Reviewed by Dr Simon Rowley, Dr Innes Asher, Dorothy Cooper
September 1996
Dose and Pharmacology Newborn Drug Protocol Index Newborn Services Home Page

Management of Administration Of Nebulised Budesonide




  1. Ensure nebuliser bowl is in working order.
  2. Budesonide is diluted in NS. Make up to 4 ml.
  3. Budesonide may be administered in the same nebuliser as salbutamol, ipratropium, or sodium cromoglycate if administration times coincide. (It is not recommended to mix sodium cromoglycate and ipratropium nebuliser solutions). Ensure total volume is made up to 4ml with NS. Mix immediately prior to use. Discard if any turbidity or precipitation occurs.
  4. Nebulisation via a ventilator circuit:
  1. Nebulisation via a mask:
  1. Avoid the aerosol reaching the eyes.
  1. Do NOT leave wet aerosol on face. Have a wet cloth ready to wipe the face thoroughly at the end of nebulisation.
  2. Thoroughly clean nebuliser immediately after use. Budesonide is sticky and will clog the nebuliser up for the next time. Wash in warm water and detergent; rinse and drain dry. Store dry in covered container. Soaking in sodium hypochlorite solution is not recommended.
  3. Change nebuliser weekly and PRN.

Observation and Documentation

  1. Assess for signs of side effects.
  2. Monitor SaO2 during administration of budesonide.
  3. Continue to provide oxygen and ventilatory support as appropriate.
  4. Ensure ventilator pressure remains unchanged during nebulisation.
  5. Document patient response to therapy.
  6. Monitor for signs of infection.


Selected References

1 Prescribing information (product disclosure) Astra (Sweden).
2 Heel R, Stanaway L (eds) New Ethicals Compendium. Detailed prescribing information. Auckland Adis Press 1988; p982-983.
3 Hughes B. Pharmacist GL/NWH. Letter April 1994.
4 Asher I. Guidelines for use of budesonide nebulising solution. Starship Children's Health. April 1994.
5 Goth's Medical Pharmacology. Clark WG, Brater DC, Johnson AR. The Mosby Company 12th Ed 1988; p791.