Drug/Small Molecule:
budesonide

PharmGKB contains no dosing guidelines for this drug/small molecule. To report known genotype-based dosing guidelines, or if you are interested in developing guidelines, click here.

PharmGKB has no annotated drug labels with pharmacogenomic information for this drug/small molecule. If you know of a drug label with PGx, send us a message.

Links to Unannotated Labels

These links are to labels associated with budesonide that have not been annotated by PharmGKB.

  1. DailyMed - DrugLabel PA166105078

PharmGKB contains no Clinical Variants that meet the highest level of criteria.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

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This is a non-comprehensive list of genetic tests with pharmacogenetics relevance, typically submitted by the manufacturer and manually curated by PharmGKB. The information listed is provided for educational purposes only and does not constitute an endorsement of any listed test or manufacturer.

A more complete listing of genetic tests is found at the Genetic Testing Registry (GTR).

PGx Test Variants Assayed Gene?

The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

Gene ? Variant?
(138)
Alternate Names / Tag SNPs ? Drugs ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
No VIP available No Clinical Annotations available VA
rs1042713 148206440G>A, 148206440G>G, 46A>A, 46A>G, 46G>A, 5285A>A, 5285A>G, 9369367G>A, 9369367G>G, ADRB2:16Arg>Gly, ADRB2:Arg16Gly, ADRB2:Gly16Arg, Arg16, Arg16=
G > A
Missense
Arg16Gly
No VIP available CA VA
rs1876828 1065+310C>T, 1107+111C>T, 1194+111C>T, 43911525C>T, 54898C>T, 582+111C>T, 9185677C>T, 955985A>A, 987+111C>T, CRHR1:rs1876828
A > G
Intronic
No VIP available No Clinical Annotations available VA
rs242939 -285+1631C>A, -285+1631C>G, -285+1631C>T, 122-3142C>A, 122-3142C>G, 122-3142C>T, 241+1631C>A, 241+1631C>G, 241+1631C>T, 38952T>A, 38952T>G, 38952T>T, 43895579C>A, 43895579C>G, 43895579C>T, 9169731C>A, 9169731C>G, 9169731C>T, 971962A>A, 971962A>C, 971962A>T, CRHR1:rs242939
A > G
Intronic
No VIP available No Clinical Annotations available VA
rs242941 -404-1310A>C, -404-1310A>G, -404-1310A>T, 122-1310A>C, 122-1310A>G, 122-1310A>T, 122-6202A>C, 122-6202A>G, 122-6202A>T, 35892C>C, 35892C>G, 35892C>T, 43892520A>C, 43892520A>G, 43892520A>T, 9166672A>C, 9166672A>G, 9166672A>T, 975003G>A, 975003G>C, 975003G>G, CRHR1:rs242941
G > T
Intronic
No VIP available No Clinical Annotations available VA
rs28364072 16748T>C, 359281A>G, 618+7T>C, 621+7T>C, 7755285A>G, FCER2:T2206C
A > G
Intronic
No VIP available No Clinical Annotations available VA
rs3752120 -266G>A, 24820239C>T, 52552021C>T
C > T
5' UTR
No VIP available CA No Variant Annotations available
rs37973 -1106G>A, 4503G>A, 7997876G>A, 8007876G>A
G > A
5' Flanking
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 138
2D structure from PubChem
provided by PubChem

Overview

Generic Names
  • budesonide
Trade Names
  • Bidien
  • Budeson
  • Budicort
  • Cortivent
  • Desowen
  • Entocort
  • Entocort EC
  • Micronyl
  • Noex
  • Preferid
  • Pulmicort
  • Pulmicort Nebuamp
  • Pulmicort Respules
  • Pulmicort Turbuhaler
  • Rhinocort
  • Rhinocort Aqua
  • Rhinocort Turbuhaler
  • Rhinosol
  • Spirocort
  • Tridesilon
Brand Mixture Names
  • Entocort Enema 0.02 Mg/Ml (Budesonide + Sodium Chloride)
  • Symbicort 100 Turbuhaler (Budesonide + Formoterol Fumarate Dihydrate)
  • Symbicort 200 Turbuhaler (Budesonide + Formoterol Fumarate Dihydrate)

PharmGKB Accession Id:
PA448681

Description

A glucocorticoid used in the management of asthma, the treatment of various skin disorders, and allergic rhinitis.

