Budesonide nasal (nose) spray is used to treat cold-like symptoms caused by allergic rhinitis. This is an inflammation of the inside of your nose that can be brought on by hay fever. It is also used to reduce swelling and shrink nasal polyps.

Budesonide is a type of medicine called a steroid (or corticosteroid). Corticosteroids are a copy of a substance your body makes naturally. They are not the same as anabolic steroids.

Budesonide nasal spray is available on prescription for adults and children. Adults can buy it from pharmacies and supermarkets.

It can also be used to treat other conditions. Read about:

• budesonide inhalers – for asthma and chronic obstructive pulmonary disease (COPD)
• budesonide tablets, capsules and granules – for inflammatory conditions such as Crohn's disease and ulcerative colitis, and autoimmune hepatitis
• budesonide rectal foam and enemas – for ulcerative colitis

• You need to use budesonide nasal spray regularly for it to work.
• It works by reducing swelling and irritation in your nose.
• The most common side effects are sneezing, nosebleeds and a dry or sore nose.
• Do not give this nasal spray to children under the age of 6 years (unless their doctor has prescribed it).
• If you're pregnant, speak to your doctor or a pharmacist before buying budesonide nasal spray at a pharmacy or supermarket.

Most adults and children aged 6 years and over can use budesonide nasal spray. Occasionally a specialist may prescribe it for a younger child.

Budesonide is not suitable for some people. To make sure this nasal spray is safe for you, tell your doctor if you:

• are allergic to budesonide or any other medicines
• are taking or have recently taken other steroid medicines
• have ever had nose surgery or get heavy or frequent nosebleeds
• have an infection in your nose or eyes
• are pregnant or trying to get pregnant
• have ever had TB (tuberculosis)
• have liver problems
• have ever had glaucoma or cataracts

Budesonide nasal spray needs to be used regularly for it to work.

You'll generally use the spray once or twice a day (once in the morning and once at night). The usual dose is 1 or 2 sprays into each nostril.

Follow the instructions that come with your nasal spray. Do not use more than the maximum number of sprays in 24 hours.

If you're using a new bottle, it will not work the first time you press the spray. Pump the spray a few times until a fine mist comes out. You'll also need to do this if you have not used the bottle for a few days.

Gently shake the bottle and remove the cap.

1. Blow your nose gently.
2. Close 1 nostril by pressing your finger against the side of your nose.
3. Bend your head forward slightly and carefully put the nozzle into your other nostril.
4. Slowly breathe in through your nose and with your fingers press down on the widest part of the nozzle to squirt the spray once into your nostril.
5. Breathe out through your mouth.
6. Follow steps 3 and 4 again to squirt a second spray into the same nostril if you need it.

Repeat the process with the other nostril, if you need it.

After using your spray, wipe the nozzle with a clean tissue and replace the cap.

Will my dose go up or down?

Once your symptoms are under control, you'll be able to use your nasal spray less often. For example, you might go from using 2 sprays to just 1 spray in each nostril in the morning.

If you bought a budesonide nasal spray from a pharmacy, stop using it when you think you no longer need it. Ask your pharmacist for advice if you're not sure when to stop. Do not use it continuously for more than 3 months without speaking to your doctor.

If your symptoms get worse after reducing your dose, you may want to increase it again.

If you have budesonide nasal spray on prescription, your doctor will tell you how often to use the nasal spray and when to change your dose.

What if I forget to use it?

If you forget to use a dose, use it as soon as you remember. Unless it's almost time for your next dose, in which case skip the missed dose and take your next one as usual.

Do not take a double dose to make up for a forgotten dose.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I use too much?

Using too much budesonide nasal spray by accident is unlikely to harm you.

Like all medicines, budesonide can cause side effects although not everyone gets them.

With budesonide nasal spray, very little medicine is absorbed into the rest of the body, so it's not likely to give you serious side effects.

Common side effects

These common side effects can happen in more than 1 in 100 people.

Keep taking the medicine but talk to your doctor if these side effects bother you or do not go away:

• sneezing
• dry or sore nose, or nosebleeds
• dry or sore throat
• unpleasant taste or smell

Serious side effects

Very few people have serious side effects when using budesonide nasal spray.

You are more likely to have a serious side effect if you use budesonide for more than a few months or take a high dose.

Tell a doctor straight away if you get:

• damage to your nose or sores inside your nose
• changes in your eyesight, such as blurred vision or a cloudy lens in the eye – these can be signs of increased pressure in your eyes (glaucoma) or a cataract

Serious allergic reaction

It happens rarely but it is possible to have a serious allergic reaction (anaphylaxis) to budesonide.

What to do about:

• sneezing – this will usually settle down as you get used to the medicine.
• dry or sore nose, or nosebleeds – stop using your nasal spray for a few days, then start again. Speak to your doctor or a pharmacist if these side effects do not go away.
• dry or sore throat – rinsing your mouth out with water or brushing your teeth after you use your nasal spray may help. If this is no better after 7 days ask your doctor for advice.
• unpleasant taste or smell – rinse your mouth with water or have a drink of water after you use your nasal spray.

There's no clear evidence that budesonide will harm your baby. For safety your doctor will only prescribe budesonide in pregnancy if the benefits outweigh the risks. They will prescribe the lowest dose that works for you.

Speak to your doctor or a pharmacist before buying budesonide nasal spray at a pharmacy or supermarket.

For more information about how using a steroid nasal spray might affect you and your baby during pregnancy, read this leaflet on treating allergic rhinitis on the Best Use of Medicines in Pregnancy (BUMPs) website.

Budesonide and breastfeeding

It's generally OK to use budesonide while breastfeeding.

However always check with your doctor or a pharmacist first. Your baby may need extra monitoring if you use a high dose of the nasal spray.

Some medicines and budesonide interfere with each other and this can increase your chances of side effects. It may mean changing your budesonide dose.

Check with a pharmacist or your doctor if you're taking:

• medicines used to treat HIV such as ritonavir or cobicistat
• antifungal medicines such as ketoconazole or itraconazole
• other medicines that contain steroids such as eczema creams, asthma inhalers, tablets, injections, eye or nose drops, and other nasal sprays

Mixing budesonide with herbal remedies and supplements

There's very little information about taking herbal remedies and supplements together with budesonide. Ask a pharmacist for advice.