Pulmicort is a brand-name prescription medication. It’s approved by the Food and Drug Administration (FDA) to treat asthma in adults and children.
Pulmicort comes in two forms, and each is approved for use in different ages. Throughout this article, “Pulmicort” is often used to describe both forms of the drug.
|Pulmicort Flexhaler||adults and children ages 6 years and older|
|Pulmicort Respules||children ages 1 year to 8 years old|
Pulmicort has a limitation of use. For details about this limitation, asthma, and how the drug is used to treat it, see the “Pulmicort: Uses” section below.
The following table provides key facts about Pulmicort.
|Drug class||inhaled corticosteroid|
|Forms||• Pulmicort Flexhaler: dry powder inhaler
• Pulmicort Respules: liquid suspension inhaled with a nebulizer
Finding a healthcare professional
Pulmicort contains the active drug budesonide. Pulmicort Flexhaler comes only as a brand-name medication. And it isn’t currently available as a generic drug. Pulmicort Respules are available in a generic form.
A generic is an identical copy of the active drug found in a brand-name medication. The Food and Drug Administration (FDA) ensures that generic drugs are as safe and effective as their original drug. Generics typically cost less than brand-name drugs.
If you’d like to know about the generic version of Pulmicort Respules, ask your doctor or pharmacist. They can tell you whether the generic medication comes in forms and strengths recommended for your condition.
As with most drugs, it’s possible to have side effects with Pulmicort. These can include some mild side effects but also some serious ones.
Side effects might differ slightly depending on the form of Pulmicort used. For example, Pulmicort Flexhaler side effects may differ from those of Pulmicort Respules.
To learn more about Pulmicort’s side effects, talk with your doctor or pharmacist. They may also provide information about managing certain side effects of this drug.
Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Pulmicort, you can do so through MedWatch.
Mild and serious side effects
Mild and serious side effects of Pulmicort are listed below. This article does not include all of Pulmicort’s possible side effects.
Mild side effects
Mild side effects* of Pulmicort may include:
- runny or stuffy nose
- sore throat
- digestive problems, such as nausea, vomiting, diarrhea, and abdominal pain
- conjunctivitis (inflammation or infection of the eyelid and white part of the eye)
- stomach flu
- upper respiratory infections, such as the common cold
- middle ear infection
- oral thrush (a type of fungal infection in the mouth)
- mild allergic reaction†
Most times, mild side effects of a drug go away within a few days or a couple of weeks. Talk with your doctor or pharmacist if any side effects become severe or don’t go away.
* This is not a complete list of Pulmicort’s mild side effects. To learn about other mild side effects of this drug, ask your doctor or pharmacist. Or you can view the prescribing information for Pulmicort Felxhaler and Pulmicort Respules.
† To learn more about allergic reaction, see below. An allergic reaction is possible after taking Pulmicort. This side effect wasn’t reported in clinical studies of Pulmicort Felxhaler or Pulmicort Respules. However, allergic reaction has been reported since both forms of Pulmicort became available for use.
Serious side effects
Serious side effects of Pulmicort may include:
- paradoxical bronchospasm (tightening of the airways after using a medication that is not expected to have this effect, such as Pulmicort)
- decreased bone mineral density, which can lead to weakened bones
- decreased function of the immune system, which may increase your risk of infection
- high level of certain white blood cells called eosinophils, which may lead to vasculitis (inflammation of the blood vessels)
- adrenal suppression (a condition that causes your adrenal glands to make reduced amounts of certain hormones, including cortisol)
- eye problems, such as glaucoma or cataracts
- severe allergic reaction*
Serious side effects from Pulmicort aren’t common, but they are possible. If you have serious side effects, call your doctor right away. However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.
* To learn more about allergic reaction, see below. An allergic reaction is possible after taking Pulmicort. This side effect wasn’t reported in clinical studies of Pulmicort Felxhaler or Pulmicort Respules. However, allergic reaction has been reported since both forms of Pulmicort became available for use.
Pulmicort’s side effects in children
Pulmicort is approved to treat asthma in children. Doctors can prescribe Pulmicort Flexhaler for children ages 6 years and older or Pulmicort Respules for children ages 1 year to 8 years old.
