Budesonide Explained

Verifiedfields:changed
Watchedfields:changed
Verifiedrevid:459985202
Width:250
Width2:250
Tradename:Pulmicort, Rhinocort, Entocort, others
Dailymedid:Budesonide
Pregnancy Au:A
Pregnancy Au Comment:/B3
Routes Of Administration:By mouth, nasal, tracheal, rectal, inhalation
Atc Prefix:A07
Atc Suffix:EA06
Atc Supplemental:,,
Legal Au:S2
Legal Au Comment:/S4
Legal Ca:Rx-only
Legal Ca Comment:[1]
Legal Uk:POM
Legal Us:OTC
Legal Us Comment:/ Rx-only[2] [3] [4]
Legal Eu:Rx-only
Legal Eu Comment:[5]
Bioavailability:10-20% (first pass effect)
Protein Bound:85-90%
Metabolism:Liver CYP3A4
Elimination Half-Life:2.0-3.6 hours
Excretion:Urine, feces
Cas Number:51333-22-3
Pubchem:40000
Drugbank:DB01222
Chemspiderid:4444479
Unii:Q3OKS62Q6X
Kegg:D00246
Chembl:1370
Pdb Ligand:8W5
Synonyms:BUD
Iupac Name:11β,21-Dihydroxy-16α,17α-[butane-1,1-diylbis(oxy)]pregna-1,4-diene-3,20-dione
C:25
H:34
O:6
Smiles:CCCC1O[C@@H]2C[C@H]3[C@@H]4CCC5=CC(=O)C=C[C@@]5([C@H]4[C@H](C[C@@]3([C@@]2(O1)C(=O)CO)C)O)C
Stdinchi:1S/C25H34O6/c1-4-5-21-30-20-11-17-16-7-6-14-10-15(27)8-9-23(14,2)22(16)18(28)12-24(17,3)25(20,31-21)19(29)13-26/h8-10,16-18,20-22,26,28H,4-7,11-13H2,1-3H3/t16-,17-,18-,20+,21?,22+,23-,24-,25+/m0/s1
Stdinchikey:VOVIALXJUBGFJZ-KWVAZRHASA

Budesonide, sold under the brand name Pulmicort, among others, is a steroid medication.[6] It is available as an inhaler, nebulization solution, pill, nasal spray, and rectal forms.[7] The inhaled form is used in the long-term management of asthma and chronic obstructive pulmonary disease (COPD).[8] [9] The nasal spray is used for allergic rhinitis and nasal polyps.[10] Modified-release pills or capsules and rectal forms may be used for inflammatory bowel disease including Crohn's disease, ulcerative colitis, and microscopic colitis.[11] [12] [13]

Common side effects with the inhaled form include respiratory infections, cough, and headaches.[14] Common side effects with the pills include feeling tired, vomiting, and joint pains.[14] Serious side effects include an increased risk of infection, loss of bone strength, and cataracts.[14] Long-term use of the pill form may cause adrenal insufficiency.[14] Stopping the pills suddenly following long-term use may therefore be dangerous.[14] The inhaled form is generally safe in pregnancy.[14] Budesonide chiefly acts as a glucocorticoid.[14]

Budesonide was initially patented in 1973.[15] Commercial use as an asthma medication began in 1981.[16] It is on the World Health Organization's List of Essential Medicines.[17] Some forms are available as a generic medication.[18] [19] In 2021, it was the 185th most commonly prescribed medication in the United States, with more than 2million prescriptions.[20] [21]

Medical uses

Asthma

Budesonide is given by metered-dose inhaler or nebulizer for maintenance and prophylactic treatment of asthma, including patients who require oral corticosteroids and those who may benefit from a systemic dose reduction.[22]

Inflammatory bowel disease

Formulations of delayed-release budesonide are an effective treatment for mild-to-moderately active Crohn's disease involving the ileum and/or ascending colon.[23] A Cochrane review found evidence for up to three months (but not longer) of maintenance of remission in Crohn's disease.[24]

Budesonide assists in the induction of remission in people with active ulcerative colitis.[25]

Budesonide is highly effective and recommended as the drug of choice in microscopic colitis, for induction and maintenance of remission, and for both the lymphocytic colitis and collagenous colitis forms.[26] [27]

Allergic rhinitis

Budesonide in the form of nasal sprays is a treatment for allergic rhinitis.[28]

Eosinophilic esophagitis

Topical budesonide has considerable effects in eosinophilic esophagitis.[29] For this use, it is formulated as a tablet that disperses in the mouth, and sold under the brand name Jorveza.

