Transfer from other glucocorticosteroid therapy may result in symptoms relating to change in systemic steroid levels. Close medical supervision in patients w/ TB, HTN, DM, osteoporosis, peptic ulcer (gastric or duodenal), glaucoma, cataract, family history of diabetes or glaucoma. Patients w/ Crohn's disease of the upper GI tract. Cushing's syndrome, adrenal suppression, growth retardation, decreased bone mineral density, cataract, glaucoma & a wide range of psychiatric/behavioural effects may occur at high doses & for prolonged periods. Regularly perform bone mineral density measurements on patients who are on budesonide for >6 mth. Increased susceptibility & severity to infections; may mask atypical & serious infections (eg, sepsis & TB). Avoid close personal contact w/ chickenpox or shingles for patients w/o history of disease; measles. Do not give live vaccines to persons w/ chronic glucocorticosteroid use. Patients w/ late stage primary biliary & hepatic cirrhosis. Possible visual disturbances; consider referral to an ophthalmologist if patient presents w/ symptoms (eg, blurred vision). Can suppress the response of the hypothalamo-pituitary adrenal axis to stress; supplementary systemic glucocorticoid should be given to patients undergoing surgery or other stresses. Avoid concomitant treatment w/ ketoconazole or other CYP3A inhibitors. Patients w/ rare hereditary problems of galactose intolerance, fructose intolerance, the Lapp lactase deficiency, sucrase isomaltase insufficiency or glucose galactose malabsorption. Regularly monitor ALT & AST levels every 2 wk for the 1st mth of treatment & at least every 3 mth thereafter in patients w/ autoimmune hepatitis. Severe hepatic dysfunction. Pregnancy & lactation. Childn & adolescent 12-18 yr.
Sign Out