Most side effects of Pulmicort in children are expected to be the same as those in adults. (For details, see “Mild side effects” and “Serious side effects” above.)
In addition, the use of Pulmicort may cause delayed growth in children. This side effect was reported in clinical studies of various inhaled forms of budesonide. (Pulmicort contains an inhaled form of budesonide.)
The risk of delayed growth in children may be greater at higher doses or with long-term use of Pulmicort. Due to this risk, doctors will prescribe the smallest dosage of Pulmicort that gives the desired outcome.
Doctors may check the height and weight of children using Pulmicort. They can compare these measurements with the usual growth rates for the child’s age. If a doctor finds signs of delayed growth, they may switch the child to a treatment other than Pulmicort.
As with most drugs, some people can have an allergic reaction after taking Pulmicort. A more severe allergic reaction is rare but possible.
Possible symptoms of mild and serious allergic reactions are listed in the table below.
|Mild allergic reaction symptoms||Serious allergic reaction symptoms|
|flushing||swelling under your skin, possibly in your hands, feet, lips, or eyelids|
|rash||swelling in your throat or mouth|
If you have an allergic reaction to Pulmicort, call your doctor right away. This is important because the reaction could become severe.
However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.
Below, you’ll find dosages that are commonly recommended for Pulmicort. However, you should take the dosage your doctor prescribes for you. They’ll recommend the dosage that’s best for your needs.
Doctors may adjust the dose of Pulmicort depending on how well the medication works for you. They’ll typically prescribe the smallest dosage that gives the desired outcome.
The dosage of Pulmicort that your doctor prescribes will depend on factors such as:
- the form of Pulmicort you take
- your age
- other asthma treatments you’ve used in the past
- the severity of the condition you’re using Pulmicort to treat
Pulmicort’s forms and strengths
Pulmicort is available as follows.
- Pulmicort Flexhaler strengths:
- 90 micrograms (mcg) per inhalation
- 180 mcg/inhalation
- Pulmicort Respules strengths:
- 0.25 milligrams (mg) per 2 milliliters (mL) of suspension
- 0.5 mg/2 mL
- 1 mg/2 mL
Pulmicort Flexhaler is available in devices that contain either 60 or 120 inhalations per inhaler. This inhaler has a built-in dose counter that tells you how many inhalation doses remain inside.
Pulmicort Flexhaler recommended dosages
Recommended dosages for Pulmicort Flexhaler in adults and children are described below.
Pulmicort Flexhaler is approved to treat asthma in adults.
Recommended dosages for Pulmicort Flexhaler in adults include the following.
- Starting dosage: 180 mcg or 360 mcg twice per day
- Maintenance dosage: increased or decreased as advised by your doctor
- Maximum dosage: 720 mcg twice per day
Pulmicort Flexhaler is approved to treat asthma in children ages 6 years and older.
Recommended dosages for Pulmicort Flexhaler in children include the following.
- Starting dosage: 180 mcg or 360 mcg twice per day
- Maintenance dosage: increased or decreased as advised by the child’s doctor
- Maximum dosage: 360 mcg twice per day
Pulmicort Respules recommended dosages
Pulmicort Respules are approved to treat asthma in children ages 1 year to 8 years old.
Recommended dosages for Pulmicort Respules in children depend on the asthma treatments they’ve used in the past. Specifically, the nebulizer dose of Pulmicort Respules can vary based on whether the child has used a bronchodilator by itself, an oral corticosteroid, or an inhaled corticosteroid in the past.
|Previous asthma treatment||Starting dosage||Maintenance dosage||Maximum dosage|
|bronchodilator alone||either 0.5 mg once per day, or 0.25 mg twice per day||increased or decreased as advised by the child’s doctor||total of 0.5 mg per day|
|oral corticosteroid||either 0.5 mg twice per day, or 1 mg once per day||increased or decreased as advised by the child’s doctor||total of 1 mg per day|
|inhaled corticosteroid||either 0.5 mg once per day, or 0.25 to 0.5 mg twice per day||increased or decreased as advised by the child’s doctor||total of 1 mg per day|
Below are some things to consider about Pulmicort’s dosage.