Berger's disease

Budesonide (Tarpeyo (US); Kinpeygo (EU, UK)) is indicated to reduce proteinuria (increased protein levels in the urine) in adults with primary immunoglobulin A (IgA) nephropathy (Berger's disease) at risk of rapid disease progression.[30]

Side effects

Nasal budesonide inhalers have been associated with a number of side effects.[31] [32] These include nose irritation or burning, bleeding or sores in the nose, lightheadedness, upset stomach, cough, hoarseness, dry mouth, rash, sore throat, bad taste in mouth, change in mucus, and blurred vision.[33] Other symptoms which should be reported immediately include difficulty in breathing, swelling of the face, white patches in the throat, mouth, or nose, irregular menstrual periods, severe acne, and on rare occasions, behavioral changes (mostly affecting children).

Overdose

Acute toxicity from an overdose of Budesonide is significantly more rare than an overdosing of budesonide over a prolonged period of therapy, however both can can cause systemic toxicity that manifests as hypercortisolism.[34] Symptoms of an overdose include more specific symptoms such as darkening and thinning of the skin, changes in body fat around the face, neck, back, and waist, increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex, as well as some less specific symptoms such as diarrhea, dizziness, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.[35] [36]

Contraindications

Budesonide is contraindicated in people with:

In Canada, there are additional contraindications labeled for Budesonide for people with:

Interactions

Budesonide is mainly metabolized in the liver by the enzyme CYP3A4.[39] Drugs that are CYP3A4 inhibitors such as ketoconazole, clarithromycin, ritonavir, and nefazodone, among many others, may inhibit the metabolism of Budesonide, prolonging its elimination and leading to possible increased rates of corticosteroid adverse effects due to unwanted drug accumulation.[40] Grapefruit is also a potent inhibitor of CYP3A4, and therefore its consumption is not recommended while on budesonide treatment.[41]

Pharmacology

Mechanism of action

Budesonide is an agonist of glucocorticoid receptors. Among its effects are:

Pharmacokinetics

Different pharmacokinetic proprieties can be seen in the absorption of budesonide depending on how it is formulated. When taken as an extended-release oral capsule, budesonide has an oral bioavailability of 9–21% and reaches peak plasma concentrations (Cmax) within 2–8 hours.[45] A high fat meal when taken with the capsule can lengthen the time it takes to reach Cmax by another 2.3 hours, but will not have any other affects on the pharmacokinetics properties of budesonide.[46] When inhaled through an metered dose inhaler, 34% of budesonide is deposited in the lung with a bioavailability of 39% and reaches Cmax within 10 minutes.[47] When nebulized, budesonide has an bioavailability of 6% and reaches Cmax within 1–3 hours. When formulated as a rectal foam, budesonide has an bioavailability of 3% to 27% and reaches Cmax around 1.5 hours.[48]

The plasma protein binding of budesonide is around 85-90%, with an apparent volume of distribution of 2.2-3.9L/kg. Budesonide is 80-90% metabolized at first pass in the liver by the hepatocytic cytochrome P450 isoenzyme 3A4 (CYP3A4) into two metabolites: 16 alpha-hydroxyprednisolone and 6 beta-hydroxybudesonide. Both of these metabolites have a negligible glucocorticoid activity of less than 1% compared to the parent compound budesonide. 60% of budesonide is excreted is through the urine as its metabolites, no unchanged budesonide is detectable in urine. The average elimination half-life in plasma is between 2-3.6 hours.

Chemistry

See also: List of corticosteroids and List of corticosteroid cyclic ketals.

Budesonide, also known as 11β,21-dihydroxy-16α,17α-(butylidenebis(oxy))pregna-1,4-diene-3,20-dione, is a synthetic pregnane steroid and non-halogenated cyclic ketal corticosteroid.[49] [50] It is the C16α hydroxyl, C16α,17α cyclic ketal with butyraldehyde derivative of prednisolone (11β,17α,21-trihydroxypregna-1,4-diene-3,20-dione).

