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Budesonide and Formoterol side effects: what 96,445 FDA adverse event reports show

Budesonide And Formoterol Fumarate Dihydrate · 1,214 reaction terms · 436,104 drug–reaction co-reports · data 2026-09-14
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Drug class

Corticosteroid

FDA label (Established Pharmacologic Class) of the closest related product

Label matched

Budesonide (Pulmicort Flexhaler)

closest FDA label found for this product string; brand list suppressed because the label is a related product, not an exact match

Who reports

96,445 reports · 61% serious · 6,674 with death outcome · 64% female

openFDA FAERS counts, all years, deduplication not applied

Used for

PULMICORT FLEXHALER is a corticosteroid indicated for: • Maintenance treatment of asthma as prophylactic therapy in adult and pediatric patients six years of age or older ( 1 ) Limitations of Use: Not indicated for the relief of acute bronchospasm ( 1 ) 1.1 Treatment of Asthma PULMICORT FLEXHALER is indicated for the maintenance treatment of asthma as prophylactic therapy in patients six years of age or older.

FDA label, Indications and Usage

What it is

Budesonide is a glucocorticoid steroid having a highly oxygenated pregna-1,4-diene structure. It is used mainly in the treatment of asthma and non-infectious rhinitis and for treatment and prevention of nasal polyposis.

PubChem CID 5281004 (ChEBI)

