doses) and contact your doctor immediately. Carry a medical identification card indicating that you may need additional medication during periods of stress or a severe asthma attack.

Like other inhaled asthma medications, Pulmicort occasionally triggers an asthma attack. If this occurs, immediately use a fast-acting inhaled bronchodilator, stop using Pulmicort, and contact your doctor.

Steroid medications may stunt growth in children and teenagers. Your doctor will prescribe the lowest effective dose of Pulmicort and monitor the child's growth carefully.

Who should not take Pulmicort Turbuhaler?

If you are allergic to budesonide, you cannot use Pulmicort.

What should I tell my doctor before I take the first dose of Pulmicort Turbuhaler?

Tell your doctor about all prescription, over-the-counter, and herbal medication you are taking before beginning treatment with Pulmicort Turbuhaler. Also, talk to your doctor about your complete medical history, especially if you have liver disease.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Adults: The usual dosage depends on your previous treatments for asthma.

If you have previously been using only fast-acting bronchodilators, the usual starting dose is 200 to 400 micrograms (mcg) twice a day. The maximum long-term dosage is 400 mcg twice daily.

If you have previously been using inhaled steroids, the usual starting dose is 200 to 400 mcg twice a day (or once daily in the morning or evening if your asthma has been well controlled). The maximum long-term dosage is 800 mcg twice daily.

If you have previously been taking oral steroids, the usual starting dose is 400 to 800 mcg twice a day. The maximum long-term dosage is 800 mcg twice daily.

If you are taking oral steroids, you will continue to do so while starting Pulmicort Turbuhaler. After one week, the doctor will lower your dose of oral steroids, then gradually lower it further at one- or two-week intervals.

Children age 6 and older: As with adults, the child's usual dosage depends on previous treatments.

If the child has previously been using only a fast-acting bronchodilator the usual starting dose is 200 mcg twice a day. The maximum long-term dosage is 400 mcg twice daily.

If the child has previously been using inhaled steroids, the usual starting dose is 200 mg twice daily. (A once-a-day dose of 200 or 400 mcg may be prescribed instead.) The maximum long-term dosage is 400 mcg twice daily.

If the child has previously been taking oral steroids, the highest recommended dose is 400 mcg taken twice a day. As with adults, the dosage of oral steroids will be gradually reduced while the child continues to take Pulmicort.

How should I take Pulmicort Turbuhaler?

Use Pulmicort Turbuhaler exactly as directed. The effectiveness of Pulmicort Turbuhaler depends on its regular use. When starting therapy, carefully read the instructions that come with the inhaler. Asthma symptoms may begin to improve in 24 hours; you may not see the maximum benefit for 1 to 2 weeks or longer. If your symptoms worsen or fail to improve, contact your doctor.

Pulmicort Turbuhaler delivers a dose of medication in dry powder form. To assure the correct dose, the inhaler must be held in an upright position, with the mouthpiece on top, during priming and loading.

Before its first use, each new inhaler must be primed. To prime the inhaler, hold it upright and turn the brown grip fully to the right, then fully to the left until it clicks. Repeat this procedure a second time. The unit is now primed.

The inhaler must be loaded with medication immediately prior to each use. Turn the brown grip fully to the right, then fully to the left until it clicks.

During inhalation, the inhaler must be held in an upright (mouthpiece up) or horizontal position. Do not shake the inhaler. Place the mouthpiece between your lips and inhale forcefully and deeply. The Pulmicort powder is then delivered to the lungs. Do not exhale through the inhaler.

You may not taste or sense any medication entering the lungs when inhaling from the Turbuhaler. This lack of sensation is not a cause for concern.

To decrease the risk of developing a fungus infection in the mouth, rinse it with water, without swallowing, after each dose. Do not use the inhaler with a spacer. Do not bite or chew the mouthpiece.

What should I avoid while taking Pulmicort Turbuhaler?

Avoid exposing the eyes to the medication. To decrease the risk of developing a fungus infection in the mouth, rinse with water, without swallowing, after each dose.

Avoid exposure to infectious diseases such as chickenpox and measles. If you are exposed, contact your doctor immediately.

What are possible food and drug interactions associated with Pulmicort Turbuhaler?

If Pulmicort Turbuhaler is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Pulmicort Turbuhaler with the following:

Clarithromycin,Erythromycin,Itraconazole,Ketoconazole.

What are the possible side effects of Pulmicort Turbuhaler?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: Aching joints, back pain, cough, fever, flu-like symptoms, fungal infection in mouth, headache, indigestion, nasal and sinus inflammation, pain, respiratory infection, sore throat, weakness

Can I receive Pulmicort Turbuhaler if I am pregnant or breastfeeding?

Pulmicort does not appear to harm the developing infant during pregnancy. Nevertheless, the possibility for harm cannot be ruled out. This medication should be used during pregnancy only if it is clearly needed.

Steroids make their way into breast milk. Because they could affect the nursing infant, discuss with your doctor whether to discontinue breastfeeding or stop taking Pulmicort Turbuhaler.

What should I do if I miss a dose of Pulmicort Turbuhaler?

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed. Do not take two doses at once.

How should I store Pulmicort Turbuhaler?

Keep the Pulmicort Turbuhaler clean at all times. Replace the cover securely after each opening. Store with the cover tightened in a dry place at room temperature. Discard the unit when a red mark appears in the indicator window.