Stereoisomerism

Society and culture

Brand names

Budesonide is a drug that is marketed under various brand and generic names internationally, some notable examples for each formulation are listed here;

Inhalation: Pulmicort; Pulmicort Flexhaler, Pulmicort Nebuamp, Pulmicort Turbuhaler, TARO-Budesonide, TEVA-Budesonide, Novolizer budesonid meda, Budenova.[51] [52]

Systemic (oral pills): Tarpeyo, Uceris, Eohilia, Cortiment, Entocort Jorveza.[53]

Nasal: MYLAN-Budesonide AQ, Rhinocort Aqua, Formancis.[54]

Topical: Entocort, Uceris, Budenofalk.[55]

Economics

In 2019, generic budesonide was listed as being involved in Teva's price fixing scheme in the United States.[56]

Legal status

In May 2022, the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive opinion, recommending the granting of a conditional marketing authorization for the medicinal product Kinpeygo, intended for the treatment of primary immunoglobulin A nephropathy. The applicant for this medicinal product is Calliditas Therapeutics AB. Kinpeygo is a hybrid medicine of Entocort which has been authorised in the EU since 2 April 1992. Kinpeygo contains the same active substance as Entocort but has a different formulation and a different indication.[57] Kinpeygo was approved for medical use in the European Union in July 2022.[58] [59]

Research

COVID-19

Budesonide was recommended in April 2021 by the UK's NHS to treat COVID-19 on a case-by-case basis for those aged 50 years of age and older.[60] After a University of Oxford research team found in a trial with 1,700 patients that budesonide could benefit many people over 50 with COVID-19 symptoms, it was recommended from 12 April 2021, by the National Health Service in the UK for general practitioners (GPs) to treat COVID-19 on a case-by-case basis.[61] [62] Results of a large-scale trial published in August 2021 suggest that inhaled budesonide improves the time of recovery and people's well-being during the recovery process.[63] [64] Inhalational budesonide was added to the recommended treatment for cases of COVID-19 in India in April 2021.[65] [66] The NIH recommendation was withdrawn in December 2021 citing the need for more research.[67] [68]

