Like all medicines, budesonide can cause side effects although not everyone gets them.
When you inhale budesonide, very little medicine gets into the rest of your body, so it's unlikely to give you side effects.
If you're on high doses of budesonide, or you're also taking other steroid medicines or certain medicines for fungal infections or HIV, you may get underactive adrenal glands (adrenal insufficiency) as a side effect. Ask your doctor if you need to carry a red steroid emergency card.
Common side effects
These common side effects of budesonide inhalers may happen in more than 1 in 100 people. There are things you can do to help cope with them:
Oral thrush
If you get oral thrush, a fungal infection that causes white patches, redness and soreness in your mouth, try rinsing your mouth with water or brushing your teeth after using your inhaler to stop this happening.
You can also ask a pharmacist to recommend a suitable treatment such as an antifungal mouth gel. They may suggest that you see your doctor to discuss the best treatment.
Keep using your budesonide inhaler while using any antifungal treatment.
Dry or sore throat, or hoarse voice
Try rinsing your mouth with water or brushing your teeth after using your inhaler to stop this happening.
Keep taking the medicine but talk to your doctor, nurse or a pharmacist if this advice does not help or if the side effects bother you or do not go away. They can check that you're using your inhaler correctly.
Serious side effects
It's unusual to have any serious side effects when using a budesonide inhaler.
Side effects are more likely if you're on a higher dose of budesonide for a long time (more than a few months).
Speak to a doctor if you get "moon face" (a puffy, rounded face), and weight gain in the upper back or belly. This happens gradually and can be a sign of Cushing's syndrome.
Call your doctor or call 111 straight away if you get:
- a high temperature, chills, a very sore throat, ear or sinus pain, a cough, coughing up more mucus (phlegm), a change in colour of your mucus, pain when you pee, mouth sores or a wound that will not heal – these can be signs of an infection
- a very upset stomach or you're being sick (vomiting), feeling very dizzy or passing out, muscle weakness, feeling very tired, mood changes, loss of appetite and weight loss – these can be signs of adrenal insufficiency
- changes in your eyesight, such as blurred vision or a cloudy lens in the eye – these can be signs of increased pressure in your eyes (glaucoma) or a cataract
Serious allergic reaction
In rare cases, budesonide inhalers may cause a serious allergic reaction (anaphylaxis).
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
Long-term side effects
Children and teenagers
Using budesonide inhalers at higher doses for a long time could possibly slow down the normal growth of children and teenagers. But the risk of this happening is very low, less than 1 in 10,000 people.
Talk to your doctor or asthma nurse if you're worried. They'll be able to explain the benefits and risks of giving your child budesonide inhalers.
Your child's doctor or asthma nurse will monitor their height and weight carefully for as long as they're using this medicine. This will help them spot any slowing down of your child's growth and change their treatment if needed.
Even if your child's growth slows down for a while, it does not seem to have much effect on their eventual adult height.
Your doctor or nurse will always aim to give you or your child the lowest dose of steroids to keep your symptoms controlled. You'll only be given higher doses if you need extra help to deal with your symptoms.
It's important to remember that inhaled steroids are one of the best ways to treat asthma and COPD and reduce your risk of symptoms and asthma attacks.
Talk to your doctor if you're worried. They'll be able to explain the benefits and risks of your child using budesonide inhalers.
Adults
If you use your inhaler as recommended by your doctor, nurse or pharmacist you're unlikely to get any lasting side effects.
Adults taking high doses (either using an inhaler or nebuliser) have an increased risk of getting adrenal gland problems or weak bones (osteoporosis) over time. This is because more of the steroid gets into your body.
Your doctor will monitor you closely and may prescribe medicines to help strengthen your bones. Calcium-rich foods (such as milk and cheese, or non-dairy milks with added calcium) and regular exercise can also help keep bones healthy.
Other side effects
These are not all the side effects of budesonide inhalers. For a full list see the leaflet inside your medicine packet.
You can report any suspected side effect using the Yellow Card safety scheme.