- Missing a dose. If you miss a dose of Pulmicort, skip the missed dose and take your next one at its usual time. Do not take extra doses of Pulmicort to make up for a missed dose. Try these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
- Length of treatment. Doctors typically prescribe Pulmicort as a long-term treatment. You’ll likely take it long term if you and your doctor feel it’s safe and effective for your condition.
Your doctor will recommend how you should use Pulmicort. It’s important to administer the drug exactly as your doctor instructs.
Pulmicort is available in two forms: Pulmicort Flexhaler (a dry powder inhaler) and Pulmicort Respules (a liquid suspension inhaled with a nebulizer).
How to use Pulmicort Flexhaler
Pulmicort Flexhaler is a dry powder inhaler. It comes as a dry powder inside a canister. You’ll inhale the powder using the Flexhaler device.
It is important to rinse your mouth with water after using Pulmicort Flexhaler. This helps to prevent oral thrush, which is a possible side effect of this drug. You’ll want to spit the water out after rinsing your mouth; do not swallow it.
How to use Pulmicort Respules
Pulmicort Respules come as a liquid suspension inside respules (small plastic containers). You’ll inhale the drug using a nebulizer.
It is important to rinse your child’s mouth with water after using Pulmicort Respules. This helps to prevent oral thrush, which is a possible side effect of this drug. Your child should spit the water out after rinsing their mouth; they should not swallow it.
Questions about using Pulmicort
Here’s a list of common questions related to taking Pulmicort.
- When should I use Pulmicort? You’ll use Pulmicort Flexhaler twice a day or Pulmicort Respules once or twice a day. Try these medication reminder options to help avoid missing doses of Pulmicort. You could also set an alarm, use a timer, or download a reminder app on your phone.
- Do I need to administer Pulmicort with food? You can use Pulmicort with or without food.
- Is there a best time of day to use Pulmicort? No, there isn’t a best time of day to use Pulmicort. You can use Pulmicort any time of day.
Doctors may prescribe drugs other than Pulmicort for your condition. Certain drugs may work better for you than others.
Pulmicort is used to treat asthma. Here’s a summary of other drugs that doctors sometimes prescribe for this condition.
To learn more about some alternatives of Pulmicort, view the following articles:
For additional information about alternatives to Pulmicort, ask your doctor. They can tell you about other medications that could be prescribed for your condition.
Prescription drugs, such as Pulmicort, are approved by the Food and Drug Administration (FDA) to treat certain conditions. Doctors sometimes prescribe drugs off-label for other conditions. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.
Using Pulmicort for asthma
The FDA has approved Pulmicort to treat asthma in adults and children. Specifically, Pulmicort Flexhaler is approved for use in adults and children ages 6 years and older. Pulmicort Respules are approved for use in children ages 1 year to 8 years old.
Asthma is a long-term lung condition. It causes inflammation in the airways of the lungs. This inflammation reduces airflow to the lungs, which leads to the symptoms of asthma.
Examples of symptoms that may occur with asthma include:
- chest tightness
- shortness of breath
Doctors prescribe Pulmicort for the long-term treatment of asthma. However, this drug has a limitation of its use. Pulmicort is not approved for the short-term relief of bronchospasm related to asthma. (Bronchospasm is the sudden tightening of muscles in the airways. This usually occurs during an asthma attack.)
For short-term relief of sudden asthma symptoms, doctors may prescribe a rescue inhaler. Pulmicort should not be used as a rescue inhaler or rescue treatment. To learn more, see “Using Pulmicort with other drugs” below.
Using Pulmicort with other drugs
Doctors won’t prescribe Pulmicort for the short-term relief of sudden asthma symptoms. Instead, they’ll prescribe a rescue inhaler for this use.
Using Pulmicort with rescue inhalers, such as albuterol
A rescue inhaler is used to quickly increase airflow to the lungs. It typically eases asthma symptoms within about 15 minutes. Albuterol (ProAir HFA, Proventil HFA, Ventolin HFA) and levalbuterol (Xopenex HFA) are examples of rescue inhalers.
