Rhinocort (Budesonide)

(byoo des' oh nide)

Budesonide nasal spray is used to relieve sneezing, runny, stuffy, or itchy nose caused by hay fever or other allergies (caused by an allergy to pollen, mold, dust, or pets). Budesonide nasal spray should not be used to treat symptoms (e.g., sneezing, stuffy, runny, itchy nose) caused by the common cold. Budesonide nasal spray is in a class of drugs called corticosteroids. It works by blocking the release of certain natural substances that cause allergy symptoms.

Budesonide comes as a suspension (liquid) (prescription and nonprescription) to spray in the nose. Budesonide nasal spray is usually sprayed in each nostril once daily. If you are an adult, you will begin your treatment with a higher dose of budesonide nasal spray and then decrease your dose when your symptoms improve. If you are giving budesonide nasal spray to a child, you will begin treatment with a lower dose of the medication and increase the dose if the child's symptoms do not improve. Decrease the dose when the child's symptoms improve. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use budesonide exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. An adult should help children younger than 12 years old to use budesonide nasal spray. Children younger than 6 years of age should not use this medication. Budesonide nasal spray is only for use in the nose. Do not swallow the nasal spray and be careful not to spray it into your eyes or mouth. Each bottle of budesonide nasal spray should only be used by one person. Do not share budesonide nasal spray because this may spread germs. Budesonide nasal spray controls the symptoms of hay fever or allergies but does not cure these conditions. Your symptoms may begin to improve 1 to 2 days after you first use budesonide, but it may take up to 2 weeks before you feel the full benefit of budesonide. Budesonide works best when used regularly. Use budesonide on a regular schedule unless your doctor has told you to use it as needed. Call your doctor if your symptoms get worse or do not improve after you use budesonide nasal spray daily for 2 weeks. Budesonide nasal spray is designed to provide a certain number of sprays. After the marked number of sprays has been used, the remaining sprays in the bottle might not contain the correct amount of medication. You should keep track of the number of sprays you have used and throw away the bottle after you have used the marked number of sprays even if it still contains some liquid. Before you use budesonide nasal spray for the first time, read the written directions that come with it. Follow these steps:

• Shake the bottle gently before each use.
• Remove the dust cover.
• If you are using the pump for the first time or have not used it for 2 or more days in a row, you must prime it by following steps 4 to 5 below. If you have used the pump before and have not missed 2 days in a row of medication, skip to step 6.
• Hold the pump with the applicator between your forefinger and middle finger and the bottom of the bottle resting on your thumb. Point the applicator away from your face.
• If you are using the pump for the first time, press down and release the pump eight times. If you have used the pump before, but not within the past 2 days, press down and release the pump once until you see a fine spray. If you have not used the pump for more than 14 days, rinse the applicator tip and prime with two or more sprays until you see a fine spray.
• Blow your nose until your nostrils are clear.
• Hold one nostril closed with your finger.
• Tilt your head slightly forward and carefully put the nasal applicator tip into your other nostril. Be sure to keep the bottle upright.
• Hold the pump with the applicator between your forefinger and middle finger and the bottom resting on your thumb.
• Begin to breathe in through your nose.
• While you are breathing in, use your forefinger and middle finger to press firmly down on the applicator and release a spray.
• Lean your head back and breathe gently in through the nostril and breathe out through your mouth.
• If your doctor told you to use additional sprays in that nostril, repeat steps 6 to 12.
• Repeat steps 6 to 13 in the other nostril.
• Do not blow your nose for 15 minutes after you use the nasal spray.
• Wipe the applicator with a clean tissue and cover it with the dust cover.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Before using budesonide nasal spray,
• tell your doctor and pharmacist if you are allergic to budesonide, any other medications, or any of the ingredients in budesonide nasal spray. Check the package label for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: ; clarithromycin (Biaxin, in Prevpac); HIV protease inhibitors such as atazanavir (Reyataz, in Evotaz), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra, in Technivie), or saquinavir (Invirase); itraconazole (Onmel, Sporanox); ketoconazole (Extina, Nizoral, Xolegel); nefazodone; or telithromycin (Ketek). Also tell your doctor and pharmacist if you are using steroid medications such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos) for asthma, allergies, or a rash. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have recently had surgery on your nose, have injured your nose in any way, or if you have sores in your nose. Also tell your doctor if you have or have ever had cataracts (clouding of the lens of the eye), glaucoma (an eye disease), asthma (sudden episodes of wheezing, shortness of breath, and trouble breathing), any type of infection, a herpes infection of the eye (an infection that causes a sore on the eyelid or eye surface), or liver disease. Tell your doctor if you have chicken pox, measles, or tuberculosis (TB; a type of lung infection), or if you have been around someone who has one of these conditions.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using budesonide, call your doctor.

Use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

Budesonide nasal spray may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dryness, stinging, burning or irritation in the nose
• tiredness
• weakness
• vomiting
• nausea
• joint or muscle pain
• nosebleeds

Some side effects can be serious. If you experience any of the following symptoms, stop using budesonide nasal spray and call your doctor immediately or get emergency medical treatment:

• vision problems
• fever, sore throat, chills, cough, and other signs of infection
• whistling sound from the nose
• hives
• rash
• itching
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• wheezing
• chest tightening
• difficulty breathing or swallowing
• white patches in the throat, mouth, or nose

You should know that this medication may cause children to grow at a slower rate. Talk to your child's doctor if your child needs to use this medication for more than 2 months per year. Budesonide nasal spray may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat and moisture (not in the bathroom). Do not freeze. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

You should clean your nasal spray applicator periodically. You will need to remove the dust cap and then gently pull on the applicator to remove it from the bottle. Wash the dust cap and applicator in warm water and rinse them in cold water, let them dry at room temperature, and then put them back on the bottle. If the spray tip is clogged, wash it in warm water and then rinse it in cold water and dry it. Do not use pins or other sharp objects to remove the blockage. Ask your pharmacist any questions you have about budesonide nasal spray. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. ¶ This branded product is no longer on the market. Generic alternatives may be available.