Pulmicort® Turbuhaler®

Pulmicort® Turbuhaler®

This product is manufactured by AstraZeneca Canada Inc. using the ingredient budesonide.

This product is inhaled into the lungs using the Turbuhaler®.


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Turbuhaler®

Why is it prescribed?

Budesonide is indicated for the prevention, and reduction of severity of asthma symptoms that are responsive to orally inhaled corticosteroids. It is also used intranasally to relieve nasal congestion in the treatment of seasonal and perennial rhinitis (runny nose) where inflammation of the lining of the nose causes it to run. Budesonide nasal preparations are also used in the treatment of nasal polyps and prevention of nasal polyps after surgical removal.

  • Pulmicort® Turbuhaler® is the brand name for this multiple dose, dry powder inhaler.
  • Your doctor or pharmacist should have instructed you on the proper use and care of your Pulmicort® Turbuhaler®. It is advisable to have your technique reassessed by the pharmacist for the first 2 or 3 refills of your prescription.
  • The Pulmicort® Turbuhaler® should be kept clean and dry at all times. Never breathe out into the device or use any fluids to clean it. Clean the outside of the mouthpiece once a week with a dry tissue. Each Pulmicort® Turbuhaler® has it's own built in drying agent located in the brown turning grip. If you shake the device, you can hear it. Pulmicort® Turbuhaler® contains no other ingredients and you may not taste or feel anything when you inhale a dose.
  • The device has a dose indicator window located underneath the mouthpiece. When a red band appears in the window, there are approximately 20 doses left. If you shake the device when it is empty, you will still be able to hear the sound of the drying agent.
  • The device is not refillable and should be discarded when empty.
  • Children using the device should be supervised by an adult who knows how to use it properly.
  • Always replace the cover after use and keep away from moisture.
  • Do not use this medication to treat an acute asthma episode. It is not a rescue medication.
  • It is very important that you use Pulmicort® Turbuhaler® regularly. If you miss a dose and remember within 6 hours, you should take your usual dose as soon as possible. Then go back to your regular schedule. If it is more than 6 hours when you remember, do not take the missed dose. Just take the next dose on time. Depending on the severity of the asthma, it could take several weeks before the full effects of the Pulmicort® Turbuhaler® are seen.
  • Rinsing the mouth with water and spitting out after each use will remove any remaining medication to help prevent local yeast (thrush) infections. Cleansing dentures has the same effect. Notify your doctor if a sore throat or mouth occurs or if you suspect a localized yeast infection.

Alternatives

Other products that have the same ingredient as Pulmicort® Turbuhaler® are •Breztri™ Aerosphere® •Mylan-Budesonide aqueous nasal spray •Pulmicort® nebuamp •Rhinocort® aqua nasal spray •Symbicort® Turbuhaler® •Taro-Budesonide inhalation solution •Teva-Budesonide inhalation solution •

See other products used in the treatment of •allergic rhinitis •asthma •hay fever •nasal polyps •perennial rhinitis •rhinitis •runny nose •seasonal rhinitis •chronic bronchitis (COPD) •COPD •emphysema (COPD) •

The recommended starting dose in adults and children 12 years of age and older is 400 to 2400 mcg daily, divided into 2 to 4 doses. The suggested dose in children 6 to 12 years of age is 200 to 400 mcg daily, divided into 2 doses. After the desired effect has been obtained, your doctor may reduce your dose to the smallest amount necessary to control your asthma symptoms.


Budesonide is a corticosteroid that possesses potent anti-inflammatory activity. Whether inhaled through the nose or into the lungs, the effect of the drug is local (acting directly on the tissue it comes in contact with). The amount absorbed by the body is minimal and therefore the incidence of unwanted effects is low.


Along with its needed effects, budesonide may cause some unwanted or undesirable effects. Generally, budesonide is well tolerated and many people will not experience unwanted effects. The severity and duration of these effects are dependant on many factors including duration of therapy, dose, route of administration and individual response. Possible unwanted effects include:

  • irritation and burning in the nose (nasal spray only)
  • dry mouth, hoarsness, and loss of voice (oral inhalation only)
  • localized infection of Candida Albicans (thrush) of the mouth and throat


Less common:

  • sore throat
  • cough
  • headache
  • dizziness
  • nausea

Rare:

  • immediate or delayed allergic reaction (e.g. rash, hives, and bronchospasm)
  • flushing, itchiness, and swelling of the eyes, face, lips and throat

 


  • Never use a higher dose than what you have been prescribed. Using higher than recommended doses will cause greater absorption by the body and possibly lead to greater occurrence of unwanted effects. Optimal relief of symptoms may require 1 to 2 weeks of continuous therapy of the inhaler or 2 to 3 days (in rare cases up to 2 weeks) of continuous therapy of the nasal spray.
  • If symptoms do not improve or the condition worsens, the doctor should be contacted.
  • Treatment with budesonide should never be stopped without first consulting your doctor.
  • Discontinuation of budesonide requires gradual tapering or you may experience a flare-up of your condition.
  • Inadequate response can often be a result of improper use of the delivery device. Your doctor or pharmacist should instruct you on the correct use of these preparations. Each product comes with a package insert that should be read and then kept as a reference.
  • Children using any of these preparations should do so under the direct supervision of an adult who is familiar with its proper use.
  • People who are using or who have used budesonide or any other corticosteroids should inform their doctor as this may change the treatment plan.
  • When people have been treated with oral corticosteroids (e.g. prednisone) for prolonged periods and are being transferred to intranasally or orally inhaled budesonide, they may experience withdrawal symptoms (e.g. joint and/or muscular pain, depression). These symptoms should be reported to your doctor, especially if you have associated asthma or another condition in which too rapid a decrease in systemic steroids may cause a severe flare-up of symptoms.
  • Budesonide may mask some signs of infection and new infections may appear. The body tends to have a decreased resistance to infections while on this therapy, so anything of this nature should be reported to the doctor.

Drug Interactions: Due to very low absorption at therapeutic doses it is unlikely that there would be any significant drug interactions. However, it is important to tell your doctor and pharmacist of any prescription or over-the-counter medications you are taking.

Use is not recommended in the following situations:

  • allergy to beclomethasone dipropionate or any component of the preparation
  • people with tuberculosis
  • untreated fungal, bacterial and viral infections
  • children under 6 years of age

Caution recommended in the following situations:

  • people previously treated for prolonged periods with oral corticosteroids (e.g. prednisone)

Use in pregnancy: Inhaled budesonide would likely not result in significant absorption, and therefore, is generally considered compatible with pregnancy.  Consult your doctor or pharmacist before using.

Use while breast-feeding:  Levels in breast milk are very minimal - no untoward effects in infant are expected.