For details about using Pulmicort with a rescue inhaler, talk with your doctor.
Using Pulmicort in children
Pulmicort Flexhaler is approved to treat asthma in children ages 6 years and older. Pulmicort Respules are approved to treat asthma in children ages 1 year to 8 years old.
For details about this condition, see “Using Pulmicort for asthma” above.
Finding a healthcare professional for Pulmicort
If you’re interested in using Pulmicort, you can find a doctor or healthcare professional who might prescribe it by searching here. You can prepare for your appointment by visiting Healthgrades’ appointment guide for asthma.
As with other medications, prices for Pulmicort may vary. The drug’s price will depend on factors such as:
Cost considerations for Pulmicort
Here are some things to consider when looking into the cost of Pulmicort.
Option for a 90-day supply. For some drugs, it’s possible to get a 90-day supply. If this option is approved by your insurance company, it can help lower the cost of the drug. It can also help you avoid frequent trips to your pharmacy. If you’d like to learn more about this option, ask your doctor, pharmacist, or insurance company.
Need for prior authorization. Before insurance coverage for Pulmicort is approved, your insurance company may require prior authorization. In this case, your doctor and insurance company will communicate about your prescription for Pulmicort. Then, the insurance company will decide whether the drug will be covered. To find out if you need prior authorization for Pulmicort, contact your insurance company.
Possible cost assistance options. Financial assistance to help lower the cost of Pulmicort is available. A savings card for Pulmicort Flexhaler may help reduce its cost. Additionally, a patient assistance program through the drug’s manufacturer may help lower Pulmicort’s price. To learn more and see whether you’re eligible for support, view this page about the savings card. You can call 800-AZandMe (800-292-6363) or visit the manufacturer’s website to learn about other possible assistance. Also, check out this article to learn about ways to save on prescription drugs.
Use of a mail-order pharmacy. Pulmicort may be dispensed through mail-order pharmacies. Getting your prescription through a mail-order pharmacy could lower its cost. It can also allow you to get the drug without leaving home. To find out more about this option, check with your doctor, pharmacist, or insurance company.
Availability of a generic form. Pulmicort Flexhaler doesn’t come in a generic form. Pulmicort Respules come in a generic form called budesonide. A generic drug is an exact copy of the active drug in a brand-name medication. Generics are typically less expensive than brand-name drugs. If your doctor prescribes Pulmicort Respules, but you want to know about taking budesonide, talk with them about which option might be better for you. Also, check your insurance plan because it might cover only one form or the other.
Pulmicort is approved to treat asthma in adults and children. This condition causes inflammation in the airways, which reduces the amount of air that reaches the lungs. To learn more about asthma, see “Pulmicort: Uses” above.
Pulmicort is an inhaled corticosteroid. Its mechanism of action (how it works) is to reduce inflammation in the airways. By reducing inflammation, Pulmicort helps improve airflow to the lungs. Having better airflow will ease asthma symptoms.
How long does Pulmicort take to start working?
Pulmicort starts working to treat asthma within 24 hours of the first dose. However, it may take several weeks of daily Pulmicort use for your asthma symptoms to ease.
Here are some common questions about Pulmicort and brief answers to them. If you’d like to know more about these topics, ask your doctor.
What should I know about stopping Pulmicort abruptly?
If you abruptly stop using Pulmicort, watch for your asthma symptoms to return.
This is because Pulmicort is used to treat asthma. So, stopping the drug may cause symptoms of this condition to come back. (For examples of these symptoms, see “Pulmicort: Uses” above.)
If you’d like to stop using Pulmicort, talk with your doctor first. They can tell you whether it’s safe to stop using the drug. If your doctor tells you it’s safe, they may switch you to a different treatment. Starting a new asthma treatment after stopping Pulmicort can lower the chances of your asthma symptoms coming back.
Do doctors prescribe Pulmicort for COPD?
However, doctors may prescribe Pulmicort off-label for COPD. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.