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 1Labeled (related wording) 3Likely indication confounding 5Reporting / coding artifact 3Lab value / disease marker 5Not in label — unassessed 23
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 1,174 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Congenital hiatus hernia89146.1
111.6–191.3ROR 146.2 · χ² 7,528 / p <1e-300
85.6 EB05 71.7 · IC025 +5.5
3/3 methods agree
Not in label — unassessedserious n=89 · ♀ 0% (drug 64%) · 100% cliniciannot reported in cached trials
Reversible airways obstruction200138.6
116.0–165.6ROR 138.9 · χ² 16,480 / p <1e-300
83.8 EB05 74.5 · IC025 +5.9
3/3 methods agree
Not in label — unassessedserious n=200not reported in cached trials
Intentional device misuse1,30589.9
84.3–95.9ROR 91.1 · χ² 80,696 / p <1e-300
63.5 EB05 60.7 · IC025 +5.9
3/3 methods agree
Reporting / coding artifactserious n=304 · 93% consumernot reported in cached trials
Total lung capacity increased7379.1
60.5–103.4ROR 79.1 · χ² 4,049 / p <1e-300
57.2 EB05 47.0 · IC025 +5.0
3/3 methods agree
Not in label — unassessedserious n=73 · ♀ 100% (drug 64%) · 100% cliniciannot reported in cached trials
Vital capacity decreased9961.1
48.8–76.3ROR 61.1 · χ² 4,501 / p <1e-300
47.3 EB05 40.0 · IC025 +4.9
3/3 methods agree
Not in label — unassessedserious n=99not reported in cached trials
Forced expiratory volume decreased57555.2
50.3–60.4ROR 55.5 · χ² 24,255 / p <1e-300
44.0 EB05 41.0 · IC025 +5.3
3/3 methods agree
Lab value / disease markerserious n=566not reported in cached trials
Respiratory gas exchange disorder7050.5
38.9–65.5ROR 50.5 · χ² 2,705 / p <1e-300
40.6 EB05 33.2 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious n=70not reported in cached trials
Forced vital capacity decreased12049.3
40.4–60.1ROR 49.3 · χ² 4,570 / p <1e-300
40.0 EB05 34.3 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=119not reported in cached trials
Obstructive airways disorder1,96746.4
44.2–48.7ROR 47.3 · χ² 71,763 / p <1e-300
38.3 EB05 36.9 · IC025 +5.2
3/3 methods agree
Not in label — unassessedserious PRR 37.0not reported in cached trials
Eosinophil count abnormal12443.2
35.7–52.4ROR 43.3 · χ² 4,220 / p <1e-300
35.9 EB05 30.9 · IC025 +4.7
3/3 methods agree
Lab value / disease markerserious n=121not reported in cached trials
Bronchopulmonary aspergillosis allergic14841.7
35.0–49.8ROR 41.8 · χ² 4,887 / p <1e-300
34.9 EB05 30.4 · IC025 +4.7
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=147not reported in cached trials
Laryngeal stenosis8939.5
31.5–49.5ROR 39.5 · χ² 2,785 / p <1e-300
33.3 EB05 27.9 · IC025 +4.5
3/3 methods agree
Not in label — unassessedserious n=89 · ♀ 100% (drug 64%) · 100% consumernot reported in cached trials
Vocal cord dysfunction7538.3
30.0–49.0ROR 38.3 · χ² 2,278 / p <1e-300
32.4 EB05 26.7 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=73 · ♀ 100% (drug 64%) · 100% consumernot reported in cached trials
Blood immunoglobulin e increased36237.8
33.8–42.3ROR 38.0 · χ² 10,992 / p <1e-300
32.2 EB05 29.5 · IC025 +4.8
3/3 methods agree
Lab value / disease markerserious n=350not reported in cached trials
Respiratory tract inflammation6937.5
29.0–48.4ROR 37.5 · χ² 2,053 / p <1e-300
31.8 EB05 26.0 · IC025 +4.3
3/3 methods agree
Not in label — unassessedserious n=66 · ♀ 100% (drug 64%)not reported in cached trials
Peak expiratory flow rate decreased6537.4
28.7–48.7ROR 37.4 · χ² 1,928 / p <1e-300
31.7 EB05 25.7 · IC025 +4.3
3/3 methods agree
Lab value / disease markerserious n=51 · ♀ 100% (drug 64%)not reported in cached trials
Bronchial wall thickening9432.3
26.0–40.1ROR 32.3 · χ² 2,446 / p <1e-300
28.0 EB05 23.6 · IC025 +4.3
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=94not reported in cached trials
Device misuse16831.1
26.4–36.5ROR 31.1 · χ² 4,242 / p <1e-300
27.2 EB05 23.9 · IC025 +4.4
3/3 methods agree
Reporting / coding artifact100% consumernot reported in cached trials
Lung hyperinflation10630.3
24.7–37.1ROR 30.3 · χ² 2,603 / p <1e-300
26.5 EB05 22.6 · IC025 +4.3
3/3 methods agree
Not in label — unassessedserious n=103not reported in cached trials
Drug delivery system issue22629.6
25.7–34.0ROR 29.6 · χ² 5,455 / p <1e-300
26.0 EB05 23.3 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=63 · 100% consumernot reported in cached trials
Full blood count abnormal1,19327.6
26.0–29.3ROR 28.0 · χ² 27,106 / p <1e-300
24.6 EB05 23.4 · IC025 +4.5
3/3 methods agree
Lab value / disease markerserious PRR 30.9not reported in cached trials
Asthma12,10526.2
25.8–26.7ROR 29.8 · χ² 262,933 / p <1e-300
23.5 EB05 23.1 · IC025 +4.5
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 25.1NCT01444430: 36/5,847 (0.6%) on Budesonide and Formoterol (serious AE)
Allergy to animal11025.4
20.8–30.9ROR 25.4 · χ² 2,278 / p <1e-300
22.7 EB05 19.3 · IC025 +4.1
3/3 methods agree
Not in label — unassessedserious n=101not reported in cached trials
Off label use of device13525.3
21.2–30.3ROR 25.4 · χ² 2,797 / p <1e-300
22.7 EB05 19.6 · IC025 +4.1
3/3 methods agree
Not in label — unassessed100% consumernot reported in cached trials
Sleep disorder due to a general medical condition1,67925.1
23.9–26.4ROR 25.5 · χ² 34,757 / p <1e-300
22.6 EB05 21.7 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious PRR 39.9not reported in cached trials
Perfume sensitivity5825.1
19.1–32.9ROR 25.1 · χ² 1,177 / p 3e-258
22.4 EB05 18.0 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=56 · ♀ 100% (drug 64%) · 100% cliniciannot reported in cached trials
Sputum discoloured96324.6
23.0–26.3ROR 24.8 · χ² 19,511 / p <1e-300
22.1 EB05 21.0 · IC025 +4.3
3/3 methods agree
Not in label — unassessedserious PRR 25.7not reported in cached trials
Dust allergy9724.2
19.6–29.9ROR 24.2 · χ² 1,918 / p <1e-300
21.8 EB05 18.4 · IC025 +4.0
3/3 methods agree
Not in label — unassessedserious n=89not reported in cached trials
Total lung capacity decreased15623.4
19.8–27.6ROR 23.4 · χ² 2,990 / p <1e-300
21.1 EB05 18.5 · IC025 +4.0
3/3 methods agree
Not in label — unassessedserious n=135not reported in cached trials
Sinus polyp5623.3
17.7–30.7ROR 23.3 · χ² 1,057 / p 3e-232
21.0 EB05 16.7 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=53 · ♀ 0% (drug 64%) · 100% consumernot reported in cached trials
Wheezing5,73823.3
22.7–23.9ROR 24.7 · χ² 110,523 / p <1e-300
21.1 EB05 20.6 · IC025 +4.4
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 22.3not reported in cached trials
Breath sounds abnormal47823.2
21.1–25.5ROR 23.3 · χ² 9,153 / p <1e-300
21.0 EB05 19.5 · IC025 +4.2
3/3 methods agree
Not in label — unassessedserious n=438not reported in cached trials
Ejection fraction5522.5
17.0–29.7ROR 22.5 · χ² 1,002 / p 3e-220
20.3 EB05 16.2 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=55 · ♀ 100% (drug 64%) · 100% cliniciannot reported in cached trials
Pulmonary function test abnormal14522.2
18.7–26.3ROR 22.2 · χ² 2,634 / p <1e-300
20.1 EB05 17.5 · IC025 +4.0
3/3 methods agree
Reporting / coding artifactserious n=119not reported in cached trials
Sensitisation6921.4
16.7–27.5ROR 21.4 · χ² 1,203 / p 7e-264
19.5 EB05 15.9 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=68 · ♀ 100% (drug 64%)not reported in cached trials
Bronchial secretion retention10820.2
16.6–24.6ROR 20.2 · χ² 1,785 / p <1e-300
18.5 EB05 15.7 · IC025 +3.8
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=93not reported in cached trials
Bronchiectasis55019.5
17.9–21.3ROR 19.6 · χ² 8,824 / p <1e-300
17.9 EB05 16.7 · IC025 +4.0
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=533not reported in cached trials