External links

Notes and References

  1. Web site: Regulatory Decision Summary - Uceris . Health Canada . 23 October 2014 . 4 June 2022 . 5 June 2022 . https://web.archive.org/web/20220605060335/https://hpr-rps.hres.ca/reg-content/regulatory-decision-summary-detail.php?linkID=RDS00675 . live .
  2. Web site: Tarpeyo- budesonide capsule, delayed release . DailyMed . 24 December 2021 . 25 December 2021 . https://web.archive.org/web/20211225032829/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=938cada4-d6bf-4252-836f-dd40f9eadb4d . live .
  3. Web site: Pulmicort Flexhaler- budesonide aerosol, powder . DailyMed . 24 December 2021 . 19 September 2021 . https://web.archive.org/web/20210919024400/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=54234b7d-3bcc-4809-1881-1d21484856a0 . live .
  4. Web site: Eohilia- budesonide suspension . DailyMed . 9 February 2024 . 26 February 2024 . 26 February 2024 . https://web.archive.org/web/20240226052716/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=56f2023a-69b2-4470-b4ad-af7ec1be527a . live .
  5. Web site: Jorveza EPAR . European Medicines Agency (EMA) . 17 September 2018 . 3 March 2023 . 4 March 2023 . https://web.archive.org/web/20230304065613/https://www.ema.europa.eu/en/medicines/human/EPAR/jorveza . live .
  6. Web site: Budesonide . live . https://web.archive.org/web/20151128150235/http://www.drugs.com/monograph/budesonide.html . 28 November 2015 . 2 December 2015 . The American Society of Health-System Pharmacists.
  7. Web site: Budesonide eent . live . https://web.archive.org/web/20151208195318/http://www.drugs.com/monograph/budesonide-eent.html . 8 December 2015 . 2 December 2015 . The American Society of Health-System Pharmacists.
  8. De Coster DA, Jones M . 2014 . Tailoring of corticosteroids in COPD management . Current Respiratory Care Reports . 3 . 3 . 121–132 . 10.1007/s13665-014-0084-2 . 4113685 . 25089228.
  9. Christophi GP, Rengarajan A, Ciorba MA . 2016 . Rectal budesonide and mesalamine formulations in active ulcerative proctosigmoiditis: efficacy, tolerance, and treatment approach . Clinical and Experimental Gastroenterology . 9 . 125–30 . 10.2147/CEG.S80237 . 4876845 . 27274301 . free.
  10. Rudmik L, Schlosser RJ, Smith TL, Soler ZM . July 2012 . Impact of topical nasal steroid therapy on symptoms of nasal polyposis: a meta-analysis . The Laryngoscope . 122 . 7 . 1431–7 . 10.1002/lary.23259 . 22410935 . 25637461.
  11. Silverman J, Otley A . July 2011 . Budesonide in the treatment of inflammatory bowel disease . Expert Review of Clinical Immunology . 7 . 4 . 419–28 . 10.1586/eci.11.34 . 21790284 . 32892611.
  12. Pardi DS, Tremaine WJ, Carrasco-Labra A . January 2016 . American Gastroenterological Association Institute Technical Review on the Medical Management of Microscopic Colitis . Gastroenterology . 150 . 1 . 247–274.e11 . 10.1053/j.gastro.2015.11.006 . 26584602.
  13. Book: British national formulary: BNF 58 . 2009 . British Medical Association . 9780857111562 . 58 . 56–57.
  14. Web site: Budesonide . live . https://web.archive.org/web/20151128150235/http://www.drugs.com/monograph/budesonide.html . 28 November 2015 . 2 December 2015 . The American Society of Health-System Pharmacists.
  15. Book: Domeij B . Pharmaceutical patents in Europe. 2000. Kluwer Law International. The Hague. 9789041113481. 278. live. https://web.archive.org/web/20151208072850/https://books.google.ca/books?id=KZfvZN2WfjcC&pg=PA278. 8 December 2015.
  16. Book: Hamley P . Small Molecule Medicinal Chemistry: Strategies and Technologies. 2015. John Wiley & Sons. 9781118771693. 390. live. https://web.archive.org/web/20151208062120/https://books.google.ca/books?id=LOudCgAAQBAJ&pg=PA390. 8 December 2015.
  17. Book: ((World Health Organization)) . World Health Organization model list of essential medicines: 21st list 2019 . 2019 . 10665/325771 . World Health Organization . World Health Organization . Geneva . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO . free.
  18. Book: Hamilton R . Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. 2015. Jones & Bartlett Learning. 9781284057560. 451.
