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The eMC  

Last Updated 15 Apr 2013

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Pulmicort 0.5mg Respules

Pulmicort (pull-mee-kort) is a medicine which is used in asthma and treatment of croup. Pulmicort contains budesonide. It is supplied by AstraZeneca UK Limited.

The information in this Medicine Guide for Pulmicort varies according to the condition being treated and the particular preparation used.

There are 5 preparations of Pulmicort available. If Pulmicort 0.5mg Respules is not the preparation you are looking for, please select from the drop down list below.

Select your preparation (type) of Pulmicort

Pulmicort 0.5mg Respules

Information specific to Pulmicort 0.5mg Respules when used in asthma

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Your medicine

Pulmicort belongs to a class of medicines called steroids. Steroids are used to help reduce inflammation. Pulmicort works in the air passages of the lungs. It helps to reduce inflammation and keep the airways open. This makes it easier to breathe.

Pulmicort helps to prevent attacks of breathlessness or asthma. It will not give you fast relief of your symptoms once an attack has started. You must use your fast-acting reliever inhaler (inhaled bronchodilator) to relieve an attack of breathlessness or asthma. Ask your prescriber or nurse for advice on what to do if you have an asthma attack or attack of breathlessness.

You must take Pulmicort every day for it to work. Pulmicort will only prevent attacks of breathlessness or asthma if it is taken regularly. You should continue to take Pulmicort even if you feel that your condition is under control. It is a good idea to take it at the same time or times every day. You should make taking it at a regular time part of your daily routine.

Other information about Pulmicort:

Do not share your medicine with other people. It may not be suitable for them and may harm them.

The pharmacy label on your medicine tells you how much medicine you should have. It also tells you how often you should have your medicine. This is the dose that you and your prescriber have agreed you should have. You should not change the dose of your medicine unless you are told to do so by your prescriber.

If you feel that the medicine is making you unwell or you do not think it is working, then talk to your prescriber.

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When to take your medicine

Some medicines work best if they are taken at a specific time of day. Getting the most from your medicine can also be affected by what you eat, when you eat and the times at which you take other medicines.

In the case of Pulmicort:

  • in addition to your regular dose, you may need to use Pulmicort to relieve bronchospasm when your breathing becomes more difficult. For more information talk to you prescriber or asthma nurse
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How to take your medicine

Some medicines have specific instructions about how to take them. This is because they work better when taken correctly. These instructions can include getting the right dose and special instructions for preparing the medicine.

In the case of Pulmicort:

  • inhale Pulmicort through the mouth, it must not be swallowed
  • follow your doctor's instructions, the pharmacy label and the patient information leaflet that comes with your medicine for advice on the best techniques for taking and when to take your medicine
  • if you need to use other nebules when you are using Pulmicort you must ask your pharmacist if you can mix them with Pulmicort
  • if you are unsure how to use your nebuliser or are having problems using it you should discuss these difficulties with your prescriber, pharmacist or nurse
  • you should always try to have your medicine in a well ventilated room
  • use a face mask or a mouthpiece to protect your eyes
  • use the respule within 12 hours of opening
  • wash your face with water after using the face mask to prevent skin irritation
  • rinse your mouth out with water after inhaling your dose. You should do this after every use as Pulmicort may increase the chances of getting infections of the throat and mouth. Rinsing with water may help reduce your chance of getting throat and mouth infections
  • if your prescriber has advised you to dilute this medicine, you may do so using sterile sodium chloride 0.9% solution. The solution should be used within 30 minutes

If you are having problems taking this form of Pulmicort, you should talk to your prescriber or pharmacist. They may be able to give you advice on other ways to take your medicine or other preparations that are easier for you to take.

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Taking too much of your medicine

Taking extra doses of some medicines can be harmful. In some cases even one extra dose can cause you problems. If you take extra doses of your medicine, you must get medical advice immediately. You may need a test to assess the effect of taking extra doses. This is because the effects of taking too much medicine are very complex so it is very important that you seek medical advice.

