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Covid-19 Primary Care Resources


Treatment with budesonide for acute Covid-19 infection



Inclusion and exclusion criteria and how to prescribe

This information is sourced from the MHRA:

The PRINCIPLE trial has reported a 3-day median benefit in self-reported recovery for patients with Covid-19 in the community setting who received inhaled budesonide. Budesonide is not currently recommended as standard care but can be considered as part of a shared decision. It is anticipated that only a ‘very limited’ number of patients are expected to be eligible for GP treatment with budesonide, NHS England has said.

Inclusion criteria:

  • Aged 65 or over or aged 50 or over with comorbidities (on the flu list)
  • Onset of Covid-19 symptoms within the past 14 days
  • Ongoing symptoms
  • Positive PCR test within the past 14 days

Exclusion criteria:

  • Those admitted to hospital before starting treatment
  • Those who are almost recovered (improving with mild or no symptoms)
  • Those already prescribed inhaled or systemic corticosteroids (people with asthma and COPD should continue using their inhalers as normal)

How to prescribe:

Use Pulmicort Turbohaler 400mcg 2 puffs twice daily (total dose 1600mcg). This should be used for a maximum of 14 days or until the inhaler runs out/symptoms resolve. The following alternative devices for delivering budesonide may be considered:

  1. Pulmicort Turbohaler® 200 micrograms
  2. Budelin Novolizer® 200 micrograms
  3. Easyhaler Budesonide® 400 micrograms
  4. Easyhaler Budesonide® 200 micrograms

Patient information on budesonide inhalers and Covid-19

See Also: PRINCIPLE Trial