Description overdue on 05/30/2014
- Latin name: Pulmicort
- ATC code: R03BA02
- Active substance: Budesonide (Budesonide)
- Manufacturer: AstraZeneca AB (Sweden)
- Composition
- Product form
- Pharmacological action
- Indications
- Pharmacodynamics and pharmacokinetics
- Contraindications
- Side effects
- Instructions for use (method and dosage)
- Overdose
- Cooperation
- Terms of sale
- Storage conditions
- Shelf life
- Cautions
- Analogs
- Synonyms
- Babies
- During pregnancy (and lactation)
- Reviews
- Price, where to buy
Composition
As part of the preparations Pulmicort and Pulmicort Turbuhaler contains a substance budesonide .
Besides Pulmicort inhalation suspension also it has in its composition Excipients: sodium citrate . sodium chloride . polysorbate 80 . sodium EDTA Purified water and the anhydrous citric acid.
Product form
Pulmicort is available in two versions: the dosage suspension to inhalations may contain 0, 25 mg / ml or 0, 5 mg / ml budesonide . Available in cardboard packs, inside which contained 20 containers of 2 ml.
Powder inhalation Pulmicort Turbuhaler also has two forms of release: 100mcg 200 doses of budesonide or 100 doses of budesonide 200mkg metered-dose inhalers. Himself inhaler consists of tanks desiccant and storing powder and a mouthpiece cover. The product is packed in a cardboard box.
Pharmacological action
The drug has glucocorticoid . anti-inflammatory , and also antiallergic action.
Indications
The drug is recommended for asthma That requires therapy using glucocorticosteroids And chronic obstructive pulmonary disease .
Pharmacodynamics and pharmacokinetics
Absorption
Budesonide, which by inhalation enters the body, it is quickly absorbed. Approximately 25-30% of the dose to the lungs. Half an hour later reached the highest concentration of the drug plasma . Systemic bioavailability Pulmicort is approximately 38% of the dose.
Metabolism and Distribution
Drug binding to plasma proteins is at a level of 90%. Budesonide distribution by volume is approximately 3 liters per kilogram. Upon completion of the suction is intense in the liver biotransformation of budesonide , Which resulted in the formation of metabolites Having low glucocorticoid activity .
Withdrawal
The substance budesonide INN is mainly metabolized with the participation of enzyme CYP 3A4. Then, in a conjugated form or in the urine unchanged metabolites excreted. The pharmacokinetics of substances budesonide in patients with impaired renal function in children is unknown. And in patients with liver disease, while in the body of budesonide may increase.
Contraindications
Pulmicort and Pulmicort Turbuhaler contraindicated for people with individual intolerance to the components of the drug. Also prescribe medication with caution when pulmonary tuberculosis (active and inactive forms) bacterial . Viral or fungal diseases respiratory organs, as well as cirrhosis .
Side effects
Respiratory: dry mouth, cough, respiratory tract irritation, carious lesions of the oropharynx . Given the possibility of caries oropharynx receiving the drug should be carefully monitored for oral hygiene.
For the endocrine system: hypofunction of the adrenal cortex And symptoms of systemic actions of glucocorticosteroids.
For the central nervous system: irritability, inappropriate behavior, nervousness, depression, blurred consciousness.
Allergic reactions: contact dermatitis . rash . angioedema . hives . In case of a nebulizer with a mask, it may be irritation of the skin.
Instructions for use (method and dosage)
Preparations Pulmicort and Pulmicort Turbuhaler used as prophylactic agents when asthma , With the use of these drugs for acute attacks of the disease it is not advisable. Given the small likelihood that they will develop systemic effects, the daily dosage of these drugs can be increased to achieve an enhanced therapeutic effect to 1000mkg instead of combining the medication with other oral corticosteroids .
Cancelling use of oral corticosteroids to go to the drug Pulmicort or Pulmicort Turbuhaler need for ten days, taking the previously selected dose of oral corticosteroids, adding a high dose of Pulmicort. After ten days, gradually reduce to the minimum effective dose receiving oral preparation (for a month, with a step reduction in terms of prednisolone at 2, 5 mg). Through this scheme, in some cases, it can even be completely abandon oral corticosteroids.
The dosage of 250 micrograms of budesonide should be somewhat diluted. How to plant a dose: dilute the drug should be 0, 9% solution sodium chloride . Before you plant saline need to take 1 ml of the drug to eventually get 2 ml.
Instructions for use Pulmicort inhalation
Dosage should be adjusted physician individually for each patient. In case the daily dose is in the range 1000mkg, it is possible to carry out reception entire dose at once. If the dose is needed more, it is better to take it a few times.
The initial daily dose of Pulmicort for children from 6 months - 250-500mkg. The daily dosage for an adult - from 1000 to 2000mkg.
Supporting the daily dosage for children aged 6 months - 250-2000mkg. Adults should be taken daily for 500-4000mkg. In case of severe obstructive conditions, the dosage may be increased at the recommendation of the attending physician.
