布地奈德

用途

• Inflammatory Bowel Disease (IBD) (Clinical Pearl)
• Inflammatory Bowel Disease (IBD) (Clinical Pearl)
• Feline Asthma (Clinical Pearl)

給藥方式

可能的副作用

• Steroid hepatopathy
• HPA-axis suppression
• Hyperadrenocorticism (rare, but risk increases with hepatic dysfunction)

注意事項與禁忌

• Hypersensitivity to budesonide
• Patients with active GI ulcers
• Active systemic infections
• Diabetes mellitus
• Cataracts
• Use with caution in patients with moderate to severe hepatic dysfunction, as they are more likely to develop signs of hypercorticism. Because budesonide suppresses the HPA-axis, animals undergoing stressful procedures (such as surgery) should be considered for exogenous systemic steroid administration. FDA Category C for pregnancy; demonstrated to be embryocidal and teratogenic in rats and rabbits.

藥物相互作用

• CYP3A Inhibitors (e.g., ketoconazole, itraconazole, erythromycin): May decrease the hepatic metabolism of budesonide, leading to increased systemic blood levels and a higher risk of glucocorticoid adverse effects.
• Antacids, H2-blockers, Proton Pump Inhibitors: May increase gastric pH, potentially causing premature dissolution of the enteric coating and reducing the drug's targeted efficacy in the intestines.
• Ketoconazole: Inhibits CYP3A4, significantly increasing systemic budesonide levels and risk of toxicity
• Itraconazole: Inhibits CYP3A4, increasing systemic budesonide levels
• Erythromycin: Inhibits CYP3A4, potentially increasing budesonide levels
• NSAIDs (e.g., Meloxicam, Carprofen): Increased risk of gastrointestinal ulceration and bleeding

常見問題