What is Pulmicort Flexhaler: Uses, Warnings & Interactions

Follow all the prescriber’s instructions. 

The dose may need to be changed during treatment. Do not change the dose unless instructed.

Please read the Patient Information and Instructions for Use that come with this medicine.

Do not stop administering or taking doses until consulting with the prescriber.

Always take Pulmicort doses with a fast-acting bronchodilator at hand to manage any sudden wheezing.

The Flexhaler should only be used by adults and children who are 6 years of age and older.

The inhaler administers only one dose at a time. Higher doses (like 360 mcg) require more than one inhalation.

Loading a dose:

• Hold the inhaler upright and screw off the white cap. 

• Hold the middle of the inhaler with one hand and grab the brown grip with the other hand.

• Twist the brown grip in one direction as far as it will go.

• Twist it back in the other direction as far as it will go. The inhaler is now loaded with one dose.

• Do not shake the inhaler after loading the dose.  

Taking a dose:

• Breathe out while facing away from the inhaler. 

• Hold the inhaler by the bottom.

• Place the mouthpiece in your mouth and close your lips around it without biting. 

• Breathe in deeply and forcefully.

• Remove the inhaler from your mouth.

• Turn away from the inhaler and breathe out.

• Take any additional inhalations by loading the inhaler and inhaling the medicine.

• When done, rinse your mouth with water and spit it out. 

Keep the inhaler and mouthpiece clean by wiping it with a dry tissue. Never use water or liquids. Never immerse the inhaler in water.

Store the inhaler at room temperature. 

• Keep the inhaler dry.

• Make sure the cap is always on except when taking a dose.

Do not take a missed or forgotten dose.

Take the next dose at its scheduled time.

Do not take extra inhalations to make up for a missed dose.

You should not use this medicine if you or your child has had an allergic reaction to budesonide or have severe milk allergies. 

This medicine is not to be used during an asthma attack.

Tell any healthcare provider or other healthcare provider who treats you that you are using this medicine.

Your doctor will need to regularly check on your progress and perform lab tests to monitor the effects of this treatment. Because budesonide can cause eye problems, regular eye exams are also needed. Keep all appointments.

Make sure your prescriber knows if you are pregnant, breastfeeding, or if you have: 

• An active or untreated infection

• A history of certain infections, such as tuberculosis, chicken pox, or measles

• Decreased bone mineral density (such as osteoporosis)

• Risk factors for decreased bone density including menopause, poor nutrition, inactivity, smoking, use of drugs that affect bone density, or a family history of osteoporosis

• Cataracts

• Glaucoma

• Any allergies

• Any other medical condition

This medicine may cause serious side effects including:

• Infections

• Yeast infections of the mouth (thrush)

• Decreased bone density 

• Suppression of adrenal gland function

• Eye problems including cataracts and glaucoma

• Severe allergic reactions

• Slowed growth (in children)

Budesonide makes people more vulnerable to infections. Take care to prevent infections by avoiding people who are sick or have infections. 

• Tell your doctor right away if you or your child have been exposed to someone with chickenpox or measles.

Do not stop using this medicine suddenly. The prescriber may need to gradually reduce the dose before discontinuation.

Your doctor may want you to carry a medical identification card stating that you or your child are using this medicine and that you or your child may need additional medicine during an emergency, a severe asthma attack, other illness, or unusual stress.

Taking a dose of Pulmicort can induce an asthma attack (paradoxical bronchospasm). Immediately treat these symptoms with a short-acting beta agonist.

Call your prescriber if symptoms do not improve or if they get worse.

To avoid drug interactions, tell the prescribing healthcare provider about all the medications you take or plan to take, particularly:

• Other corticosteroids

• Anticonvulsants

• Immune suppressants

• Atazanavir, clarithromycin, erythromycin, indinavir, itraconazole, ketoconazole, nefazodone, ritonavir, saquinavir, telithromycin

For people currently taking oral corticosteroids to treat their asthma or COPD, switching to Pulmicort may cause corticosteroid withdrawal symptoms. The physician will need to gradually decrease the oral corticosteroid dosage. During times of stress or acute symptoms, the physician may restart oral corticosteroids.

Tell other healthcare providers you are using this medicine before they prescribe new medications.