Contact your prescriber, pharmacist, specialist clinic or NHS Direct on 0845 46 47 for advice.

Make sure you take all of your medicine containers with you if you are advised to go to hospital.

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Stopping your medicine

If you are not having any problems taking this medicine then do not stop having it, even if you feel better, unless advised to do so by your prescriber. If, however, you find that this medicine is causing you problems then you should talk to your prescriber about your concerns.

If your medical team decides that it is best that you do not take this medicine any more, they may advise that you do not stop Pulmicort abruptly. This is because, in some instances, stopping Pulmicort abruptly can cause withdrawal symptoms or cause your original condition to return. In these instances, reducing the dose of Pulmicort gradually over time may reduce the chances of having these problems.

If you are in any doubt, contact your prescriber, pharmacist, specialist clinic or NHS Direct on 0845 46 47.

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Looking after your medicine

The instructions on how you should keep your medicine are on the pharmacy label. You should keep your medicine in the original container. This will help to keep your medicine in the best condition and also allow you to check the instructions. Do not take the medicine if the packaging appears to have been tampered with or if the medicine shows any signs of damage. Make sure that the medicine is out of the sight and reach of children.

In the case of Pulmicort:

  • do not store in temperatures above 30°C
  • store the medicine in the foil envelope to protect it from light
  • you must dispose of this medicine three months after opening the foil envelope. It is a good idea to make a note of the date when you open the envelope
  • store this medicine upright
  • you must not freeze this medicine

You must not take the medicine after the expiry date shown on the packaging. If you have any unused medicine, return it to your pharmacist who will dispose of it safely.

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Whether this medicine is suitable for you

Pulmicort is not suitable for everyone and some people should never use it. Other people should only use it with special care. It is important that the person prescribing this medicine knows your full medical history.

Your prescriber may only prescribe this medicine with special care or may not prescribe it at all if you:

Furthermore the prescriber may only prescribe this medicine with special care or may not prescribe it at all for an infant under the age of three months.

As part of the process of assessing suitability to take this medicine a prescriber may also arrange tests:

  • to check that this medicine is not having any undesired effects
  • to check that this medicine is having the desired effect

Over time it is possible that Pulmicort can become unsuitable for some people, or they may become unsuitable for it. If at any time it appears that Pulmicort has become unsuitable, it is important that the prescriber is contacted immediately.

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Side-effects

A medicine is only made available to the public if the clinical trials have shown that the benefits of taking the medicine outweigh the risks.

Once a medicine has been licensed, information on the medicine's effects, both intended and unintended, is continuously recorded and updated.

Some side-effects may be serious while others may only be a mild inconvenience.

Everyone's reaction to a medicine is different. It is difficult to predict which side-effects you will have from taking a particular medicine, or whether you will have any side-effects at all. The important thing is to tell your prescriber or pharmacist if you are having problems with your medicine.

Common: More than 1 in 100 people who have Pulmicort:

  • cough
  • hoarse voice
  • infection of the mouth and throat
  • irritation of the throat

Rare: More than 1 in 10,000 people who have Pulmicort:

  • aggressive behaviour
  • behavioural changes
  • bronchospasm - if you develop an increase in wheezing immediately after using your inhaler you must treat this immediately with a fast-acting inhaled bronchodilator and then seek immediate medical advice
  • bruising
  • depression
  • difficulty speaking
  • feeling anxious
  • if Pulmicort is used in large amounts or for a long period of time other side-effects may occur. These are related to the effect that steroids have on the body. These may include Cushing's syndrome or Cushing-like symptoms, adrenal problems, growth suppression in children and adolescents, lowering of bone mineral density, cataracts or glaucoma
  • immediate hypersensitivity reactions or delayed hypersensitivity reactions such as rashes, dermatitis, urticaria, angioedema or anaphylactic reactions
  • psychomotor hyperactivity
  • sleeping problems

The frequency of these side-effects is unknown:

  • allergic or arthritic conditions such as rhinitis, eczema, muscle pain or joint pain when changing from an oral steroid to Pulmicort
  • may affect the results for certain tests
  • withdrawal symptoms can occur when changing from an oral steroid to Pulmicort. These may include tiredness, headache, nausea or vomiting.

