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Budesonide side effects: what 58,545 FDA adverse event reports show

Budesonide · Pulmicort Flexhaler · 1,235 reaction terms · 281,232 drug–reaction co-reports · data 2026-09-14
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Drug class

Corticosteroid

FDA label (Established Pharmacologic Class) · compare the class

Brand names

Pulmicort Flexhaler

openFDA label

Who reports

58,545 reports · 65% serious · 3,687 with death outcome · 59% 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, the active component of PULMICORT FLEXHALER, is a corticosteroid designated chemically as (RS)-11β, 16α, 17,21-Tetrahydroxypregna-1,4-diene-3,20-dione cyclic 16,17-acetal with butyraldehyde. Budesonide is provided as a mixture of two epimers (22R and 22S).

FDA label, Description section

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 (related wording) 5Likely indication confounding 3Reporting / coding artifact 1Lab value / disease marker 3Not in label — unassessed 28
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. 1,195 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 hernia129504.9
385.8–660.8ROR 506.0 · χ² 26,455 / p <1e-300
201.9 EB05 174.3 · IC025 +6.6
3/3 methods agree
Not in label — unassessedserious n=129 · ♀ 0% (drug 59%) · 100% cliniciannot reported in cached trials
Vaginal flatulence165424.3
338.3–532.1ROR 425.5 · χ² 31,416 / p <1e-300
188.8 EB05 165.8 · IC025 +6.7
3/3 methods agree
Not in label — unassessedserious n=165 · ♀ 100% (drug 59%)not reported in cached trials
Spirometry abnormal295364.6
309.9–429.0ROR 366.5 · χ² 52,389 / p <1e-300
177.6 EB05 161.3 · IC025 +6.9
3/3 methods agree
Lab value / disease markerserious n=295 · ♀ 0% (drug 59%)not reported in cached trials
Mite allergy300320.2
274.0–374.4ROR 321.9 · χ² 49,845 / p <1e-300
166.5 EB05 151.2 · IC025 +6.8
3/3 methods agree
Not in label — unassessedserious n=300 · ♀ 0% (drug 59%)not reported in cached trials
Acquired factor v deficiency47262.8
180.1–383.4ROR 263.0 · χ² 6,871 / p <1e-300
142.3 EB05 111.3 · IC025 +5.4
3/3 methods agree
Not in label — unassessedserious n=47 · ♀ 0% (drug 59%) · 100% consumernot reported in cached trials
Total lung capacity abnormal140209.0
169.6–257.5ROR 209.5 · χ² 18,058 / p <1e-300
129.3 EB05 112.3 · IC025 +6.2
3/3 methods agree
Not in label — unassessedserious n=138 · ♀ 0% (drug 59%)not reported in cached trials
Eosinophilic bronchitis74206.9
155.3–275.7ROR 207.2 · χ² 9,423 / p <1e-300
126.5 EB05 104.1 · IC025 +5.7
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=74 · ♀ 100% (drug 59%) · 100% cliniciannot reported in cached trials
Mycotic allergy303201.8
175.2–232.3ROR 202.8 · χ² 38,362 / p <1e-300
127.6 EB05 116.0 · IC025 +6.5
3/3 methods agree
Not in label — unassessedserious n=302 · ♀ 0% (drug 59%)not reported in cached trials
Coagulation factor deficiency55184.5
133.2–255.7ROR 184.7 · χ² 6,468 / p <1e-300
116.6 EB05 93.0 · IC025 +5.4
3/3 methods agree
Not in label — unassessedserious n=55 · ♀ 0% (drug 59%)not reported in cached trials
Dust allergy318176.7
154.5–202.1ROR 177.7 · χ² 36,882 / p <1e-300
117.2 EB05 106.8 · IC025 +6.5
3/3 methods agree
Not in label — unassessedserious n=315 · ♀ 0% (drug 59%)not reported in cached trials
Malignant melanoma stage 055156.3
113.8–214.6ROR 156.4 · χ² 5,770 / p <1e-300
104.7 EB05 83.5 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=55 · ♀ 0% (drug 59%) · 100% cliniciannot reported in cached trials
Bronchopulmonary aspergillosis allergic269149.0
129.2–171.8ROR 149.7 · χ² 27,687 / p <1e-300
104.2 EB05 94.2 · IC025 +6.3
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=269not reported in cached trials
Steroid dependence211118.4