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Budesonide and Formoterol as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (1 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Asthma12,10526.2
25.8–26.7ROR 29.8 · χ² 262,933 / p <1e-300
23.5 EB05 23.1 · IC025 +4.5
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 25.1NCT01444430: 36/5,847 (0.6%) on Budesonide and Formoterol (serious AE)
Cough7,9356.3
6.2–6.5ROR 6.8 · χ² 34,937 / p <1e-300
6.2 EB05 6.0 · IC025 +2.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 6.8NCT01444430: 1/5,846 (0.0%) on Budesonide and Formoterol (serious AE)
Drug ineffective (drug did not work)6,8161.1
1.1–1.2ROR 1.1 · χ² 101 / p 4e-24
1.1 EB05 1.1 · IC025 +0.1Reporting / coding artifactserious PRR 1.6not reported in cached trials
Off label use (used outside approved label)5,9101.5
1.4–1.5ROR 1.5 · χ² 963 / p 1e-211
1.5 EB05 1.4 · IC025 +0.5Reporting / coding artifactserious PRR 1.2not reported in cached trials
Wheezing5,73823.3
22.7–23.9ROR 24.7 · χ² 110,523 / p <1e-300
21.1 EB05 20.6 · IC025 +4.4
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 22.3not reported in cached trials
Fatigue (tiredness)5,4101.5
1.5–1.6ROR 1.5 · χ² 982 / p 8e-216
1.5 EB05 1.5 · IC025 +0.6Labeled adverse reaction
exact term
serious PRR 1.9not reported in cached trials
Malaise (feeling unwell)4,6112.3
2.2–2.4ROR 2.4 · χ² 3,396 / p <1e-300
2.3 EB05 2.2 · IC025 +1.1
3/3 methods agree
Not in label — unassessedserious PRR 2.4not reported in cached trials
Headache4,5801.6
1.5–1.6ROR 1.6 · χ² 1,036 / p 1e-227
1.6 EB05 1.6 · IC025 +0.6Labeled adverse reaction
exact term
serious PRR 2.0not reported in cached trials
Nausea4,0061.1
1.1–1.1ROR 1.1 · χ² 40 / p 1e-10
1.1 EB05 1.1 · IC025 +0.1Labeled adverse reaction
exact term
serious PRR 1.4not reported in cached trials
Death3,8091.0
0.9–1.0ROR 1.0 · χ² 6 / p 0.006
1.0 EB05 0.9 · IC025 -0.1
PRR-only: not supported by EBGM or IC
Outcome field, not a reactionserious PRR 0.9NCT01444430: 1/5,847 (0.0%) on Budesonide and Formoterol (serious AE)
Drug dose omission3,6434.8
4.7–5.0ROR 5.0 · χ² 10,816 / p <1e-300
4.7 EB05 4.6 · IC025 +2.2
3/3 methods agree
Reporting / coding artifactserious PRR 5.7 · 88% consumernot reported in cached trials
Intentional product misuse3,5549.2
8.9–9.5ROR 9.5 · χ² 25,101 / p <1e-300
8.9 EB05 8.6 · IC025 +3.1
3/3 methods agree
Reporting / coding artifactserious PRR 5.7 · 90% consumernot reported in cached trials

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Tenofovir disoproxil fumarate ↔ Bone loss.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Budesonide and Formoterol?

In FDA FAERS, the most frequently co-reported reaction terms for Budesonide and Formoterol are dyspnoea, asthma, cough, pneumonia, wheezing, fatigue. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Budesonide and Formoterol have an FDA boxed warning?

No. The FDA label retrieved for Budesonide and Formoterol has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Budesonide and Formoterol causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.