Pulmicort

Pulmicort for inhalation is an effective glucocorticoid drug that has been successfully used to treat respiratory diseases, including in children.

Produced in the form of powder, there is also a suspension for inhalation, which must be diluted with saline. The effect of the drug occurs immediately during the procedure.

The active substance of this drug is budesonide. After the inhalation, the substance is rapidly absorbed into the body and then drained through the urine. Its specific sensitivity is 15 times greater than that of prednisolone.

Clinical and pharmacological group

GCS for inhalations.

Terms of sale from pharmacies

It is possible to buy under the prescription of the doctor.

Price

How much does Pulmicort cost in pharmacies? The average price is at the level of800 rubles.

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Composition and form of release

The pulmicort for inhalation is available in the form of a powder and a suspension. A white suspension is placed in 1 ml or 2 ml containers. The drug is sold in two dosages 5 mg / ml and, mg / ml. The first option is mainly used to treat children from 6 months to 12 years. Pulmicort for inhalation, mg is most often used in the therapy of adult patients. The price of the drug varies from 900 to 1300 rubles.

• Powder for inhalation is called Pulmicort Tulbuhaler and is released in a volume of 100 and 200 doses, placed in a metered-dose inhaler.

The composition of the drug - one active substance and several auxiliary. The basis of the drug is micronized budesonide, which turns out to be a complex therapeutic effect: it removes inflammation and swelling, and stops allergic reaction.

Is it a hormonal drug or not?

This drug is hormonal. But do not be afraid and categorically refuse to treat Pulmicort. Yes, hormonal drugs can increase weight. Yes, there are cases of getting used to the hormones contained in the medicines.

But it is also known that some diseases, for example, bronchial asthma, are treated only by hormonal drugs. A Pulmicort allows you to achieve a stable remission and significantly improve your health and well-being.

pharmachologic effect

Like any other glucocorticoid, Pulmicort has pronounced anti-inflammatory, anti-allergic and mineral corticoid effects.

The mechanism of action is based on the reduction of synthesis in the cells of the body of prostaglandins, leukotrienes, prostacyclin, which have an irritating effect and damage tissues, activating inflammatory processes. Also, during the exudation phase, a large number of interleukins are released - inflammatory mediators that damage the cell walls and cause fluid to enter the intercellular space.

Main effects from reception:

• significant decrease in sputum;
• decreased sensitivity of the mucous membranes of the pharynx, nasopharynx and nasal cavity to external stimuli;
• increased susceptibility to glucocorticosteroids;
• reduction of allergic edema of mucous membranes;
• decrease in production of mucus and liquid by small bronchioles and alveoli;
• ensuring the full patency of the upper respiratory tract;
• evacuation of inflammatory cells and inhibition of exudation with the formation of an allergic secret;
• strengthening the body and increasing its resistance to prolonged physical exertion

Indications for use

Pulmicort suspension for inhalation is prescribed for the following diseases and conditions:

• chronic obstructive pulmonary disease (COPD);
• obstructive bronchitis;
• bronchial asthma;
• asthma of an allergic nature;
• cough of uncertain etiology.

Inhalations with pulmicort reduce the production of mucus and simplify its retreat. Another excellent effect has an aggregate with the addition of a suspension against dry cough and with severe inflammatory processes of the oral cavity. How to use the product is indicated in the product instructions.

Contraindications

Pulmicort is contraindicated to use:

• children younger than 6 months;
• with individual drug intolerance;
• in the active phase of pulmonary tuberculosis;
• with cutaneous syphilis;
• in the presence of fungi and respiratory infections;
• with severe liver damage;
• with skin tuberculosis, dermatitis, skin tumors.

Intended use for pregnancy and lactation

When pregnant with budesonide, no increased risk of fetal anomalies was found. However, do not completely exclude these risks, so when taking the drug during pregnancy It is necessary to use the minimum effective dosage of the drug in order to avoid deterioration of the bronchial asthma.

Animal studies have shown results of fetal anomalies with SCS, but these data can not be transferred to people who receive recommended doses of glucocorticosteroids.

For nursing mothers, the following information will be helpful: there is no evidence that budesonide can enter the breast milk. But still, when prescribing this drug, it is necessary to take into account potential risks for the child, comparing them with the prospective benefit.

Use in Pediatrics

In children and adolescents receiving treatment with GCS (any form) for an extended period, it is recommended to monitor growth rates on a regular basis. When appointing GCS, it is necessary to evaluate the ratio of the prospective benefit from the use of the drug and the potential risk of slowing growth.

The use of budesonide in a dose of up to 400 μg / day in children older than 3 years did not lead to systemic effects. Biochemical signs of the systemic effect of the drug may occur when the drug is used at a dose of 400 to 800 mcg / day. When the dose exceeds 800 mcg / day, the systemic effects of the drug are often encountered.