  19. Web site: First Generic Drug Approvals 2023 . U.S. Food and Drug Administration (FDA) . 30 May 2023 . https://web.archive.org/web/20230630003621/https://www.fda.gov/drugs/drug-and-biologic-approval-and-ind-activity-reports/first-generic-drug-approvals . 30 June 2023 . live . 30 June 2023.
  20. Web site: The Top 300 of 2021 . ClinCalc . 14 January 2024 . 15 January 2024 . https://web.archive.org/web/20240115223848/https://clincalc.com/DrugStats/Top300Drugs.aspx . live .
  21. Web site: Budesonide - Drug Usage Statistics . ClinCalc . 14 January 2024 . 29 April 2017 . https://web.archive.org/web/20170429130248/https://clincalc.com/DrugStats/Drugs/Budesonide . live .
  22. Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GiNA) 2011. Available at https://www.ginasthma.org
  23. Lichtenstein GR, Hanauer SB, Sandborn WJ . 2009 . Management of Crohn's Disease in Adults . Am J Gastroenterol . 104 . 2. 465–83 . 19174807 . 10.1038/ajg.2008.168. 10176441. free .
  24. Kuenzig ME, Rezaie A, Seow CH, Otley AR, Steinhart AH, Griffiths AM, etal . Budesonide for maintenance of remission in Crohn's disease. . Cochrane Database Syst Rev . 2014 . 8 . 8. CD002913 . 10.1002/14651858.CD002913.pub3 . 7133546 . 25141071 .
  25. Habal FM, Huang VW . 2012 . Review Article: A Decision-Making Algorithm For the Management of Pregnancy in the Inflammatory Bowel Disease Patient . Aliment Pharmacol Ther . 35 . 5. 501–15 . 22221203 . 10.1111/j.1365-2036.2011.04967.x. 34662981 . free .
  26. Pardi DS, Tremaine WJ, Carrasco-Labra A . January 2016 . American Gastroenterological Association Institute Technical Review on the Medical Management of Microscopic Colitis . Gastroenterology . 150 . 1 . 247–274.e11 . 10.1053/j.gastro.2015.11.006 . 26584602.
  27. Miehlke S, Guagnozzi D, Zabana Y, Tontini GE, Kanstrup Fiehn AM, Wildt S, Bohr J, Bonderup O, Bouma G, D'Amato M, Heiberg Engel PJ, Fernandez-Banares F, Macaigne G, Hjortswang H, Hultgren-Hörnquist E, Koulaouzidis A, Kupcinskas J, Landolfi S, Latella G, Lucendo A, Lyutakov I, Madisch A, Magro F, Marlicz W, Mihaly E, Munck LK, Ostvik AE, Patai ÁV, Penchev P, Skonieczna-Żydecka K, Verhaegh B, Münch A . European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations . United European Gastroenterology Journal . 9 . 1 . 13–37 . February 2021 . 33619914 . 8259259 . 10.1177/2050640620951905.
  28. Stanaland BE . Once-daily budesonide aqueous nasal spray for allergic rhinitis: a review . Clinical Therapeutics . 26 . 4 . 473–92 . April 2004 . 15189745 . 10.1016/s0149-2918(04)90050-1.
  29. Rawla P, Sunkara T, Thandra KC, Gaduputi V . Efficacy and Safety of Budesonide in the Treatment of Eosinophilic Esophagitis: Updated Systematic Review and Meta-Analysis of Randomized and Non-Randomized Studies . Drugs in R&D . 18 . 4 . 259–269 . December 2018 . 30387081 . 6277325 . 10.1007/s40268-018-0253-9.
  30. Web site: FDA approves first drug to decrease urine protein in IgA nephropathy, a rare kidney disease . U.S. Food and Drug Administration (FDA) . 17 December 2021 . 18 December 2021 . 19 December 2021 . https://web.archive.org/web/20211219081148/https://www.fda.gov/drugs/fda-approves-first-drug-decrease-urine-protein-iga-nephropathy-rare-kidney-disease . live .
  31. Web site: GENERIC NAME: BUDESONIDE - NASAL AEROSOL INHALER (byou-DESS-oh-nide). https://web.archive.org/web/20081106080137/http://www.emedicinehealth.com/budesonide-nasal_aerosol_inhaler/article.htm. dead. 6 November 2008. eMedicineHealth.
  32. Web site: What are the possible side effects of budesonide nasal (Childrens Rhinocort Allergy, Rhinocort Allergy, Rhinocort Aqua)? . eMedicineHealth . 25 August 2020 . 6 August 2020 . https://web.archive.org/web/20200806011138/https://www.emedicinehealth.com/drug-budesonide_nasal/article_em.htm#sideeffects . live .
  33. Web site: Budesonide: CMDh scientific conclusions and grounds for variation, amendments to the product information and timetable for the implementation - PSUSA/00000449/201604. European Medicines Agency (EMA). 19 May 2017. 10 March 2017. live. https://web.archive.org/web/20170908174615/http://www.ema.europa.eu/docs/en_GB/document_library/Periodic_safety_update_single_assessment/2017/03/WC500223322.pdf. 8 September 2017.
