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Systemic effects of two nasally administered glucocorticosteroids
J A Wihl1, K E Andersson, S A Johansson
1ENT Department, University Hospital, Malmö, Sweden.
Allergy
|June 1, 1997
Summary
Nasal corticosteroids budesonide (BUD) and beclomethasone dipropionate (BDP) can affect cortisol levels. BUD significantly reduced urinary cortisol in single and multiple doses, while BDP showed effects only at higher multiple doses.
Area of Science:
- Pharmacology
- Endocrinology
- Nasal Drug Delivery
Background:
- Topical corticosteroids like budesonide (BUD) and beclomethasone dipropionate (BDP) are commonly used for nasal conditions.
- Systemic absorption and potential HPA axis suppression are concerns with nasal corticosteroid use.
Purpose of the Study:
- To compare the effects of nasal budesonide and beclomethasone dipropionate on plasma and urinary cortisol in healthy volunteers.
- To evaluate dose-dependent systemic effects of these two nasal corticosteroids.
Main Methods:
- Healthy volunteers received single or multiple doses of budesonide (BUD) or beclomethasone dipropionate (BDP) via nasal application.
- Plasma cortisol and urinary cortisol (U-cortisol) were measured to assess systemic effects.
Main Results:
- Single high doses of BUD (400 and 800 micrograms) significantly reduced U-cortisol.
- Multiple doses of BUD reduced U-cortisol at all tested doses.
- Multiple high doses of BDP (400 micrograms) also significantly reduced U-cortisol.
Conclusions:
- Budesonide demonstrated a greater potential for systemic effects (urinary cortisol reduction) compared to beclomethasone dipropionate at equivalent or lower doses.
- These findings highlight the importance of considering the specific corticosteroid compound and its application site when assessing potential systemic effects.
- Prescribers should aim for the lowest effective dose to minimize potential HPA axis suppression.
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