Budesonid Easyhaler

The Budesonid Easyhaler is a dry powder inhaler containing the inhaled corticosteroid budesonide. It is a generic alternative to the Pulmicort Turbuhaler and is used for the long-term treatment of bronchial asthma.

The Easyhaler is a breath-actuated dry powder inhaler with a built-in dose counter. It is particularly easy to use and is well suited for patients who have difficulty with coordination when using metered-dose inhalers.

Budesonide forms the foundation of asthma maintenance therapy.

Budesonide has a local anti-inflammatory effect in the airways:

Mechanism of action: 1. Budesonide binds to glucocorticoid receptors in the cells 2. Activates anti-inflammatory gene expression 3. Inhibits the production of inflammatory mediators 4. Reduces the influx of inflammatory cells

Effects:

• Reduction of mucosal swelling
• Reduction of mucus production
• Lowering of bronchial hyperresponsiveness
• Prevention of airway restructuring (remodeling)

Time course:

• First effects: after a few days
• Full effect: after 1-2 weeks of regular use
• No immediate effect in acute shortness of breath!

The Budesonid Easyhaler is suitable for:

• All severity levels of asthma (as maintenance therapy)
• Adults and children aged 6 years and older
• Patients who prefer a simple dry powder inhaler

Advantages of the Easyhaler:

• Easy to use
• Built-in dose counter
• No propellant needed
• No coordination needed between spraying and inhaling

Not suitable for:

• Acute asthma attacks
• As the sole therapy in severe asthma
• Patients with very low inspiratory strength

Budesonid Easyhaler:

• 100 µg per single dose
• 200 µg per single dose
• 400 µg per single dose

Dosage for asthma (adults):

• Mild: 200-400 µg per day (in 1-2 doses)
• Moderate: 400-800 µg per day
• Severe: 800-1600 µg per day

For children:

• 100-400 µg per day depending on severity

Note: Aim for the lowest possible effective dose.

Easyhaler – inhalation technique: 1. Remove the protective cap 2. Hold the device upright and shake it firmly once 3. Press and release (click – the dose is loaded) 4. Breathe out deeply (not into the inhaler) 5. Close your lips tightly around the mouthpiece 6. Breathe in strongly and deeply 7. Hold your breath for 5-10 seconds 8. Breathe out slowly 9. Rinse your mouth with water and spit it out

Important:

• Use regularly, even when you have no symptoms
• Do not stop abruptly
• Rinse your mouth after every inhalation (to prevent oral thrush)

Do not use in case of:

• Hypersensitivity to budesonide or lactose

Use with caution in case of:

• Active pulmonary tuberculosis
• Fungal, viral or bacterial respiratory infections
• Severe hepatic impairment

Pregnancy: Can and should be used for asthma. Uncontrolled asthma is more dangerous for mother and child than budesonide.

Breastfeeding: Passes into breast milk in small amounts. Use is possible.

Common (1-10%):

• Oral thrush (oral candidiasis)
• Throat irritation
• Difficulty swallowing
• Cough after inhalation

Uncommon (0.1-1%):

• Anxiety, depression
• Cataract, blurred vision
• Muscle spasms, tremor

Rare (0.01-0.1%):

• Hypersensitivity reactions (including rash, contact dermatitis, urticaria, angioedema and anaphylactic shock)
• Bronchospasm (acute shortness of breath immediately after inhalation)
• Hoarseness, voice disorders
• Adrenal suppression, slowed growth in children (especially with high doses over a long period)
• Behavioral changes (especially in children), restlessness, nervousness
• Skin changes

Very rare (less than 0.01%):

• Reduced bone density
• Glaucoma

Frequency not known:

• Sleep disorders, aggression, irritability, psychomotor hyperactivity, psychosis

Prevention: Rinse your mouth after every inhalation. Use the lowest possible dose.

Interactions:

• CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir) – increased budesonide levels
• Estrogens – may enhance the effects of budesonide

No relevant interaction with:

• Bronchodilators (a useful combination)
• Most other medications