  34. Book: Kalola UK, Ambati S . Budesonide . 2024 . StatPearls . http://www.ncbi.nlm.nih.gov/books/NBK563201/ . 2024-04-28 . Treasure Island (FL) . StatPearls Publishing . 33085348 .
  35. Web site: Budesonide (Oral Route) Precautions - Mayo Clinic . 2024-05-03 . www.mayoclinic.org.
  36. Web site: Budesonide inhalation Uses, Side Effects & Warnings . 2024-05-03 . Drugs.com . en.
  37. Todd GR, Acerini CL, Ross-Russell R, Zahra S, Warner JT, McCance D . Survey of adrenal crisis associated with inhaled corticosteroids in the United Kingdom . Archives of Disease in Childhood . 87 . 6 . 457–461 . December 2002 . 12456538 . 1755820 . 10.1136/adc.87.6.457 .
  38. Todd GR, Acerini CL, Buck JJ, Murphy NP, Ross-Russell R, Warner JT, McCance DR . 2002 . Acute Adrenal Crisis in Asthmatics Treated With High-Dose Fluticasone Propionate . Eur Respir J . 19 . 6 . 1207–9 . 10.1183/09031936.02.00274402 . 12108877 . free.
  39. Web site: April 28, 2024 . Budesonide (Oral Inhalation) . Lexi-Drugs . UpToDate Lexidrug. . UpToDate Inc..
  40. Ajimura CM, Jagan N, Morrow LE, Malesker MA . Drug Interactions With Oral Inhaled Medications . The Journal of Pharmacy Technology . 34 . 6 . 273–280 . December 2018 . 34861014 . 6231282 . 10.1177/8755122518788809 .
  41. Book: Handbook of drug-nutrient interactions . Baily DG . 2010 . Humana Press . 978-1-60327-362-6 . Boullata JI, Armenti VT . 2nd . New York, NY . 282 . Grapefruit and Other Fruit Juices Interactions with Medicines . https://books.google.com/books?id=6MSRviXlDtAC&pg=PA282.
  42. Book: Saunders Nursing Drug Handbook 2019 E-Book . Kizior RJ, Hodgson BB . 21 February 2018 . Elsevier Health Sciences . 978-0-323-61257-9 . 160 . 5 October 2020 . https://web.archive.org/web/20240430044452/https://books.google.com/books?id=eJNNDwAAQBAJ&q=Budesonide+protein+synthesis&pg=160#v=snippet&q=Budesonide%20protein%20synthesis&f=false . 30 April 2024 . live.
  43. Book: Mosby's Canadian Nursing Drug Reference - E-Book . Skidmore-Roth L, Richardson F . 9 July 2020 . Elsevier Health Sciences . 978-1-77172-084-7 . 187 . 5 October 2020 . https://web.archive.org/web/20240311071449/https://books.google.com/books?id=iS_wDwAAQBAJ&q=Budesonide+fibroblasts+migration&pg=187#v=snippet&q=Budesonide%20fibroblasts%20migration&f=false . 11 March 2024 . live.
  44. Book: Gavins F, Flower RJ . Budesonide . January 2008 . xPharm: The Comprehensive Pharmacology Reference . 1–5 . Enna SJ, Bylund DB . https://www.sciencedirect.com/science/article/pii/B9780080552323613509 . 2024-05-03 . New York . Elsevier . 978-0-08-055232-3 .
  45. Web site: April 28, 2024 . Budesonide (Systemic) . Lexi-Drugs . UpToDate Lexidrug. . UpToDate Inc..
  46. Web site: Budesonide . 2024-04-28 . go.drugbank.com . en.
  47. Web site: April 28, 2024 . Budesonide (Oral Inhalation) . Lexi-Drugs . UpToDate Lexidrug. . UpToDate Inc..
  48. Web site: April 28, 2024 . Budesonide (Topical) . Lexi-Drugs . UpToDate Lexidrug. . UpToDate Inc..
  49. Book: Elks J . The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies. 14 November 2014. Springer. 978-1-4757-2085-3. 186, 1011. live. https://web.archive.org/web/20170908174614/https://books.google.com/books?id=0vXTBwAAQBAJ&pg=PA186. 8 September 2017.
  50. Book: Lemke TL, Williams DA . Foye's Principles of Medicinal Chemistry. 2008. Lippincott Williams & Wilkins. 978-0-7817-6879-5. 1253–. live. https://web.archive.org/web/20170908174614/https://books.google.com/books?id=R0W1ErpsQpkC&pg=PA1253. 8 September 2017.
  51. Web site: April 28, 2024 . Budesonide (Oral Inhalation) . Lexi-Drugs . UpToDate Lexidrug. . UpToDate Inc..
  52. Web site: Budesonide . 2024-04-28 . go.drugbank.com . en.
  53. Web site: April 28, 2024 . Budesonide (Systemic) . Lexi-Drugs . UpToDate Lexidrug. . UpToDate Inc..
  54. Web site: April 28, 2024 . Budesonide (Nasal) . Lexi-Drugs . UpToDate Lexidrug. . UpToDate Inc..
  55. Web site: April 28, 2024 . Budesonide (Topical) . Lexi-Drugs . UpToDate Lexidrug. . UpToDate Inc..