A prerequisite therapy using the drug Pulmicort is the selection of a minimum maintenance dose individually.
The suspension of the drug Pulmicort is used for inhalation with the help of compressor nebulizer Which has a special mask and mouthpiece. The nebulizer is attached to a compressor that generates the desired air flow (approximately 5-8 liters per minute), to be filled in volume of 2-4 ml. Note that Ultrasonic nebulizers for Pulmicort suspension do not fit!
Before using the product in Nebula gently shake the container contained within the slurry. Open the container and gently squeeze the contents into the nebulizer. If the need for only 1 ml of the suspension, the contents of the container to squeeze out until the liquid level reaches the marked line. Before you can use the remaining liquid contained in the liquid container should be shaken by means of rotational movements. Given that using Pulmicort nebulizer gets into the patient's lungs during inhalation, it is necessary to instruct the patient that he inhaled smoothly and carefully.
If inhalation is not obtained their own children to breathe using a nebulizer, you should use a special mask, making sure that it fits tightly to the face.
The mouthpiece, chamber nebulizer and mask should be cleaned after each use by rinsing with warm water using a detergent, or according to the instructions of the generating company. Himself nebulizer should be thoroughly rinsed, then dried by connecting the air inlet valve or the compressor with the camera.
Instructions for use Pulmicort Turbuhaler
Dosage is selected for each patient individually.
The daily dose for children from 6 years - 100-800mkg. Generally, a daily dose is taken 2-4 inhalation. Thus, the daily dose that does not exceed 400mkg may be taken at one time. Go to the drug once a day should always be performed under the supervision of a pediatrician.
The daily rate for adults - 200-800mkg. If the dose is not more 400mkg, it can be done at one time and in large doses can produce breakdown of several techniques. In the treatment of severe exacerbations daily dose may be increased to 1600mkg. In case a patient using the aerosol form of the drug Pulmicort Turbuhaler, the daily dose can be reduced. Selecting a maintenance dose of the drug, should seek to ensure that was assigned the minimum effective dose.
To use the inhaler turbuhaler there are some rules. The drug enters the respiratory tract when the active inhalation through the mouthpiece. Turbuhaler is a reusable inhaler which allows inhaling and dispense the drug in small doses.
The drug Symbicort is easy to use, just need to follow the simple instructions:
- Requires unscrew, and then remove the cap.
- The inhaler should be held upright to spout at the bottom. Upload dose inhaler should be turning the dispenser up to the stop anti-clockwise and then return the dispenser to its original position until you hear a click.
- Breathe out, after removing the inhaler from the mouth.
- That the required dose into the lungs, take a deep breath through your mouth, teeth clenched pre mouthpiece and around his lips. In case requires not one, but several inhalations, repeat 2, 3 and 4 times the number of steps required.
- Close the inhaler by a cap.
- Be sure to rinse your mouth with water, which will reduce the risk of oropharyngeal fungus to a minimum.
Given the small amount of powder which you inhale inhalation, you may not feel its taste. But if you have done everything according to the instructions, you can be sure to get the necessary dose of the drug during inhalation.
Once a week, the mouthpiece should be cleaned from the outside, using for this purpose, dry cloth. Do not use liquids to clean.
When an inhaler red mark appears, it means that it remains around twenty doses. And when the red mark will be at the bottom of the window dose, which means that the inhaler is empty.
Overdose
In the case of acute overdose, clinical manifestations arise. If overdose is chronic, it can manifest effects Cushing And suppression occur adrenal .
In addition, there may be clinical manifestations of Cushing: arterial hypertension , Muscle weakness, weight gain, amenorrhea . hyperpigmentation . Also in chronic overdose in the treatment of Cushing to gradually abolish the drug systematically reducing the dosage.
Cooperation
Systemic effects may be increased Pulmicort Estrogen and methandrostenolone That increase the concentration of the drug in the blood plasma. The therapeutic effect of the drug is enhanced by pre-inhalation beta-agonists , Dilates the bronchi.
Terms of sale
The drug is available by prescription.
Storage conditions
Preparations Pulmicort and Pulmicort Turbuhaler should be stored in a cool dry place with an ambient temperature not exceeding 30 degrees Celsius.
Containers inside the suspension should be stored in its original envelope, which protects the drug from light.
Shelf life
The drug is stored for 2 years.
After opening the envelope with the container during use of the drug is reduced to 3 months.
Opened containers should be used for a period not exceeding 12 hours.
Cautions
To reduce to a minimum the risk of oropharyngeal fungus, the patient should be instructed that after each inhalation, this drug should be carefully rinse your mouth with water.
Preparations Pulmicort and Pulmicort Turbuhaler Avoid taking together with the itraconazole . ketoconazole And other substances in the body retention CYP 3A4 . If these substances were still assigned to a patient at the same time budesonide (the main active ingredient of the drug), it is necessary to maximize the time between doses of these drugs.