101.3–138.3ROR 118.8 · χ² 18,291 / p <1e-300
88.2 EB05 78.6 · IC025 +6.0
3/3 methods agree
Not in label — unassessedserious n=209 · ♀ 23% (drug 59%)not reported in cached trials
Capillaritis63109.9
82.8–145.8ROR 110.0 · χ² 5,098 / p <1e-300
82.0 EB05 66.3 · IC025 +5.2
3/3 methods agree
Not in label — unassessedserious n=63 · ♀ 0% (drug 59%) · 100% cliniciannot reported in cached trials
Growth failure6887.4
67.0–114.0ROR 87.5 · χ² 4,585 / p <1e-300
68.9 EB05 56.2 · IC025 +5.1
3/3 methods agree
Not in label — unassessedserious n=68 · 100% cliniciannot reported in cached trials
Catarrh16581.5
68.8–96.5ROR 81.7 · χ² 10,592 / p <1e-300
65.9 EB05 57.9 · IC025 +5.5
3/3 methods agree
Not in label — unassessedserious n=165 · ♀ 25% (drug 59%) · 90% cliniciannot reported in cached trials
Ejection fraction10881.1
65.8–100.0ROR 81.3 · χ² 6,882 / p <1e-300
65.4 EB05 55.7 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=108 · ♀ 100% (drug 59%)not reported in cached trials
Laryngeal stenosis10175.9
61.2–94.0ROR 76.0 · χ² 6,078 / p <1e-300
61.9 EB05 52.4 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=101 · ♀ 100% (drug 59%) · 71% consumernot reported in cached trials
Total lung capacity increased4774.2
54.2–101.7ROR 74.3 · χ² 2,745 / p <1e-300
60.1 EB05 47.0 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious n=47 · ♀ 100% (drug 59%) · 100% cliniciannot reported in cached trials
Antineutrophil cytoplasmic antibody positive12574.1
61.1–89.9ROR 74.3 · χ² 7,390 / p <1e-300
60.9 EB05 52.4 · IC025 +5.3
3/3 methods agree
Lab value / disease markerserious n=125 · ♀ 0% (drug 59%)not reported in cached trials
Sensitisation12771.1
58.8–86.1ROR 71.3 · χ² 7,248 / p <1e-300
58.8 EB05 50.7 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=126 · ♀ 100% (drug 59%)not reported in cached trials
Reversible airways obstruction8570.8
56.1–89.3ROR 70.9 · χ² 4,812 / p <1e-300
58.4 EB05 48.7 · IC025 +5.1
3/3 methods agree
Not in label — unassessedserious n=85not reported in cached trials
Vocal cord dysfunction8270.3
55.5–89.1ROR 70.4 · χ² 4,611 / p <1e-300
58.0 EB05 48.2 · IC025 +5.1
3/3 methods agree
Not in label — unassessedserious n=79 · ♀ 100% (drug 59%)not reported in cached trials
Encephalitis cytomegalovirus7069.1
53.5–89.2ROR 69.2 · χ² 3,870 / p <1e-300
57.1 EB05 46.7 · IC025 +5.0
3/3 methods agree
Not in label — unassessedserious n=70 · ♀ 0% (drug 59%) · 100% cliniciannot reported in cached trials
Eosinophilic granulomatosis with polyangiitis27756.9
50.1–64.5ROR 57.1 · χ² 13,043 / p <1e-300
48.9 EB05 44.3 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=277 · ♀ 13% (drug 59%)not reported in cached trials
Neuritis20454.6
47.2–63.3ROR 54.8 · χ² 9,255 / p <1e-300
47.2 EB05 42.1 · IC025 +5.2
3/3 methods agree
Not in label — unassessedserious n=203 · ♀ 0% (drug 59%)not reported in cached trials
Factor v leiden mutation5152.5
39.1–70.5ROR 52.6 · χ² 2,199 / p <1e-300
45.1 EB05 35.7 · IC025 +4.5
3/3 methods agree
Not in label — unassessedserious n=51 · ♀ 0% (drug 59%) · 100% consumernot reported in cached trials
Granuloma skin10149.6
40.3–61.1ROR 49.7 · χ² 4,175 / p <1e-300
43.3 EB05 36.7 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=101 · ♀ 100% (drug 59%) · 100% cliniciannot reported in cached trials
Female genital tract fistula20047.0
40.6–54.5ROR 47.2 · χ² 7,905 / p <1e-300
41.4 EB05 36.8 · IC025 +5.0
3/3 methods agree
Not in label — unassessedserious n=200 · ♀ 100% (drug 59%)not reported in cached trials
Vital capacity decreased5044.6
33.2–59.8ROR 44.6 · χ² 1,853 / p <1e-300
39.1 EB05 30.9 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=50 · ♀ 100% (drug 59%) · 100% cliniciannot reported in cached trials
Full blood count abnormal1,12042.5
