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Budesonide nasal spray

Updated 2 Feb 2023 | Nasal allergy


Nasal spray containing budesonide.

Drugs List

  • BENACORT 64microgram nasal spray
  • budesonide 64microgram aqueous nasal spray
  • Therapeutic Indications


    Allergic rhinitis - perennial and seasonal
    Rhinitis - vasomotor
    Treatment of nasal polyps



    Once daily dosing:
    2 applications into each nostril every morning.
    If good effect is achieved, 1 application into each nostril every morning.

    Twice daily dosing:
    1 application into each nostril morning and evening.

    In seasonal rhinitis, treatment should be limited to three months.

    Nasal Polyps
    Once daily dosing:
    2 applications into each nostril every morning.

    Twice daily dosing:
    1 application into each nostril morning and evening.

    Treatment can be continued for up to three months.

    Additional Dosage Information

    Treatment of seasonal rhinitis should, if possible, start before exposure to the allergens.


    Children under 6 years

    Precautions and Warnings

    Children aged 6 to 18 years
    Recurrent epistaxis
    Uncontrolled nasal infection
    Pulmonary tuberculosis
    Recent nasal surgery
    Recent nasal trauma

    Corticosteroid cover required in adrenal insufficiency
    May mask symptoms or signs of infections
    Systemic corticosteroids may be needed during elective surgery
    Systemic corticosteroids may be needed during periods of stress
    Concomitant treatment may be necessary for allergy eye symptoms
    Not all available brands/formulations are licensed for use in children
    Not all available products are licensed for all uses
    Consider adrenal suppression when transferring from systemic steroid
    If growth in children is slowed, consider referral to a paediatrician
    If visual disturbances occur, perform ophthalmic evaluation
    Inspect nasal mucosa regularly in patients on long term treatment
    Monitor regularly the height of children receiving prolonged treatment
    Prolonged or high dose may lead to adrenal suppression
    Corticosteroids may cause growth retardation in children under 18 years
    During transfer from oral steroids allergic conditions may be unmasked
    Systemic effects possible with any inhaled corticosteroid
    Discontinue if localised infection occurs
    Maintain treatment at the lowest effective dose
    Duration of use should not exceed 3 months
    Several days treatment needed to obtain full effect
    Advise patient to seek medical advice if treatment is ineffective
    Refer to doctor if symptoms persist after 2 weeks treatment
    Use regularly to maintain freedom from symptoms

    Pregnancy and Lactation


    Use budesonide with caution in pregnancy.

    The use of budesonide has not been associated with appreciable human teratogenicity and inhaled budesonide does not appear to represent a significant risk for congenital defects or malformations during early pregnancy.

    In animal studies glucocorticosteroids have been shown to induce malformations. This is not thought to be relevant for humans given recommended doses.

    Animal studies have also identified an involvement of excess prenatal glucocorticoids in increased risks for intrauterine growth retardation, adult cardiovascular disease and permanent changes in glucocorticoid receptor density, neurotransmitter turnover and behaviour at exposures below the teratogenic dose range.

    The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( ) or if this is unavailable at the backup site ( ).


    Use budesonide with caution in breastfeeding.

    Budesonide has a relatively low molecular weight and high lipid solubility and can be anticipated to be excreted into breast milk. The amount inhaled budesonide secreted into breast milk are minimal and infant exposure is negligible, and it is considered to be acceptable to use during breastfeeding.

    Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
    Specialist advice is available from the UK Drugs in Lactation Advisory Service at

    Side Effects

    Adrenal suppression
    Aggression in children
    Anaphylactic reaction
    Blurred vision
    Cushing's syndrome
    Cushingoid facies
    Growth retardation (children)
    Haemorrhagic secretions (slight)
    Hypersensitivity reactions
    Increased intra-ocular pressure
    Muscle spasm
    Nasal dryness and stinging
    Nasal ulceration
    Perforation of nasal septum
    Psychomotor hyperactivity
    Sleep disorders


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: September 2018

    Reference Sources

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

    Summary of Product Characteristics: Benacort 64micrograms Nasal Spray. McNeil Products Ltd. Revised July 2018.

    Summary of Product Characteristics: Budesonide 64micrograms/actuation, Aqueous Nasal Spray. Sandoz Limited. Revised June 2017.

    Summary of Product Characteristics: Rhinocort Aqua 64micrograms, nasal spray. McNeil Products Ltd. Revised July 2018.

    NICE Evidence Services Available at:
    Last accessed: 9 September 2018

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    Last revised: 06 November 2015
    Last accessed: 09 September 2018

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