Budesonide nasal spray

Budesonide nasal (nose) spray is used to treat cold-like symptoms caused by allergic rhinitis. This is swelling (inflammation) of the inside of your nose that can be brought on by allergies like hay fever.

It's also used to shrink nasal polyps (painless, soft growths inside the nose) to relieve a blocked nose.

Budesonide is a type of medicine called a steroid (or corticosteroid). Steroids are a copy of a substance your body makes naturally. They're not the same as anabolic steroids.

Budesonide nasal spray is available on prescription for adults and children aged 6 years old and over. You can also buy it from pharmacies and shops for adults aged 18 years old and over.

Budesonide also comes as:

• an inhaler – for asthma and chronic obstructive pulmonary disease (COPD)
• tablets, including tablets that dissolve on your tongue, capsules and granules – for inflammatory conditions such as Crohn's disease, ulcerative colitis, autoimmune hepatitis and eosinophilic oesophagitis
• rectal foam and enemas – for ulcerative colitis

Most adults and children aged 6 years old and over can use budesonide nasal spray. Occasionally, a specialist may prescribe it for a younger child.

Budesonide nasal spray is not suitable for some people. To make sure it's safe for you, tell your doctor before starting to use it if you:

• have ever had an allergic reaction to budesonide or any other medicine
• are taking or have recently taken other steroid medicines
• have ever had nose surgery or get heavy or frequent nosebleeds
• have an infection in your nose or eyes
• are pregnant or trying to get pregnant
• have ever had TB (tuberculosis)
• have liver problems
• have ever had glaucoma or cataracts

Each spray usually contains 64 micrograms of budesonide.

You'll usually use the spray once or twice a day, once in the morning and once at night. The usual dose is 1 or 2 sprays into each nostril.

Follow the instructions that come with your medicine. Do not use more than the maximum number of sprays in 24 hours.

You need to use the spray regularly for it to work.

If you buy budesonide nasal spray without a prescription, you can use it less often once your symptoms are under control. For example, you might go from using 2 sprays twice a day to just 1 spray twice a day.

If your symptoms get worse after reducing your dose, you may want to increase it again.

If you have budesonide nasal spray on prescription, your doctor will tell you how often to use it and when to change your dose.

If you're using a new bottle, it will not work the first time you press the spray. Pump the spray a few times until a fine mist comes out. You'll also need to do this if you have not used the bottle for a few days.

Gently shake the bottle, remove the cap and keep upright. Pump the nozzle until it starts to spray mist.

1. Blow your nose gently.
2. Put the tip of the nozzle into 1 nostril, being careful to keep it pointing towards the side of the nostril and not the middle (nasal septum).
3. Spray once into your nostril (or twice if you are told you need to).
4. Repeat steps 2 and 3 in the other nostril if you need it.

After using your spray, wipe the nozzle with a clean tissue and replace the cap.

If you buy budesonide nasal spray from a pharmacy or shop, check the leaflet that comes with the medicine. It will tell you how long you can use it for. This is usually between 1 and 3 months. But If you feel no better after 7 to 14 days, speak to your doctor or pharmacist.

Also ask your doctor or pharmacist's advice if you feel better before 7 days but are not sure if you can stop.

If you're prescribed budesonide, your doctor may advise you to use it for longer.

If you forget to use your spray, use it as soon as you remember, unless it's almost time for your next dose. If this happens, skip the missed dose and have your next one at the usual time.

Do not add extra sprays to your dose to make up for a forgotten dose.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

Using too much budesonide nasal spray is unlikely to harm you.

Speak to a pharmacist or doctor if you're worried.

If you're using very high doses of budesonide, or you're using it with other steroid medicines, tablets for fungal infections or tablets for HIV, ask your doctor, nurse or a pharmacist if you need to carry a blue steroid card, or a red steroid emergency card, or both.

If you need any medical or dental treatment, show your blue or red steroid card to the doctor, dentist or pharmacist so they know you're taking budesonide.

These common side effects of budesonide nasal spray can happen in more than 1 in 100 people. There are things you can do to help cope with them:

This will usually settle down as you get used to the medicine.

Stop using your nasal spray for a few days, then start again.

Speak to your doctor or a pharmacist if this advice does not help and the side effects still bother you or do not go away.

Very few people have serious side effects when using budesonide nasal spray.

You're more likely to have a serious side effect if you use budesonide for more than a few months or take a high dose.

Tell a doctor or call 111 straight away if you get:

• damage to your nose or sores inside your nose
• changes in your eyesight, such as blurred vision or a cloudy lens in the eye – these can be signs of increased pressure in your eyes (glaucoma) or a cataract

Serious allergic reaction

In rare cases, budesonide nasal spray may cause a serious allergic reaction (anaphylaxis).

Call 999 now if:

• your lips, mouth, throat or tongue suddenly become swollen
• you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
• your throat feels tight or you're struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of budesonide nasal spray. For a full list see the leaflet inside your medicines packet.

Budesonide nasal spray can be used during pregnancy.

Very little of the medicine gets into your bloodstream and almost none gets to your baby. Even if a small amount does get to your baby, it will not harm them.

It's OK to use budesonide nasal spray while breastfeeding.

Only tiny amounts get into breast milk, so side effects in your baby are very unlikely.

If you notice that your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your health visitor, midwife, pharmacist or doctor as soon as possible.

There's no evidence that using budesonide nasal spray reduces fertility in either men or women.

Tell your doctor if you're:

• trying to get pregnant
• pregnant
• breastfeeding

Some medicines can affect budesonide nasal spray. This may increase your chance of having side effects or change how well it works. It may mean you need to change your dose of budesonide.

Speak to a pharmacist or your doctor before starting to use it if you're taking:

• medicines used to treat HIV such as ritonavir or cobicistat
• antifungal medicines such as itraconazole
• other medicines that contain steroids such as eczema creams, asthma inhalers, steroid tablets, injections or eye drops

There's not enough information to say that complementary medicines, herbal remedies and supplements are safe to use with budesonide nasal spray. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.