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Symptoms of overdose: The acute toxicity of budesonide is low. Chronic use in excessive doses can result in systemic glucocorticosteroid effects, such as increased susceptibility to infection, hypercorticism and adrenal suppression. Atrophy of the adrenal cortex can occur and the ability to adapt to stress can be impaired.
Therapeutic management of overdose: For acute overdosage, even in excessive doses, is not expected to be a clinical problem. The treatment with inhaled budesonide should be continued at the recommended dose to control asthma. HPA axis function recovers in a few days.
In stress situations, it may be necessary to administer corticosteroids as a precaution (eg high doses of hydrocortisone). Patients with adrenocortical atrophy are regarded as being steroid-dependent and must be adjusted to the adequate maintenance therapy of a systemic corticosteroid until the condition has stabilised.