If you feel unwell or if you have concerns about a side-effect, you will need to seek advice. If you feel very ill, get medical help straight away. Contact your prescriber, pharmacist, nurse or call NHS Direct on 0845 46 47.

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Taking other medicines

If you are taking more than one medicine they may interact with each other. At times your prescriber may decide to use medicines that interact, in other cases this may not be appropriate.

The decision to use medicines that interact depends on your specific circumstances. Your prescriber may decide to use medicines that interact, if it is believed that the benefits of taking the medicines together outweigh the risks. In such cases, it may be necessary to alter your dose or monitor you more closely.

Tell your prescriber the names of all the medicines that you are taking so that they can consider all possible interactions. This includes all the medicines which have been prescribed by your GP, hospital doctor, dentist, nurse, health visitor, midwife or pharmacist. You must also tell your prescriber about medicines which you have bought over the counter without prescriptions.

The following medicines may interact with Pulmicort:

The following types of medicine may interact with Pulmicort:

If you are taking Pulmicort and one of the above medicines or types of medicines, make sure your prescriber knows about it.

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Complementary preparations and vitamins

Medicines can interact with complementary preparations and vitamins. In general, there is not much information available about interactions between medicines and complementary preparations or vitamins.

If you are planning to take or are already taking any complementary preparations and vitamins you should ask your prescriber whether there are any known interactions with Pulmicort.

Your prescriber can advise whether it is appropriate for you to take combinations that are known to interact. They can also discuss with you the possible effect that the complementary preparations and vitamins may have on your condition.

If you experience any unusual effects while taking this medicine in combination with complementary preparations and vitamins, you should tell your prescriber.

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Driving and operating machinery

When taking any medicine you should be aware that it might interfere with your ability to drive or operate machinery safely.

In the case of Pulmicort:

  • this medicine will not affect your ability to drive or operate machinery

You should see how this medicine affects you before you judge whether you are safe to drive or operate machinery. If you are in any doubt about whether you should drive or operate machinery, talk to your prescriber.

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Diet

Medicines can interact with certain foods. In some cases, this may be harmful and your prescriber may advise you to avoid certain foods.

In the case of Pulmicort:

  • there are no specific foods that you must exclude from your diet when having Pulmicort
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Alcohol

Alcohol can interact with certain medicines.

In the case of Pulmicort:

  • there are no known interactions between alcohol and Pulmicort

 

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Family planning and pregnancy

Most medicines, in some way, can affect the development of a baby in the womb. The effect on the baby differs between medicines and also depends on the stage of pregnancy that you have reached when you take the medicine.

In the case of Pulmicort:

  • if you have this medicine during your pregnancy, your baby may need to have some monitoring after birth

You need to discuss your specific circumstances with your doctor to weigh up the overall risks and benefits of taking this medicine. You and your doctor can make a decision about whether you are going to take this medicine during pregnancy.

If the decision is that you should not have Pulmicort, then you should discuss whether there is an alternative medicine that you could take during pregnancy.

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Breast-feeding

Certain medicines can pass into breast milk and may reach your baby through breast-feeding.

In the case of Pulmicort:

  • this medicine passes into breast milk. Taking Pulmicort and breast-feeding will not affect your baby

If you are having Pulmicort and plan to breast-feed you must inform your doctor or midwife.

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Ingredients of your medicine

Medicines contain active ingredients. They may also contain other, additional ingredients that help ensure the stability, safety and effectiveness of the medicine. They are also added to improve the medicine's appearance and to make it easier to use. Some may be used to prolong the life of the medicine.

Pulmicort contains:

If you are not able to take any of the ingredients in your medicine, talk to your prescriber or pharmacist to see if they can suggest an alternative medicine. If you have reacted badly to Pulmicort before, do not have Pulmicort. Talk to your prescriber, pharmacist or nurse as soon as possible.

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Pulmicort, Version 11, last updated 15 Apr 2013