  56. News: Murphy H. 11 May 2019. Teva and Other Generic Drugmakers Inflated Prices Up to 1,000%, State Prosecutors Say. The New York Times. 27 May 2020. 30 May 2020. https://web.archive.org/web/20200530154338/https://www.nytimes.com/2019/05/11/health/teva-price-fixing-lawsuit.html. live.
  57. Web site: Kinpeygo: Pending EC decision . European Medicines Agency (EMA) . 20 May 2022 . 20 May 2022 . 20 May 2022 . https://web.archive.org/web/20220520151855/https://www.ema.europa.eu/en/medicines/human/summaries-opinion/kinpeygo . live . Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  58. Web site: Kinpeygo EPAR . European Medicines Agency (EMA) . 17 May 2022 . 3 March 2023 . 4 March 2023 . https://web.archive.org/web/20230304065605/https://www.ema.europa.eu/en/medicines/human/EPAR/kinpeygo . live .
  59. Web site: Kinpeygo Product information . Union Register of medicinal products . 3 March 2023 . 4 March 2023 . https://web.archive.org/web/20230304065613/https://ec.europa.eu/health/documents/community-register/html/h1657.htm . live .
  60. Web site: COVID-19 Therapeutic Alert - Inhaled Budesonide for Adults (50 Years and Over) with COVID-19 . Central Alerting System . 12 April 2021 . 16 April 2021 . 12 April 2021 . https://web.archive.org/web/20210412150959/https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103154 . live .
  61. News: Covid: Asthma drug 'speeds up recovery at home' . Roxby P . BBC News . 12 April 2021 . 12 April 2021 . 12 April 2021 . https://web.archive.org/web/20210412184831/https://www.bbc.co.uk/news/health-56717486 . live .
  62. News: Blakely R. Asthma drug Budesonide speeds up Covid recovery times. The Times. 12 April 2021. subscription. 0140-0460. 13 April 2021. 6 November 2021. https://web.archive.org/web/20211106022706/https://www.thetimes.co.uk/article/asthma-drug-speeds-up-covid-recovery-times-t0630b7lp. live.
  63. Platform trial rules out treatments for COVID-19 . NIHR Evidence . 31 May 2022 . 10.3310/nihrevidence_50873 . Plain English summary . 1 June 2022 . 1 June 2022 . https://web.archive.org/web/20220601095141/https://evidence.nihr.ac.uk/alert/platform-trial-rules-out-covid-treatments/ . live .
  64. Yu LM, Bafadhel M, Dorward J, Hayward G, Saville BR, Gbinigie O, Van Hecke O, Ogburn E, Evans PH, Thomas NP, Patel MG, Richards D, Berry N, Detry MA, Saunders C, Fitzgerald M, Harris V, Shanyinde M, de Lusignan S, Andersson MI, Barnes PJ, Russell RE, Nicolau DV, Ramakrishnan S, Hobbs FD, Butler CC . Inhaled budesonide for COVID-19 in people at high risk of complications in the community in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial . Lancet . 398 . 10303 . 843–855 . September 2021 . 34388395 . 8354567 . 10.1016/S0140-6736(21)01744-X .
  65. News: 29 April 2021. New guidelines prescribe inhaled steroid 'Budesonide', antiparasitic drug 'Ivermectin' for mild Covid cases. The New Indian Express. 11 July 2021. 6 November 2021. https://web.archive.org/web/20211106022707/https://www.newindianexpress.com/nation/2021/apr/29/new-guidelines-prescribe-inhaled-steroid-budesonide-antiparasitic-drug-ivermectin-for-mild-covid-cases-2296446.html. live.
  66. Web site: 24 May 2021. Clinical Management Protocol for Covid-19 (in Adults). Ministry of Health and Family Welfare (India). 10 July 2021. 5 December 2021. https://web.archive.org/web/20211205052720/https://www.mohfw.gov.in/pdf/UpdatedDetailedClinicalManagementProtocolforCOVID19adultsdated24052021.pdf. live.
  67. Web site: Burns C . NICE removes budesonide from recommended COVID-19 treatments . 1 June 2022 . The Pharmaceutical Journal . 15 December 2021 . 26 June 2022 . https://web.archive.org/web/20220626033349/https://pharmaceutical-journal.com/article/news/nice-removes-budesonide-from-recommended-covid-treatments . live .
  68. Web site: Withdrawal of the Recommendation for Consideration of Inhaled Budesonide as a Treatment Option for COVID-19 . Central Alerting System . 20 May 2022 . 30 June 2022 . https://web.archive.org/web/20220630023652/https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103185 . live .

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