The use of GCS to treat bronchial asthma can cause dysplasia. The results of observations of children and adolescents who received budesonide for a long period (up to 11 years) showed that the growth of patients reaches the expected normative indices for adults.

Dosage and route of administration

As indicated in the instructions for use, Pulmicort is used with a special device for inhalation - a nebulizer, which converts the suspension into an aerosol. With a calm and even breath through the mouthpiece, the drug in the form of an aerosol enters the lungs of the patient. In small children, the procedure is performed through a special mask.

To use Pulmicort in the form of a suspension, ultrasonic nebulizers are not suitable! To use the nebulizer proceed after a careful study of the instructions, strictly observing all recommendations.

After each inhalation, it is required to thoroughly rinse the mouth with water, this will reduce the risk of developing candidiasis of the oropharynx, and you also need to rinse your face with water to prevent skin irritation. The diluted suspension is used in the next half an hour.

After each procedure, the nebulizer camera should be cleaned.

With the help of the compressor, the air flow rate (5-8 liters per minute) required to fill the nebulizer with a volume of 2-4 ml is created. The device is equipped with a special mask and mouthpiece.

The doctor sets the dose of Pulmicort individually.

When appointing a daily dose of 1 mg, it is administered at a time, if the dose is higher, divide into 2 divided doses.

To carry out the inhalation, the suspension is preliminarily diluted with saline (9% sodium chloride) in the following proportions:. Thus, Pulmicort, 5 for inhalations (the volume of one nebulus - 1 ml) is diluted with 1 ml of saline. For a nebulus with a volume of 2 ml suspension (, g of active substance), the volume of saline required for dilution is 2 ml, respectively.

Recommended daily dosing:

• Adults, including elderly patients: the initial dose is 1-2 mg, the maintenance dose is -4 mg. To achieve the desired effect in severe exacerbation of the disease, the dose can be increased;
• Children after the age of 6 months: the initial dose 5 mg, if necessary, an increase of up to 1 mg is permitted. The maintenance dose is 5-2 mg.

Each patient is given a minimum effective maintenance dose, which provides a clinical effect.

Because of the lower risk of unwanted systemic effects, in some cases it is recommended an increase in the daily dose of the drug to 1 mg in the form of monotherapy, instead of a combination with GCS for reception inside.

Patients who are on treatment with GCS for oral administration should begin the withdrawal of therapy in a period of stable condition. Against the background of the usual dose of GCS for oral administration for 10 days, the patient receives high doses of Pulmicort. Then within a month the dose of oral GCS gradually decreases, to the minimum effective. Very often it is possible to completely cancel the intake of GCS inside.

With pronounced cirrhosis of the liver, the duration of action of the drug is increased.

Side effect

Most often you can see the following negative effects of the substance:

• headache and dizziness;
• nausea and vomiting of gastric contents immediately after taking the drug (especially dangerous for patients with ulcers);
• the appearance of angioedema on the skin surface;
• small-point and large-scale rash on upper and lower extremities, abdominal and thoracic surface;
• apathy, inclination to depression;
• the colonization of the oral cavity by conditionally pathogenic microorganisms called Candida and cause thrush of the oral cavity and pharynx;
• irritation, discoloration and dryness of mucous membranes;
• hoarseness of the voice due to swelling of the vocal cords;
• spasm of small bronchi and bronchioles;
• ulceration on the inside of the cheeks and tongue.

If side effects occur, it is recommended to consult a doctor. If, with a decrease in dosage, a part of the pathogenic effects of the medication is lost, it is worthwhile to seriously think about finding analogues or completely replacing the course of therapy. A competent specialist usually prescribes several similar medicines at the same time in order to select the necessary dosage.

Overdose

In the case of acute overdose, there are no clinical manifestations. If the overdose is chronic, then the effects of hypercorticism may appear, and suppression of adrenal function may occur.

In addition, there may be clinical manifestations of hypercorticism: hypertension, muscle weakness, weight gain, amenorrhea, hyperpigmentation. Also, with a chronic overdose for the treatment of hypercorticism, the drug is gradually withdrawn, systematically reducing the dosage.

special instructions

To prevent skin irritation after using a nebulizer with a mask, the face should be washed.

To minimize the risk of fungal oropharyngeal injury, the patient should be instructed to thoroughly rinse the mouth with water after each inhalation of the drug.

Joint administration of budesonide with ketoconazole, itraconazole or other potential inhibitors of CYP3A4 should be avoided. If such a combination is necessary, you should increase the time between doses of the drugs to the maximum possible.

Because of the possible risk of weakening adrenal function, special attention should be paid to patients who are transferred from systemic SCS to Pulmicort. Also, special attention should be paid to patients taking high doses of GCS or who received long-term recommended maximum doses of inhaled glucocorticosteroids. In stressful situations, such patients may show signs and symptoms of adrenal insufficiency. When stress or in cases of surgical intervention, additional therapy with systemic GCS is recommended.

