Budesonide

Inhaled or oral corticosteroid for IBD in dogs and cats; inhaled form for equine and small animal respiratory disease; high first-pass hepatic metabolism. Corticosteroid with high first-pass hepatic metabolism (>90%). Mechanism: glucocorticoid receptor agonist with high local anti-inflammatory potency → inhibits phospholipase A2, COX, and cytokine synthesis. Extensive first-pass metabolism to inactive metabolites after oral absorption minimizes systemic effects. Available as oral capsules (IBD) and inhaled formulations (respiratory disease). Key information Enteric-coated capsule — do not crush or open. Less systemic absorption than prednisone. Still causes HPA axis suppression with long-term use. Taper on discontinuation. Store at room temperature.

Oral capsules: Administer orally. May be given with food to improve compliance and reduce GI upset. Administer with food to reduce GI adverse effects. Capsules may be opened and contents mixed into food. Do not crush or chew enteric-coated beads if present. Inhaled (equine): use appropriate inhaler device; administer during inspiration. Store at room temperature; protect from light. If a dose is missed Give the missed dose as soon as you remember. If the next dose is due within a few hours, skip the missed dose and resume the regular schedule. Never give a double dose.

GI: vomiting, diarrhea, anorexia. HPA axis suppression (despite high first-pass metabolism — significant suppression documented with prolonged oral use in dogs). PU/PD. Immunosuppression. Adrenal insufficiency risk with abrupt discontinuation after prolonged use.

For animals HPA axis suppression occurs even with oral formulation — monitor with prolonged use. Avoid in pregnant animals. Taper slowly on discontinuation. Avoid live vaccines during therapy. Drug interactions: CYP3A4 inhibitors increase systemic exposure. For people handling this medication Wear gloves when handling. Wash hands thoroughly with soap and water after handling. Inhaled/oral corticosteroid — minimize skin contact. Keep out of reach of children. Pregnant women and women of childbearing age should avoid contact.

Contact your veterinarian. Inhaled or oral corticosteroid overdose causes immunosuppression, GI signs, and adrenal suppression with chronic excess use.