40.0–45.2ROR 43.3 · χ² 40,473 / p <1e-300
38.0 EB05 36.2 · IC025 +5.1
3/3 methods agree
Lab value / disease markerserious PRR 44.9not reported in cached trials
Bronchial secretion retention13241.7
34.8–49.9ROR 41.8 · χ² 4,649 / p <1e-300
37.2 EB05 32.2 · IC025 +4.8
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=128 · ♀ 85% (drug 59%)not reported in cached trials
Pulmonary function test abnormal15739.9
33.9–47.1ROR 40.0 · χ² 5,318 / p <1e-300
35.8 EB05 31.4 · IC025 +4.8
3/3 methods agree
Reporting / coding artifactserious n=148 · ♀ 100% (drug 59%)not reported in cached trials
Normochromic normocytic anaemia29639.1
34.7–44.1ROR 39.3 · χ² 9,858 / p <1e-300
35.2 EB05 32.0 · IC025 +4.9
3/3 methods agree
Not in label — unassessedserious n=296 · ♀ 0% (drug 59%)not reported in cached trials
Hypertensive urgency4836.8
27.3–49.5ROR 36.8 · χ² 1,480 / p <1e-300
33.0 EB05 25.9 · IC025 +4.2
3/3 methods agree
Not in label — unassessedserious n=48 · ♀ 0% (drug 59%) · 100% consumernot 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 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
Drug ineffective (drug did not work)6,2831.7
1.7–1.8ROR 1.8 · χ² 1,974 / p <1e-300
1.7 EB05 1.7 · IC025 +0.7Reporting / coding artifactserious PRR 3.0not reported in cached trials
Off label use (used outside approved label)6,0952.5
2.5–2.6ROR 2.7 · χ² 5,814 / p <1e-300
2.5 EB05 2.5 · IC025 +1.3
3/3 methods agree
Reporting / coding artifactserious PRR 2.8not reported in cached trials
Asthma4,81816.0
15.6–16.5ROR 17.4 · χ² 65,328 / p <1e-300
15.4 EB05 15.0 · IC025 +3.9
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 15.4NCT01444430: 36/5,847 (0.6%) on Budesonide (serious AE)
Fatigue (tiredness)3,6201.7
1.6–1.7ROR 1.7 · χ² 1,008 / p 1e-221
1.7 EB05 1.6 · IC025 +0.7Labeled adverse reaction
exact term
serious PRR 1.9not reported in cached trials
Cough3,3124.3
4.1–4.4ROR 4.5 · χ² 8,324 / p <1e-300
4.2 EB05 4.1 · IC025 +2.0
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.3NCT01444430: 1/5,846 (0.0%) on Budesonide (serious AE)
Headache3,2201.8
1.8–1.9ROR 1.9 · χ² 1,278 / p 3e-280
1.8 EB05 1.8 · IC025 +0.8Labeled adverse reaction
exact term
serious PRR 2.3not reported in cached trials
Diarrhoea (diarrhea)2,8641.6
1.5–1.7ROR 1.6 · χ² 655 / p 8e-145
1.6 EB05 1.5 · IC025 +0.6Not in label — unassessedserious PRR 1.9NCT01444430: 1/5,847 (0.0%) on Budesonide (serious AE)
Condition aggravated2,8243.4
3.3–3.5ROR 3.5 · χ² 4,729 / p <1e-300
3.3 EB05 3.2 · IC025 +1.7
3/3 methods agree
Reporting / coding artifactserious PRR 3.9not reported in cached trials
Nausea2,7741.3
1.2–1.3ROR 1.3 · χ² 153 / p 1e-35
1.3 EB05 1.2 · IC025 +0.3Labeled adverse reaction
exact term
serious PRR 1.6not reported in cached trials
Wheezing2,47715.6
15.0–16.2ROR 16.3 · χ² 32,507 / p <1e-300
15.0 EB05 14.5 · IC025 +3.8
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 15.4not reported in cached trials
Malaise (feeling unwell)2,2851.9
1.8–1.9ROR 1.9 · χ² 931 / p 7e-205
1.9 EB05 1.8 · IC025 +0.8Not in label — unassessedserious PRR 1.9not reported in cached trials
Pain2,2161.3
1.2–1.3ROR 1.3 · χ² 148 / p 2e-34
1.3 EB05 1.2 · IC025 +0.3Labeled adverse reaction
exact term
serious PRR 1.5NCT01444430: 2/5,847 (0.0%) on Budesonide (serious AE)

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.

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?

In FDA FAERS, the most frequently co-reported reaction terms for Budesonide are dyspnoea, asthma, fatigue, cough, headache, diarrhoea. 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 have an FDA boxed warning?

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

Do FAERS signals prove that Budesonide 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.