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Is topical high‐volume budesonide sinus irrigation safe?
Author(s) -
Cai Yi,
Gudis David A.
Publication year - 2018
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26880
Subject(s) - budesonide , medicine , saline , corticosteroid , anesthesia , therapeutic irrigation , surgery
BACKGROUND Chronic rhinosinusitis (CRS) is an inflammatory disease affecting the nasal cavity and paranasal sinus mucosa. Corticosteroids are commonly used for CRS medical management in various formulations, including oral steroids and nasal sprays. In recent years, concentrated budesonide respules added to high-volume saline irrigations have also been adopted in the treatment of CRS patients. The dosing of budesonide used in these concentrated irrigations ranges from 0.25 mg to 2 mg per 240 mL saline irrigation, compared to 64 lg to 400 lg per spray in budesonide nasal spray formulations. However, very little high-volume budesonide irrigation is retained in the sinuses. The concern for increased systemic steroid absorption and associated side effects remains an active area of investigation. Given the increasing adoption of this off-label usage and the higher doses of budesonide used, it is important to examine the safety profile of topical high-volume budesonide irrigation.