Rhinocort belongs to glucocorticoid preparation for inhalation and topical use. It has anti-inflammatory, antiallergic, antioxidative and antipruritic effects. With the inhalation route of administration, an expressed clinical effect usually develops within 5-7 days course application.
Inhalation: chronic obstructive pulmonary disease, bronchial asthma.
- Severe violations of the hepatic functional state;
- Infections of the gastrointestinal tract (bacterial, amoebic, fungal, viral;
- Age up to 18 years;
- Fungal infections of the respiratory system;
- The active form of pulmonary tuberculosis;
- Respiratory tuberculosis;
- Bacterial, fungal and viral respiratory infections.
The dose is proscribed individually, taking into account the severity of the pathology that supports the dose of systemic glucocorticoids. The regimen is the following:
- adults – in several doses 200 – 800 mcg per day (up to 1600 mcg per day);
- children, the dose is set depending on age.
With prolonged use of budesonide (Rhinocort), candidiasis may develop. This drug can suppress the work of the hypothalamus-pituitary-adrenal system. Before surgery or exposure to other stress factors, additional administration of systemic glucocorticoids is recommended.
- Sensory organs and the nervous system: depression, irritability, euphoria, cataracts, glaucoma.
- Cardiovascular system and blood: increased blood pressure, vasculitis (withdrawal syndrome after prolonged therapy), the risk of thrombosis.
- Digestive system: pain in the epigastric region, duodenal ulcer, dyspeptic symptoms, pancreatitis.
- Endocrine system: Cushing’s syndrome (including obesity of the body, moon face), decreased glucose tolerance, diabetes mellitus, hypokalemia, sodium retention with the formation of edema, impaired secretion of sex hormones (hirsutism, amenorrhea, impotence), atrophy or decreased function of the adrenal cortex;
- Musculoskeletal system: osteoporosis, muscle weakness, aseptic necrosis of the bones;
- Skin: red striae, allergic exanthema, petechiae, steroid acne, ecchymosis, contact dermatitis, worsening of wound healing;
- Others: increased risk of developing infectious diseases.
There may be also observed: sore throat, dysphonia, cough, irritation or dryness of the oral cavity or pharynx, candidiasis of mucosal cavity, pharyngitis, nausea, paradoxical bronchospasm.
Cytochrome P450 inhibitors (including erythromycin, ketoconazole, cyclosporine) can inhibit metabolism and, thereby, enhance the glucocorticoid effect of budesonide. Budesonide can potentiate the action of cardiac glycosides due to potassium deficiency; saluretics can increase hypokalemia. The combined use of cimetidine and budesonide can lead to a slight increase in the level of budesonide in the blood serum. Omeprazole (when used together) does not affect the pharmacokinetics of budesonide. Ketoconazole markedly increases the concentration of budesonide in plasma and enhances its glucocorticoid effect. The simultaneous use of ketoconazole and budesonide increase in an increase in the systemic action of budesonide by 3 to 8 times.
If it is necessary to use ketoconazole and budesonide at the same time, it is necessary to increase the time interval between their use to the maximum possible, and also consider reducing the dose of budesonide. Since budesonide is metabolized by the CYP3A4 isoenzyme, CYP3A4 inhibitors can inhibit its metabolism, thereby increasing its plasma content and enhance the effect. Be cautious when using budesonide during prolonged therapy with CYP3A4 inhibitors such as itraconazole, ketoconazole, ritonavir, indinavir, atazanavir, saquinavir, erythromycin, nelfinavir, telithromycin.