Source: Drug Bank

Indication

For the treatment of mild to moderate active Crohn's disease. Also for the treatment of asthma, non-infectious rhinitis (including hay fever and other allergies), and for treatment and prevention of nasal polyposis.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

The exact mechanism of action of budesonide in the treatment of Crohn's disease is not fully understood. However, being a glucocorticosteroid, budesonide has a high local anti-inflammatory effect.

Source: Drug Bank

Pharmacology

Budesonide is a synthetic corticosteroid used in Crohn's disease to decrease the symptoms and inflammation associated with the disease, especially at times of flare up. Budesonide has a high topical glucocorticosteroid (GCS) activity and a substantial first pass elimination. The formulation contains granules which are coated to protect dissolution in gastric juice, but which dissolve at pH >5.5, ie, normally when the granules reach the duodenum. Thereafter, a matrix of ethylcellulose with budesonide controls the release of the drug into the intestinal lumen in a time-dependent manner.

Source: Drug Bank

Food Interaction

A mean delay in time to peak concentration of 2.5 hours is observed with the intake of a high-fat meal, with no significant differences in AUC.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Following absorption, budesonide is subject to high first pass metabolism (80-90%). In vitro experiments in human liver microsomes demonstrate that budesonide is rapidly and extensively biotransformed, mainly by CYP3A4, to its 2 major metabolites, 6b-hydroxy budesonide and 16a- hydroxy prednisolone. The glucocorticoid activity of these metabolites is negligible (<1/100) in relation to that of the parent compound.

Source: Drug Bank

Protein Binding

85-90%

Source: Drug Bank

Absorption

Absorption is complete following oral administration.

Source: Drug Bank

Half-Life

2.0 and 3.6 hours

Source: Drug Bank

Toxicity

Single oral doses of 200 and 400 mg/kg were lethal in female and male mice, respectively. The signs of acute toxicity were decreased motor activity, piloerection and generalized edema.

Source: Drug Bank

Clearance

Source: Drug Bank

Route of Elimination

Budesonide is excreted in urine and feces in the form of metabolites.

Source: Drug Bank

Volume of Distribution

Source: Drug Bank

Chemical Properties

Chemical Formula

C25H34O6

Source: Drug Bank

Isomeric SMILES

CCCC1O[C@@H]2C[C@H]3[C@@H]4CCC5=CC(=O)C=C[C@@]5([C@H]4[C@H](C[C@@]3([C@@]2(O1)C(=O)CO)C)O)C

Source: OpenEye

Canonical SMILES

[H][C@@]

Source: Drug Bank

Average Molecular Weight

430.5339

Source: Drug Bank

Monoisotopic Molecular Weight

430.23553882

Source: Drug Bank

PharmGKB Curated Pathways

Pathways created internally by PharmGKB based primarily on literature evidence.

  1. Glucocorticoid Pathway (Peripheral Tissue), Pharmacodynamics
    Genes involved in mediating glucocorticoid effects at the tissue level in the CNS and in the peripheral tissues including heart, lung, vasculatrue and guts.
  1. Glucocorticoid Pathway - Transcription Regulation, Pharmacodynamics
    Model displaying genes which may be involved in the nuclear complex formed that regulates transcription in response to glucocorticoids.

External Pathways

Links to non-PharmGKB pathways.

  1. chromatin remodeling by hswi/snf atp-dependent complexes - (BioCarta via Pathway Interaction Database)
  2. corticosteroids and cardioprotection - (BioCarta via Pathway Interaction Database)

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

Drug Targets

Gene Description
NR3C1 (source: Drug Bank)

Drug Interactions

Drug Description
itraconazole The imidazole increases levels/effect of budesonide (source: Drug Bank)
itraconazole The imidazole increases levels/effect of budesonide (source: Drug Bank)
ketoconazole The imidazole increases levels/effect of budesonide (source: Drug Bank)
ketoconazole The imidazole increases levels/effect of budesonide (source: Drug Bank)
budesonide The imidazole increases levels/effect of budesonide (source: Drug Bank)
budesonide The imidazole increases levels/effect of budesonide (source: Drug Bank)
budesonide The imidazole increases levels/effect of budesonide (source: Drug Bank)
budesonide The imidazole increases levels/effect of budesonide (source: Drug Bank)
budesonide Telithromycin may reduce clearance of Budesonide. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Budesonide if Telithromycin is initiated, discontinued or dose changed. (source: Drug Bank)
budesonide Tipranavir may increase the plasma concentration of Budesonide. Monitor for toxic Budesonide effects during concomitant administration. (source: Drug Bank)
budesonide Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of budesonide by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of budesonide if voriconazole is initiated, discontinued or dose changed. (source: Drug Bank)

Curated Information ?

