Synthetic glucocorticosteroid test cypionate vs enanthate for the topical (inhaled) applications, has anti-inflammatory, anti-allergic and immunosuppressive effect. It increases production lipomodulina, an inhibitor of phospholipase A, inhibits the release of arachidonic acid, inhibits the synthesis of products of arachidonic acid metabolism – cyclic endoperikisey and prostaglandins.It prevents the accumulation of neutrophils boundary, reduces the inflammatory exudation and production of lymphokines inhibits the migration of macrophages, reduces the intensity of infiltration and granulation processes, the formation of chemotactic substances (which explains the efficacy in the “late” reactions, allergies); inhibits the release of mast cell inflammatory mediators ( “immediate” allergic reaction). It increases the number of active beta-adrenergic receptors, eliminating their desensitization (restores the patient’s response to bronchodilators, allowing you to reduce the frequency of their use) reduces the bronchial testosterone isocaproate mucosa swelling, mucus production. It improves mucociliary transport. Well tolerated in long-term treatment has not mineralokortikosteroidnoy activity almost no resorptive action.
Absorption – low. After inhalation of 20-25% reaches the small bronchi, the dose received by the gastrointestinal tract (GIT) is absorbed and almost completely (90%) of biotransformation in the liver to inactive metabolites. Bioavailability -10% of incoming number in the stomach and 28% – for pulmonary fraction. Time of occurrence of the maximum concentration in blood plasma – 15-45 minutes after inhalation. Relationship to plasma proteins – 88%. It has a high systemic clearance – 84 l \ h. The half – 2.8 h, the maximum plasma concentration – 0.01 mmol \ l. Is displayed through the intestine as metabolites – 10%, kidneys 70%.
Budekort prescribed as a basic anti-inflammatory agent in various forms and degrees of severity of asthma (including hormone-dependent -for reducing the dose of oral corticosteroids); the lack of effectiveness of bronchodilators and \ or kromoglitsievoy acid and nedocromil sodium; in chronic obstructive pulmonary disease (COPD) – with varying severity of airway obstruction.
: Hypersensitivity and idiosyncrasy of the drug.
Pulmonary tuberculosis (active form), bacterial and viral infections of the respiratory, acute bronchospasm, asthmatic status (as a priority means), bronchitis neastmaticheskoy nature. Children under 6 years of age.
Be wary – cirrhosis, glaucoma, hypothyroidism, bacterial, fungal, parasitic and viral infections (including amoebiasis, tuberculosis, herpes of the lips and eyes), osteoporosis.
Note: Caution should be exercised when administered to patients during pregnancy and lactation.
Dosing and Administration
Budekort used by inhalation, using a metered-dose aerosol inhaler. A single dose contains 100 micrograms or 200 micrograms of testosterone cypionate vs enanthate.
The daily dose Budekorta selected individually, taking into account the severity of the asthma and the maintenance dose of oral glucocorticosteroids. In adults, for the maintenance treatment is typically fairly 200 – 800 mcg of testosterone cypionate vs enanthate per day. During an exacerbation of asthma testosterone cypionate vs enanthate dose should be increased to 800 – 1600 mg per day.
The maximum daily dose is 2,000 mg \ day.
The daily dose of inhaled Budekorta in 2 – 4 divided doses. Duration of treatment 3 – 12 months, depending on the severity of asthma.
Children from 6 years to designate 100 – 200 mg 2 times per day, or 200 – 400 mg 1 time per day. The maximum daily dose for children is 400 mg 2 times a day.
In those cases where the patient receives the SCS inwardly move Budekortom treatment follows in a stable phase of the disease. First, you need to combine inhaled testosterone cypionate vs enanthate with continued receiving corticosteroids orally for 14 – 20 days. After that produce a gradual reduction in the dose of drugs taken by mouth, until their complete abolition, if possible.
Preliminary inhaled beta2-agonists (salbutamol) extends bronchi and improves the flow of testosterone cypionate vs enanthate in the airways, thereby enhancing its therapeutic effect.