Due to the risk that pituitary-adrenal function may be impaired, it needs to pay particular attention to those patients who are transferred to the reception Pulmicort and Pulmicort Turbuhaler with oral corticosteroids. In addition, special attention should be given to patients by the fact that for a long time received the maximum recommended doses of glucocorticoids. In these patients in stressful situations are possible symptoms and signs adrenal insufficiency . Also in cases where surgery is recommended for stress or additional therapy using systemic corticosteroids.
We must pay special attention to those patients who are transferred from the system to receive inhaled glucocorticosteroids, and in cases where the expected violation pituitary-adrenal function . In these cases, you need to carefully lower the dose of systemic corticosteroids, as well as control the adrenal hormone function.
If a patient is transferred from receiving oral corticosteroids for drugs Pulmicort or Pulmicort Turbuhaler , Then he can feel symptoms such as joint pain or muscle aches . In this case, it may be necessary to temporarily increase the dose of oral corticosteroids. In some cases there may be a nausea and vomiting . headache , Fatigue, indicating a systemic glucocorticosteroid insufficiency.
If you have replaced oral corticosteroids to inhaled, sometimes in connection with the accompanying manifest allergic ( eczema or rhinitis ), Which was previously cupped using systemic drugs.
In addition, patients should be instructed to carry out that if the effectiveness of the therapy would be reduced with the help of bronchodilators Short-acting, you should seek medical advice as unwarranted increase in the frequency of use of the drug may defer the appointment of an adequate dosage for treatment. If there was a sudden deterioration, it is necessary to consider the possibility of treatment with oral corticosteroids.
Analogs of Pulmicort
Beklazon
Fliksotid
Budesonide
Aldetsin
Preparations Pulmicort Nebula and in Pulmicort Turbuhaler analogs have the following:
Apulein, benacort, Benakap, Boudin, Ster-Neb, budesonide, Benarin, budesonide Iziheyler, Tafen Nazal, Budoster, budesonide-Nativ, Budieyr, Novopulmon E Novolayzer, Tafen Novolayzer .
What's better : Flomax or Pulmicort?
Additional reviews can often find this issue. This is somewhat different preparations: inhalation Berodual with spasms of the bronchi and help relieve shortness of breath and Pulmicort is used to relieve swelling from inflammation. With obstructive bronchitis Some children prescribed Flomax with Pulmicort.
Synonyms
Budenofalk, budesonide, Symbicort, Benarin, benacort, Symbicort.
Babies
Pulmicort for children and adolescents, who for a long time, regardless of the delivery method receive treatment with corticosteroids can affect their growth, so you should carefully monitor the performance of their growth. In the case of prescribing Pulmicort or Pulmicort Turbuhaler you need to weigh the benefit of the intended use of these drugs, with the potential risks associated with the slowdown of the young organism.
During pregnancy and lactation
When taken by pregnant substance budesonide did not show any increased risk of abnormalities in the fetus. However, do not completely rule out these risks, so while taking the drug during pregnancy You need to use the minimum effective dose of the preparation to avoid deterioration asthma .
Animal studies have shown the results of fetal abnormality when receiving corticosteroids, but these data can not be transferred to the people who get the recommended doses of corticosteroids.
For nursing mothers will use the following information: information that budesonide can get into breast milk - not identified. Nevertheless, the appointment of the drug should take into account potential risks for the child, comparing them with the intended use.
Reviews for Pulmicort
Online you can find the different, sometimes even opposite responses. As a rule, among the most frequent adverse such that we are talking about allergic reactions Occurring after use of the drug, the emergence of problems with the adrenal glands, as well as on the general body disorders related to hormonal changes. However, many do not know for sure whether or not a hormonal drug, although it is stated in the instructions.
Various forums have also had reports that some complained about the sharp deterioration of health, which occurred after the cessation of drug use. Typically, such reviews written by those people who have given up the drug too quickly, not gradually reduce the dosage, how to do it. Reviews for Pulmicort Turbuhaler similar.
Upon receipt of child responses are more alarming, which is caused by concerns about the extensive list of side effects of the drug, as well as the fact that the hormone medication. However, categorically negative reviews inhalation children were found. However, many noted that the laryngitis in children it has been appointed Pulmicort.
Among the positive reviews can be found such that say about the effectiveness of the drug already in the first sessions of the reception. Many say that the drug copes with asthma attacks and great help in the claimed indications for use, as evidenced by the majority of your review.
Price, where to buy
Price Pulmicort inhalation It varies depending on the calculated doses. 20 pieces of 500 g / ml can be bought from 1368 to 1489r. Are nebula 20 pieces of 250 g / ml - from 961 to 1084r.
Price Pulmicort Turbuhaler installed in different pharmacies 850 to 950r for option 100mcg per dose. How much is the option with 200mkg dose? About 820r.
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