For this use, inhaled corticosteroids are prescribed with long-acting beta-agonists (LABAs). These are medications used to help control COPD symptoms. Examples of LABAs include salmeterol (Serevent) and formoterol (Perforomist).
If you’re interested in treatment options for COPD, talk with your doctor. They can recommend treatment options for your condition.
Will Pulmicort cure my asthma?
No, it isn’t likely. Asthma is a long-term condition without a known cure.
However, Pulmicort can help with the long-term management of asthma symptoms. To learn more about asthma and how the drug is used to treat it, see the “Pulmicort: Uses” section above.
Pulmicort isn’t known to interact with alcohol. If you drink alcohol, talk with your doctor about an amount that’s safe to consume during Pulmicort treatment.
Pulmicort may interact with other medications. However, the drug isn’t known to interact with supplements or foods.
Different interactions can cause different effects. Some interactions can interfere with a drug’s effectiveness. Others can increase a drug’s side effects or cause them to be severe.
Before you start Pulmicort, be sure to tell your doctor about any medications, herbs, vitamins, or supplements you take. They can check for any possible interactions between these products and Pulmicort.
If any of the interactions listed below might pertain to you, talk with your doctor. They can tell you what you need to do to avoid the interaction.
- Pulmicort and certain other medications. Because Pulmicort may interact with the following drugs, your doctor may recommend you do not take it with these drugs. Examples include:
- Pulmicort and herbs and supplements. Pulmicort isn’t known to interact with any herbs or supplements. If you have questions about taking specific supplements with Pulmicort, talk with your doctor or pharmacist.
- Pulmicort and foods. There aren’t any known interactions between Pulmicort and foods. If you have questions about eating certain foods with Pulmicort, talk with your doctor or pharmacist.
For information about drug-condition interactions, see the “Pulmicort: Precautions” section below.
It isn’t known for certain whether Pulmicort is safe to use during pregnancy.
Animal studies have shown harm to offspring born to animals given budesonide injections while pregnant. (Pulmicort contains an inhaled form of budesonide.) However, animal studies don’t necessarily predict what happens in humans.
If you’re pregnant or planning a pregnancy, talk with your doctor before using Pulmicort. They can advise you on the risks and benefits of Pulmicort treatment during pregnancy.
Pulmicort and birth control needs
Doctors aren’t sure whether it’s safe to take Pulmicort during pregnancy. Talk with your doctor about your birth control needs with Pulmicort if you’re sexually active and you or your partner can become pregnant. Your doctor can recommend if you should use birth control with this medication.
Pulmicort passes into breast milk. It isn’t known if the drug may cause side effects in a child that is breastfed.
If you’re breastfeeding or planning to breastfeed, talk with your doctor. They can tell you about the risks and benefits of using Pulmicort while breastfeeding. Your doctor can also recommend other healthy ways to feed your child while you’re using Pulmicort.
Tell your doctor about your health history before starting treatment with Pulmicort. Your doctor may not recommend this medication if you have certain factors affecting your health or specific medical conditions. These situations are considered drug-condition interactions.
These factors and conditions include those listed below.
- Liver problems. Before using Pulmicort, tell your doctor if you have liver problems such as liver failure. Pulmicort is removed from your body by your liver. If you have liver problems, your body may not be able to remove the drug as well as it should. This could lead to a buildup of Pulmicort in your body, which may increase your risk of side effects. If you have liver problems, your doctor will watch closely for side effects during Pulmicort treatment.
- Infections, including herpes infection in the eye and tuberculosis (TB). Before using Pulmicort, tell your doctor if you have an infection or recently had one. Especially tell them if you have or ever had a herpes infection in your eye or TB. Pulmicort may worsen any current infection you have. It can also increase the chance that a herpes or TB infection you’ve already had will come back. Your doctor will likely treat your current infection before starting Pulmicort. They’ll also advise whether it’s safe for you to use Pulmicort if you’ve had a herpes infection in the eye or TB.