Particular attention should be given to patients who are transferred from systemic to inhaled glucocorticosteroids (Pulmicort) or in the case where a disorder of the pituitary-adrenal function can be expected. In such patients, it is necessary with special care to reduce the dose of GCS for systemic use and monitor the performance of the hypothalamic-pituitary-adrenal system. This category of patients may require an additional appointment of GCS for oral administration during periods of stressful situations, such as trauma, surgery.

When switching from oral GCS to Pulmicort, patients may experience previously observed symptoms, such as muscle pain or joint pain. In such cases, a temporary increase in the dose of GCS for oral administration may be required. In rare cases, symptoms such as a feeling of fatigue, headache, nausea and vomiting, indicating a systemic failure of GCS, can be observed.

When switching from GCS for oral ingestion to inhalation, it is sometimes possible to exacerbate existing allergic reactions, rhinitis and eczema, which were previously treated with systemic drugs.

Pulmicort therapy when applied 1 or 2 times / day showed efficacy for the prevention of asthma physical effort.

Interaction with other drugs

When using the drug, it is necessary to take into account the interaction with other drugs:

1. There was no interaction of budesonide with other drugs used in the treatment of bronchial asthma.
2. Another potential inhibitor of CYP3A4, itraconazole, also significantly increases the plasma concentration of budesonide.
3. Preliminary inhalation of beta-adrenostimulants expands bronchi, improves the flow of budesonide into the respiratory tract and enhances its therapeutic effect.
4. Phenobarbital, phenytoin, rifampicin when used simultaneously reduces the effectiveness of Pulmicort (due to the induction of microsomal oxidation enzymes).
5. Methandrostenolone, estrogens strengthen the action of budesonide.

When combined, ketoconazole (at a dose of 200 mg 1 time / day) increases the plasma concentration of budesonide (ingested at a dose of 3 mg 1 time / day) by an average of 6 times. When taking ketoconazole 12 hours after the administration of budesonide, the concentration of the latter in the blood plasma increased by an average of 3 times. There is no information on such an interaction with taking budesonide in the form of inhalation, but it is expected that in this case an increase in the concentration of budesonide in the blood plasma should be expected. If it is necessary to take ketoconazole and budesonide, you should increase the time between doses of the drugs to the maximum possible. You should also consider the possibility of reducing the dose of budesonide.

Reviews

We offer you to read reviews of people who used Pulmicort for inhalations:

1. Sasha. A good remedy, quickly removes symptoms and cough. True use probably have a long time, and maybe for life. The child has asthma, although he is an adult, but still suffers, since the disease imposes restrictions on his communication with peers and not many can understand and accept it as is. One thing is good, although they will not take it to the army.
2. Zhenya. Last year, the son fell ill with pneumonia complicated by obstructive bronchitis, he coughed for a long time, nothing helped, while the doctor the lung specialist has not written out to us Pulmicort for inhalations (it is suitable only for nebulizer). The drug well removes inflammation and is hormonal, a week after inhalation, a positive result was seen. They passed the entire course and the child fully recovered.
3. Marina. Pulmicort was the only assistant in the treatment of my son, who had bilateral bronchitis with a severe cough. The very next day after the admission the child ceased suffocatingly coughing, could sleep and eat peacefully.

Analogues

Structural analogs for the active substance:

• Apulein;
• Benacorte;
• Benarin;
• Budenit Steri Neb;
• Budenofalk;
• Budesonide;
• Budesonid Ishihyler;
• Budiere;
• Budostere;
• Novopulmon E Novolayzer;
• Pulmicort Turbuhaler;
• Tafen nasal;
• Tafen Novolayzer.

Before buying an analogue, consult your doctor.

Pulmicort or Berodual - which is better?

There is no single answer to this question. Many specialists use these drugs together to treat pulmonary diseases.

Berodual is great for preventing disease, cures asthma (eliminates shortness of breath). Expands the bronchi, blocking the receptors. The therapeutic effect occurs in the shortest possible time. It is used in combination with other medicines. You can use Berodual from 6 years of age. It is not hormonal, therefore it is absolutely safe for children's age.

Pulmicort should be used with caution, because it is a hormonal drug and has contraindications.

In case of an exacerbation in a child of asthma, treatment with inhalations from the combination of Pulmicort and Berodual will help.

Shelf life and storage conditions

The drug is stored at a temperature of no more than 30 ° C. After opening an envelope containing pulmicort containers, the drug must be consumed within 3 months.

The opened container is stored for no more than 12 hours. A mandatory condition for storage of the drug is protection from sunlight and normal humidity in the room.

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