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Having Cough And Nose Block When A Dose Of Budecort Is Skipped. Is The Child Dependent On Budecort?

Posted on Fri, 22 Nov 2013

Question: hi my son is 7 years old and I have been prescribed to give him budecort twice a day which i am giving regularly from more than 3 months now. and before that also ocassionally since two years..but now the moment i reduce to once or make it irregular his nose gets filled up and he starts to cough.. has my child got dependent on it? and are there any side effects for prolonged use? i hear that his immunity would not get developed because of this

Answered by Dr. Satyadeo Choubey (43 minutes later)

Brief Answer: Probably asthma is not fully controlled Detailed Answer: Hi, Thanks for your query. Budesonide(budecort) is not a habbit forming drug ...so relax. Because your child happens to be symptom free on this medication, he seems of having asthma, may be partially controlled. You may double the dose of steroid to 200 (if taking 100). or else add montelukast to his current medication. Once his symptom increases you may use salbutamol inhaler. In asthma tretament, inhalation technique is of utmost importance especially in children. So do monitor that and if hand- mouth co-ordination is not good you may use a spacer. This is one of the commonest cause of treatment failure. Allergens especially tobacco smoke, exposure to cold air, viral infections, house dust mites, animals with fur like cats and dogs, cockroaches, Indoor and outdoor molds are known factor for difficult to control asthma. Don't be tense of side effect of budesonide as the doses are too low in inhalers (in micrograms) and also is not systemically absorbed too much in blood to cause side effects... Try these and if possible get your child tested with a chest specialist of your area where a simple breath test called spirometry can be done for the diagnosis. You may also use a device called peakflow meter at your home to know the level of control at home itself.... Best wishes

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Satyadeo Choubey (7 hours later)

Hi doc, Thanks for detailed answer. I forgot to mention that he takes Montair - 4 also along with this prescribed treatment. We are using Peak-flows to calculate. He usually blows 190-200 (his weight is 18.9 Kg and height is 121 cm) We use spacer but i feel that Nebulizer is more effective. could this be the case. Is the dosage more in Nebulizer than the puff? Also is it really a bad idea to stop budecort or reduce on my own when I feel he is doing ok? Is there any relation with his septicemia and Allergies? I have also noticed that sometimes he suddenly gets fever and although he is just ok his nose immediately gets clogged with mild cough. This happens so sudden that it is difficult to tell the reason.. Doctors say that it is simple viral fever. Although now it happens once a year around october. His Septicemia also was in October. Not sure if there is any relation with these months when the weather is changing.....The reason I wanted to bring this was that is there any bacteria in his body that gets activated on some trigger? As the fever subsides by in 3-4 days with simple crocin. His clogged nose stays for long and i have to start the budecort again. Thanks XXXX

Answered by Dr. Satyadeo Choubey (47 minutes later)

Brief Answer: Get an ENT examination for presence of polyp/adeno Detailed Answer: Thanks for follow up Asthma in 50% has concomitant allergic rhinitis with the symptoms of frequent cough and cold, running nose, sneezing etc. Any respiratory problem exacerbates in winters, reason being, change in ambient environmental temperature leads to increased airway re-activity and also respiratory viruses are especially active in cold weather. If viral infection is not taken care of properly, will lead to super-added bacterial infection and increased ailment. Get an ENT expert examination of your child to ascertain if he is having nasal polyps or adenoids, which are fairly common in children and present with similar symptoms. Do continue with budecort and do not stop or change the frequency without consulting a doctor. you can use saline nebulisation when his nose is clogged. Both nebulisation and inhalers are equally effective and dose reaching the airways is essentially almost same. Use spacer if hand mouth co-ordination is not proper... Best wishes

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Satyadeo Choubey (24 minutes later)

Hi Doc, Thank you so much. I hope I am not overwhelming you with my info and questions... But your advise is turning out to be very very helpful and I want to get the myths out of my head. Please review the reports of a few test that I got done: X-RAY SKULL for PNS(water's view) and NASOPHARYNX Lateral View for Adenoids X-RAY Chest P.A. View

Answered by Dr. Satyadeo Choubey (46 minutes later)

Brief Answer: Report not much serious Detailed Answer: Well, thanks for follow up, I went through the xray and reports. But they are 1 year old and depicting only mild abnormality which is expected in this scenario......nothing seems serious. Many thing can change over a span of 1 year. You can get him seen by ENT specialist in a govt. hospital for adenoids and turbinates.... Regards

Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Shanthi.E