- Eye problems, such as cataracts or glaucoma. Pulmicort may worsen any eye problems you already have. Before using the medication, be sure to tell your doctor if you have eye problems. This includes glaucoma and cataracts. Talk with your doctor about whether Pulmicort is a safe treatment option for you. If you use Pulmicort, they’ll watch for changes in vision and may check your eyes more often than usual.
- Being unvaccinated for chickenpox or measles. If you’ve never received a chickenpox vaccine or measles vaccine, tell your doctor before using Pulmicort. The drug may increase your risk of getting these infections. Your doctor may recommend that you receive these vaccines before starting treatment. They will also recommend that you avoid close contact with people who have chickenpox or measles.
- Weakened bones. Pulmicort may cause you to have reduced bone mineral density, which can lead to weakened bones and fractures. If you already have weakened bones, Pulmicort can further increase your risk of fractures. Your doctor can tell you whether it’s safe to use Pulmicort.
- Allergic reaction. Your doctor will likely not prescribe Pulmicort if you’ve had an allergic reaction to it or any of its ingredients. Note that Pulmicort Flexhaler contains lactose, a sugar found in milk that may contain traces of milk protein. If you have a severe milk protein allergy, your doctor may not prescribe Pulmicort Flexhaler. (Pulmicort Respules do not contain lactose or milk protein.) To find out about other treatment options, talk with your doctor.
- Pregnancy. If you’d like additional information about taking Pulmicort while pregnant, view the “Pulmicort: Using while pregnant” section above.
- Breastfeeding. If you’d like additional information about taking Pulmicort while breastfeeding, view the “Pulmicort: Using while breastfeeding” section above.
To learn more about effects of Pulmicort that could be harmful, see the “Pulmicort: Side effects” section above.
Serious effects can occur if you use more than the recommended dosage of Pulmicort. Do not use more Pulmicort than your doctor recommends.
Symptoms of overdose
Using more than the recommended dosage of Pulmicort for long periods of time could lead to high blood level of cortisol in the blood. (Cortisol is a hormone involved with many systems in the body. Examples include the digestive system and immune system.)
Symptoms of high cortisol may include:
- high blood pressure
- weight gain
- moon-shaped face
- buffalo hump (a lump of fat between the shoulder blades)
- thinning skin
What to do in case of overdose
Call your doctor if you think you’ve used too much of this drug. Also, you can call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or a local emergency number. Or go to the nearest emergency room right away.
Here’s some information about Pulmicort’s expiration date, as well as how to store and dispose of the drug.
Expiration. Your pharmacist will add an expiration date to the label on Pulmicort’s packaging. This date is usually 1 year from the date the medication was dispensed to you. Expiration dates help ensure that a medication is effective during a period of time.
The Food and Drug Administration (FDA) advises that you avoid taking expired drugs. If you have an unused medication and it’s past the drug’s expiration date, talk with your pharmacist. They can let you know whether you might still be able to use the medication.
Storage. Many factors determine how long a medication remains good to use. These factors include how and where you store the drug.
Pulmicort Flexhaler should be stored at a room temperature between 68°F and 77°F (20°C and 25°C). The inhaler cover should be kept tightly sealed. Avoid storing Pulmicort Flexhaler in areas where it could get damp or wet, such as bathrooms.
Pulmicort Respules should be stored upright at a room temperature between 68°F and 77°F (20°C and 25°C). The medication should be kept away from light in its original aluminum foil envelope. If stored properly, Pulmicort Respules remain safe to use for 2 weeks after the envelope is opened.
Disposal. It’s important to safely dispose of Pulmicort if you no longer need to take it and have unused medication. Doing so helps prevent others, including children and pets, from accidentally taking the drug. It also helps avoid causing harm to the environment.
Ask your pharmacist for information about disposing of Pulmicort. Also, check out this page for several tips on safe medication disposal.
If you have questions about Pulmicort, talk with your doctor. They can help advise you on whether Pulmicort could be a good treatment option for you.
Here’s a list of questions you may want to ask your doctor:
- Do I take any medications that may interact with Pulmicort?
- Can my child switch from Pulmicort Flexhaler to Pulmicort Respules or vice versa?
- How is Pulmicort different from other treatments for my condition?
Disclaimer: Healthgrades has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.