EvidenceDisease
No Dosing Guideline available DL CA VA No VIP available No VIP available
Asthma

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
May Prevent
Contraindicated With

Publications related to budesonide: 18

No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Classification of childhood asthma phenotypes and long-term clinical responses to inhaled anti-inflammatory medications. The Journal of allergy and clinical immunology. 2014. Howrylak Judie A, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Inhaled corticosteroid treatment modulates ZNF432 gene variant's effect on bronchodilator response in asthmatics. The Journal of allergy and clinical immunology. 2013. Wu Ann Chen, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Predicting inhaled corticosteroid response in asthma with two associated SNPs. The pharmacogenomics journal. 2012. McGeachie M J, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Association of hypothalamic-pituitary-adrenal axis-related polymorphisms with stress in asthmatic children on inhaled corticosteroids. Neuroimmunomodulation. 2012. Tsartsali Lemonia, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Genomewide association between GLCCI1 and response to glucocorticoid therapy in asthma. The New England journal of medicine. 2011. Tantisira Kelan G, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Nortriptyline reverses corticosteroid insensitivity by inhibition of phosphoinositide-3-kinase-delta. The Journal of pharmacology and experimental therapeutics. 2011. Mercado Nicolas, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
In utero smoke exposure and impaired response to inhaled corticosteroids in children with asthma. The Journal of allergy and clinical immunology. 2010. Cohen Robyn T, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Association between CRHR1 polymorphism and improved lung function in response to inhaled corticosteroid in patients with COPD. Respirology (Carlton, Vic.). 2009. Kim Woo J, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Machine learning methods and docking for predicting human pregnane X receptor activation. Chemical research in toxicology. 2008. Khandelwal Akash, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Influence of CYP3A4, CYP3A5, and ABCB1 genotype and expression on budesonide pharmacokinetics: a possible role of intestinal CYP3A4 expression. Clinical pharmacology and therapeutics. 2008. Ufer M, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Pharmacogenomics and outcome of asthma: no clinical application for long-term steroid effects by CRHR1 polymorphisms. The Journal of allergy and clinical immunology. 2008. Dijkstra Antoon, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Effect of ADRB2 polymorphisms on response to longacting beta2-agonist therapy: a pharmacogenetic analysis of two randomised studies. Lancet. 2007. Bleecker Eugene R, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
FCER2: a pharmacogenetic basis for severe exacerbations in children with asthma. The Journal of allergy and clinical immunology. 2007. Tantisira Kelan G, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Effects of supportive treatment such as antioxidant or leukotriene receptor antagonist drugs on inflammatory and respiratory parameters in asthma patients. Clinical pharmacology and therapeutics. 2007. Tug T, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Corticosteroid pharmacogenetics: association of sequence variants in CRHR1 with improved lung function in asthmatics treated with inhaled corticosteroids. Human molecular genetics. 2004. Tantisira Kelan G, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Identification of a novel glucocorticoid receptor mutation in budesonide-resistant human bronchial epithelial cells. Molecular endocrinology (Baltimore, Md.). 2003. Kunz Susan, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Inhibition of VCAM-1 expression in human bronchial epithelial cells by glucocorticoids. American journal of respiratory cell and molecular biology. 1999. Atsuta J, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
In vitro glucocorticoid receptor binding and transcriptional activation by topically active glucocorticoids. Arzneimittel-Forschung. 1998. Smith C L, et al. PubMed

LinkOuts

Web Resource:
Wikipedia
National Drug Code Directory:
0093-6815-45
DrugBank:
DB01222
ChEBI:
3207
KEGG Drug:
D00246
PubChem Compound:
63006
PubChem Substance:
7847312
Drugs Product Database (DPD):
2241003
Therapeutic Targets Database:
DAP000320
FDA Drug Label at DailyMed:
2414058b-5d39-42f2-915f-03a5e1101ab5

Clinical Trials

These are trials that mention budesonide and are related to either pharmacogenetics or pharmacogenomics.

Common Searches

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Sources for PharmGKB drug information: DrugBank, Open Eye Scientific Software.