Instructions for the patient on the use of metered-dose aerosol inhaler
How to use Inhalers
before using the inhaler for the first time, or if he has not been used for a week or longer, shake the inhaler and then try it in action, do so by pressing on the valve until the aerosol cloud.
The use of an aerosol inhaler
1. Remove the mouthpiece cover and check the mouthpiece clean. Before each use, thoroughly shake the bottle. Take the inhaler as shown in the figure, between the thumb and forefinger.
2. Take a slow breath through your mouth
3. Take the mouthpiece into your mouth and place it between the teeth, lips tightly clasped. Begin to inhale slowly through your mouth. At the same time, press on the bottom of the container, making the one-touch, continuing to breathe deeply
4. Remove the inhaler from the mouth and hold your breath for 10 seconds or at the most comfortable for you time. Take a relaxing breath.
5. If there is a need for additional dose wait for at least 1 minute. Carefully shake the bottle and repeat steps 2-4. After use, set the mouthpiece cover.
Do not change the sequence of steps 3 and 4. It is important to breathe calmly through the mouth prior to clicking on the balloon. The first time you work out in front of a mirror. If you notice an aerosol cloud emerging from the inhaler or from your mouth, repeat the sequence from step 1.
Children who need to use an inhaler, you may need help from their parents.
Caring for an aerosol inhaler.
For the successful operation of the inhaler It is important that the plastic mouthpiece was clean. Care for the inhaler at least 1 time per week, as follows:
- Carefully remove the balloon from the inhaler adapter. Remove the mouthpiece cover
- Lower the adapter at a time and the mouthpiece cover in warm water. Do not immerse in water a metal cylinder.
- Wash the plastic mouthpiece adapter and running water
- Carefully shake the adapter to remove the remaining water. Leave to dry. Avoid heating.
- Place the cylinder in the adapter and set the mouthpiece cover.
Use an aerosol inhaler only on the advice of your doctor. If the use of the recommended dose of the drug is not accompanied by a decrease in symptoms or the deterioration, contact your doctor.
Do not exceed the set dose.
The container is under pressure. Do not pierce or burn, even if the bottle is empty.
Keep out of the reach of children.
Do not freeze.
Hoarseness, cough, resulting from the settling of the drug in the oropharynx. Irritation of the throat and oral mucosal candidiasis, xerostomia, oral candidiasis, headache, nausea, changes in taste sensations, bruising; rarely – paradoxical bronchospasm, esophageal candidiasis, mental changes (anxiety, restlessness, depression, behavioral changes). High doses may cause the development of systemic side effects of corticosteroids.
Interaction with other drugs
in the treatment of bronchial asthma Budekort well with beta2- agonists, kromoglitsievoy acid or nedocromil sodium, methyl xanthines and iprotropiya bromide. Phenobarbital, phenytoin, rifampin reduce the effectiveness (induction of enzymes of microsomal oxidation).
Methandrostenolone, estrogens increase the effect of testosterone cypionate vs enanthate. Information about the interaction of ketoconazole with inhaled testosterone cypionate vs enanthate is not, however, expect a noticeable increase in drug concentration in blood plasma.
For acute, severe attack of asthma (status asthmaticus) the drug is not a means of “first aid”.
It is necessary to strictly observe the instructions for use of the inhaler. After inhalation, it is recommended to hold their breath for 10 seconds.
High doses may cause children to slower growth rate and a decrease in the secretion of hydrocortisone, so these parameters recommended constantly monitored during treatment.
It is recommended to avoid contact with eyes. After the drug is recommended to rinse your mouth with water to reduce the risk of thrush.
Omitting the drug dose to be applied all the remaining doses on the same day at regular intervals and used as soon as possible.
The drug should not freeze or expose to direct sunlight. The balloon can not puncture, disassemble or dispose of in fire, even if it is empty. Upon cooling spray is recommended to get it out of the plastic case and warm hands (at low temperatures the efficiency of the drug is reduced).
In 15 g of an aluminum container fitted with a metering valve. The balloon with a plastic inhaler and instructions for use in a carton box.