Budesonide for nebulization (Pulmicort Respules) - Uses, Side Effects, and More

What are the most common side effects of budesonide for nebulization?

The most common side effects of budesonide for nebulization are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

• Infection in the nose or throat, sore throat, or common cold symptoms, stuffy or runny nose
• Cough
• Ear infections
• Flu-like symptoms
• Oral thrush (see below)
• Stomach flu, vomiting, diarrhea, stomach pain
• Nose bleeds
• Pink eye (conjunctivitis)
• Rash

There may be other side effects of budesonide for nebulization that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of budesonide for nebulization?

While less common, the most serious side effects of budesonide for nebulization are described below, along with what to do if they happen.

Severe Allergic Reactions. Budesonide for nebulization may cause allergic reactions, which can be serious. Stop using budesonide for nebulization and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching, skin rash, or pale red bumps on the skin called hives
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Oral Thrush. Budesonide for nebulization can cause a fungal infection in your mouth and throat, a condition known as oral thrush or oral candidiasis. To help prevent the risk of thrush, rinse your mouth with water and spit out the water (do not swallow it) after each dose of budesonide for nebulization. Contact your healthcare provider if you notice any of the following symptoms of oral thrush. 

• Cracking in the corners of the mouth
• Loss of taste
• Red or white patches in the mouth or throat
• Raised white spots in the mouth or throat
• Pain in the throat
• Hoarseness

Sudden Breathing Problems. Budesonide for nebulization may cause the muscles around the airways to tighten (bronchospasm) right after you use it, instead of relaxing these muscles. In some cases this can be serious. Stop using budesonide for nebulization and contact your healthcare provider right away if your breathing gets worse instead of better right after using budesonide.

Eye Problems. Budesonide for nebulization may increase pressure inside the eye and cause or worsen narrow-angle glaucoma, which can lead to blindness. It can also cause cataracts (clouding of the eye lens). It is important to have regular eye exams while using budesonide for nebulization. Tell your healthcare provider right away if you have any of the following symptoms of glaucoma or cataracts.

• Loss of vision or vision changes
• Eye pain or redness
• Severe headache or vomiting
• Seeing bright, colorful circles around lights (vision halos)
• Vision that is cloudy, blurry, foggy, or filmy

Reduced Adrenal Function. Long-term use of budesonide for nebulization can cause your adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. This is especially a concern if you have been taking a corticosteroid by mouth, such as prednisone, and you stop it and switch to budesonide for nebulization. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your healthcare provider if you have any of the following symptoms of adrenal insufficiency.

• Nausea and vomiting
• Weakness, tiredness, or lack of energy
• Dizziness

Infection. Budesonide for nebulization can weaken your immune system, making you more likely to get an infection, including a serious infection. Tell your healthcare provider if you have any of the following symptoms of an infection, or if you have been exposed to chickenpox or measles.

• Fever
• Chills
• Feeling tired
• Body aches and pains
• Nausea or vomiting

Weak Bones. Using budesonide for nebulization for a long time may cause the bones to become weaker, leading to reduced bone density (osteopenia). It may also cause a more serious condition called osteoporosis, which can cause bones to break (fracture) more easily. Talk with your healthcare provider about any risk factors you have for weak bones, such as limited ability to move around, family history of weak bones, poor eating habits, long-term use of a corticosteroid, which is a medicine for certain inflammatory conditions or medicine to treat and prevent seizures. If you use budesonide for nebulization, your healthcare provider may monitor your bone density or recommend treatment based on the results. Tell your healthcare provider if you break a bone, and get a bone mineral density test if one is ordered for you.

Slow Growth. Budesonide for nebulization may slow down growth in children and adolescents who are still growing. Talk with the healthcare provider if you have any concerns about how your child is growing.

Immune System Reaction. Rarely, using budesonide for nebulization may increase your risk of developing an immune system reaction. The reaction is sometimes called Churg-Strauss Syndrome or eosinophilic granulomatosis with polyangiitis. You may have high levels of eosinophils, including small masses of immune cells in inflamed tissues, and vasculitis. This is especially a concern if you have been taking a corticosteroid by mouth, such as prednisone, and you stop it and switch to budesonide for nebulization. Tell your healthcare provider if you have any of the following symptoms.

• Rash
• Worsening breathing problems
• Heart problems
• Pain, burning, tingling, numbness, or weakness in your arms, hands, legs, or feet