Budesonide Nasal Spray

How it works

Budesonide is a glucocorticoid that suppresses inflammatory mediators in the nasal mucosa, reducing congestion, rhinorrhoea, sneezing and polyp-related obstruction with limited systemic exposure.

Prescribing in practice

• Local effects such as nasal dryness, irritation and epistaxis are common, and nasal septal perforation has been reported rarely, so correct spray technique aimed away from the septum is important.
• Maximum benefit in allergic rhinitis is achieved with regular continued use rather than occasional dosing, ideally started before the allergen season.
• Prolonged high-dose intranasal corticosteroid use, especially with other steroid routes, carries a small risk of systemic effects, and growth should be monitored in children on long-term treatment.

Monitoring

For long-term use review nasal mucosal health and symptom control, and monitor growth in children receiving prolonged therapy.

Counselling the patient

• Use every day as prescribed for best effect, even when symptoms are mild.
• Aim the spray slightly outward, away from the central wall of the nose.
• Report persistent nosebleeds or crusting.

Evidence & guidelines

Intranasal corticosteroids such as budesonide are first-line treatment for moderate-to-severe allergic rhinitis in NICE and allergy guidance.