Pulmicort Turbuhaler

Generic Name: budesonide inhalation (bew DEH so nide)
Brand Names: Pulmicort Respules, Pulmicort Turbuhaler

What is the most important information I should know about budesonide inhalation?
• Budesonide inhalation will not stop an asthma attack that has already started. It is used to prevent attacks.
• Avoid exposing yourself to known sources of infection. Stay away from people with chicken pox, measles, or any other type of infection. Your immune system may not be strong enough to fight off an infection while you are taking budesonide inhalation.
• Do not use more of this medication than is prescribed for you. Too much may cause serious side effects.
• Use budesonide inhalation on a regular basis for best results. It may take several weeks to get the maximum effect of this medication.
• It is very important that you use your budesonide inhaler or nebulizer properly, so that the medicine gets into your lungs. Talk to your doctor about proper inhaler or nebulizer use.
• Seek medical attention if you notice that you require more than your usual or more than the maximum amount of any asthma medication in a 24-hour period. An increased need for medication could be an early sign of a serious asthma attack.

What is budesonide inhalation?
• Budesonide is a steroid. It prevents the release of substances in the body that cause inflammation.
• Budesonide inhalation is used to prevent asthma attacks.
• Budesonide may also be used for purposes other than those listed in this medication guide.

Who should not use budesonide inhalation?
• Before using budesonide inhalation, tell your doctor if you have a viral, bacterial, or fungal infection of any kind. The absorption of this drug into your system can inhibit your body's ability to fight off infections. You may not be able to use budesonide inhalation if you have an infection.
• Budesonide inhalation will not stop an asthma attack that has already started. It is used to prevent attacks. Do not use budesonide inhalation to treat an asthma attack. If you are having an asthma attack that is not responding to any treatment, seek emergency medical attention.
• Budesonide inhalation is in the FDA pregnancy B. This means that it is not expected to harm an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant.
• It is not known whether budesonide passes into breast milk. Do not use budesonide inhalation without first talking to your doctor if you are breast-feeding a baby.

How should I use budesonide inhalation?
• Use budesonide inhalation exactly as directed by your doctor. Read the information insert included with your inhaler. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• If you are also using a bronchodilator such as albuterol (Proventil, Ventolin), pirbuterol (Maxair), or bitolterol (Tornalate), your doctor may want you to use the bronchodilator first, then use your budesonide inhaler. Using the medications in this order will allow more budesonide to reach your lungs.
• The Pulmicort Turbuhaler must be primed the first time it is used. Turn the cover and lift it off while holding the unit upright. Turn the grip all the way to the right then all the way to the left until it clicks. Repeat this procedure. The unit is now primed. You will not have to prime it again, even if you do not use it for an extended period of time.
• To inhale a dose, hold the unit upright, turn the cover and lift it off. While still holding the unit upright, twist the grip all the way to the right and all the way to the left until it clicks. Do not blow or exhale into the unit, and do not shake it. Turn your head away and breathe out fully. Place your lips around the mouthpiece while holding the unit upright or horizontally. Take a deep, slow breath. You may not taste, smell, or feel any medicine when you inhale, however you are receiving a dose. Hold your breath for several seconds, then exhale slowly. If more than one dose is required, repeat this process. Replace the cover on the unit and twist it firmly into place after each use.
• The Pulmicort Respules are intended for administration with a jet nebulizer (not an ultrasonic nebulizer). The Pulmicort Respules should not be mixed with any other nebulizable medications in the nebulizer. Gently shake the Respule using a circular motion before use.
• To reduce the chance of developing a yeast infection in your mouth, rinse your mouth with water after a dose of budesonide inhalation but do not swallow. Also, if you are using a nebulizer with a face mask, wash the area of your face covered by the mask.
• It is very important that you use your budesonide inhaler or nebulizer properly, so that the medicine gets into your lungs. Talk to your doctor about proper inhaler or nebulizer use.
• Do not use more of this medication than is prescribed for you, but use it consistently, as directed, even when you are feeling better. It may be several weeks before you see effects from budesonide. Talk to your doctor if your symptoms do not improve or if they get worse.
• Budesonide will not stop an attack after it has started. It is used to prevent attacks from occurring. Keep another medicine on hand to treat attacks.
• Seek medical attention if you notice that you require more than your usual or more than the maximum amount of any asthma medication in a 24-hour period. An increased need for medication could be an early sign of a serious asthma attack.
• If you are switching from an oral steroid (pills or liquid) to budesonide inhalation, carry or wear identification that will let others know that you may require a systemic steroid during a severe asthma attack or during another traumatic situation. Discuss with your doctor the precautions necessary when discontinuing an oral steroid.
• There are 200 doses in each Pulmicort Turbuhaler. A red mark will appear in the top of the dose indicator window when there are 20 doses of medicine remaining. You should get your next inhaler at this time. When the red mark reaches the bottom of the indicator window, the inhaler is empty and should be thrown away.
• Store this medication at room temperature away from moisture and heat. Keep the inhaler clean and dry at all times. Do not refrigerate or freeze the Pulmicort Respules. After opening an aluminum foil envelope, any unused Pulmicort Respules should be returned to the envelope to protect them from light. Any individually opened Respules should be used promptly. The Pulmicort Respules are good for up to 2 weeks at room temperature, when protected from light after the envelope has been opened. Record the date the envelope was opened on the back of the envelope in the space provided.

What happens if I miss a dose?
• Use the missed dose as soon as you remember. However, if it is almost time for your next regularly scheduled dose, skip the missed dose and use the next one as directed. Do not use a double dose of this medication.

What happens if I overdose?
• An overdose of this medication is not likely to occur. If you do think an overdose has occurred, call an emergency room or poison control left.

What should I avoid while taking budesonide inhalation?
• Avoid items or activities that you know are allergens for you if they make your symptoms worse. Clean areas where dust or pet fur may aggravate your condition.
• Avoid exposing yourself to known sources of infection. Stay away from people with chicken pox, measles, or any other type of infection. Your immune system may not be strong enough to fight off an infection while you are taking budesonide inhalation.

What are the possible side effects of budesonide inhalation?
• Serious side effects from budesonide inhalation are not likely to occur. If you experience any of the following serious side effects, stop using budesonide inhalation and seek emergency medical attention or notify your doctor immediately:
· an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
· numbness, tingling, or pain;
· a rash or unexplained open sores or bruising; or
· worsening respiratory symptoms.
• Other, less serious side effects may be more likely to occur. Continue to take budesonide inhalation and talk to your doctor if you experience
· dry mouth, nose, or throat after use;
· yeast (or another) infection in the mouth or throat (white patches);
· hoarseness or deepening of the voice, cough, or sore throat;
· headache;
· weakness or fatigue;
· weight loss;
· increased tanning of the skin;
· lightheadedness or dizziness;
· unpleasant (or loss of) taste or smell;
· nausea or abdominal pain;
· decreased growth in children taking large doses;
· increased pressure in the eyes, glaucoma, or tearing of the eyes;
· cataracts, which may develop after long-term use; or
· mood changes such as depression, aggression, irritability, or anxiety (these effects are very rare).
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect budesonide inhalation?
• Before using this medication, tell your doctor and pharmacist about any other drugs you are taking. The use of other oral, nasal, or inhaled steroids may increase the chance of side effects or overdose.
• The effects of budesonide inhalation may be increased by the antifungal medicine ketoconazole (Nizoral). If you are using this or another antifungal medication, talk to your doctor.
• Drugs other than those listed here may also interact with budesonide inhalation or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.