What is Pulmicort: Uses, Warnings & Interactions

Updated May 14, 2025  •  Published Dec 31, 2020

Pulmicort is a prescription inhaled corticosteroid FDA-approved as an asthma maintenance treatment. Its active ingredient is budesonide, a common generic corticosteroid. When inhaled into the lung’s airways, budesonide blocks inflammation due to both allergic and non-allergic reactions. This helps reduce the frequency of asthma attacks. Doses are inhaled once daily, either through an inhaler (Pulmicort Flexihaler) or a nebulizer (Pulmicort Respules).

Pulmicort overview

BRAND NAMES:

  • Pulmicort Flexhaler, Pulmicort Respules

Generic Names:

  • Budesonide

Uses:

  • Prevents asthma attacks.

Therapeutic Classes:

  • Anti-inflammatory, anti-asthmatic, inhaled corticosteroid

Forms:

  • Aerosol powder, suspension for nebulizer

How it’s taken:

  • Inhalation

What is Pulmicort used for?

Pulmicort is an inhaled corticosteroid that provides maintenance treatment in people with asthma. Pulmicort is not used as a rescue inhaler.

What form(s) does Pulmicort come in

  • Aerosol powder (Pulmicort Flexhaler metered inhaler)

    • 90 mcg

    • 180 mcg

  • Suspension for nebulizer (Pulmicort Respules)

    • 0.25 mg/2 mL

    • 0.5 mg/2 mL

    • 1 mg/2 mL

What are common Pulmicort doses?

  • For asthma maintenance treatment in adults: 

    • Pulmicort Flexhaler: 180–720 mcg inhaled twice daily

  • For asthma maintenance treatment in children 6–17 years of age: 

    • Pulmicort Flexhaler: 180–360 mcg inhaled twice daily

  • For asthma maintenance treatment in children 12 months–8 years of age: 

    • Pulmicort Respules: 0.25 mg twice daily or 0.5 mg once daily for children on bronchodilators alone or inhaled corticosteroids OR 0.5 mg twice daily or 1 mg once daily for children on oral corticosteroids

Common Pulmicort prescriptions

  • Pulmicort
    2ml of 0.25mg/2ml ampule

  • Pulmicort
    2ml of 0.5mg/2ml plas cont

  • Pulmicort
    2ml of 1mg/2ml plas cont

How to take Pulmicort

  • Take your medicine as directed. Your dose may need to be changed during treatment. Do not change the dose unless instructed to do so by the prescriber.

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

  • Do not stop administering or taking doses until talking to the prescriber or other healthcare provider.

  • Taking a dose may provoke wheezing. Always take Pulmicort doses with a fast-acting bronchodilator at hand to manage any sudden wheezing.

  • How to use Pulmicort Flexhaler:

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

    • It is a powder inhaler, so read the instructions. A healthcare provider can demonstrate the proper way to use the inhaler.

    • The powder is stored in the inhaler.

    • The Pulmicort inhaler must be primed before it’s used the first time. Follow the instructions that come with this medicine.

    • After it’s been primed, it does not need priming again even if it’s unused for a prolonged time.

    • The Pulmicort Flexhaler administers only one dose at a time. If the prescription calls for higher doses (like 360 mcg), take more than one dose.

    • To load a dose, hold the inhaler upright and screw off the white cap. Hold it in the middle, and with the other hand, twist the brown grip in one direction as far as it will go, then twist it back in the other direction as far as it will go. A dose is now loaded in the inhaler.

    • DO NOT SHAKE THE INHALER AFTER A DOSE IS LOADED.

    • To take a dose, turn away from the inhaler and breathe out. 

    • Then, holding the inhaler by the bottom, place the mouthpiece in the mouth and close your lips around it without biting or chewing it. 

    • Breathe in deeply and forcefully.

    • Remove the inhaler.

    • Turn away from the inhaler and breathe out.

    • Take any additional doses 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 it dry and make sure the cap is always on except when taking a dose.

  • How to administer Pulmicort Respules:

    • Use this medicine only in young children 12 months to 8 years of age. 

    • Only use Pulmicort Respules suspension with a jet nebulizer connected to an air compressor. The nebulizer must be connected to a face mask or mouthpiece.

    • Do not mix Pulmicort Respules suspension with any other medicine.

    • Pulmicort Respules ampules come in an aluminum envelope. Once the aluminum envelope has been opened, the medicine must be used within two weeks. If it isn’t, throw it away.

    • If an ampule is opened, use it immediately.

    • Pulmicort Respules comes in three dosage strengths.

    • Each small plastic container contains one dose. 

    • Use one container for each daily or twice-daily dose unless the doctor gives you different instructions.

    • Follow the nebulizer instructions for administering doses correctly.

    • Wash the child’s face after each dose to prevent skin irritation.

    • Store Pulmicort Respules ampules in an upright position in the aluminum foil envelope. Store at room temperature, protected from light. Do not put the ampules in the refrigerator or freeze them.

What to do if you miss a dose of Pulmicort

  • If a dose is missed, skip it.

  • Take the next dose at its regular time.

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

Pulmicort contraindications

  • Pulmicort is contraindicated in anyone who has had an allergic reaction to budesonide. 

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

  • People with severe allergies to milk proteins should not use Pulmicort Flexhaler.

Pulmicort warnings

  • Tell any doctor 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: 

    • Liver problems

    • Bone density problems such as osteoporosis

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

    • Cataracts

    • Glaucoma

    • An active or untreated infection, especially a herpes infection in the eye

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

    • Any other medical condition

  • This medicine may cause serious side effects including:

    • Underactive adrenal gland

    • Yeast infections of the mouth

    • Decreased bone density 

    • Infections

    • Eye problems including cataracts and glaucoma

    • Severe allergic reactions

    • Slowed growth (in children)

  • You may get infections more easily while using this medicine. Avoid 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. Your doctor may need to slowly decrease your dose before you stop it completely.

  • 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 or other illness, or unusual stress.

Pulmicort interactions

  • To avoid potentially hazardous drug interactions, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medications, and supplements you use, particularly:

    • Other corticosteroids

    • Anti-seizure drugs

    • Immune suppressants

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

  • For people currently taking oral corticosteroids to treat their asthma or COPD, switching to Pulmicort may cause withdrawal symptoms. The dose of oral corticosteroids will need to decrease gradually. During this time, patients may need to start retaking oral corticosteroids in times of stress or acute symptoms.

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

Pulmicort side effects

Serious side effects

Talk to a doctor if you notice any signs or symptoms of a possible serious side effect, including:

  • Worsening of asthma symptoms

  • Redness, sores, or white patches in your mouth or throat

  • Changes in vision

  • Tiredness, weakness, vomiting, low blood pressure, darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash

  • Infection: fever, chills, aches and pains, tiredness, nausea, vomiting 

  • Allergic reaction: Skin rash, skin redness, skin swelling, severe itching, swelling of the face, mouth, or tongue, trouble breathing, trouble swallowing, chest pain

Less serious side effects

  • Sore nose

  • Sore throat

  • Stuffy nose

  • Nausea

  • Hay fever

  • Upper respiratory tract infections

  • Ear infections

  • Gastrointestinal infections

Sources:

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