budesonide   Click here for help

GtoPdb Ligand ID: 7434

Synonyms: Entocort® | Eohilia® (budesonide oral suspension) | Jorveza® | Pulmicort® | S-1320 | Uceris®
Approved drug Immunopharmacology Ligand
budesonide is an approved drug (FDA (1997), EMA (2018))
Compound class: Synthetic organic
Comment: Budesonide is a glucocorticoid steroid. The INN document specifies that the approved drug consists of a racemic mixture of two epimers, based on the stereocentre of the carbon where the butyl chain meets the rest of the molecule. Our structure does not specify strereochemistry at this point and represents the mixture. The two epimers are represented by CID 40000 and CID 63006.

COVID-19: Results from a Phase 2 clinical trial have shown that a short duration administration of budesonide in the early phase of SARS-CoV-2 infection reduces both the likelihood of needing urgent medical care and time to recovery [5].
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2D Structure
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Physico-chemical Properties
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Hydrogen bond acceptors 6
Hydrogen bond donors 2
Rotatable bonds 4
Topological polar surface area 93.06
Molecular weight 430.24
XLogP 1.91
No. Lipinski's rules broken 0
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Canonical SMILES CCCC1OC2C(O1)(C(=O)CO)C1(C(C2)C2CCC3=CC(=O)C=CC3(C2C(C1)O)C)C
Isomeric SMILES CCCC1O[C@H]2[C@](O1)(C(=O)CO)[C@@]1([C@@H](C2)[C@@H]2CCC3=CC(=O)C=C[C@@]3([C@H]2[C@H](C1)O)C)C
InChI InChI=1S/C25H34O6/c1-4-5-21-30-20-11-17-16-7-6-14-10-15(27)8-9-23(14,2)22(16)18(28)12-24(17,3)25(20,31-21)19(29)13-26/h8-10,16-18,20-22,26,28H,4-7,11-13H2,1-3H3/t16-,17-,18-,20+,21?,22+,23-,24-,25+/m0/s1
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Summary of Clinical Use Click here for help
Used by inhalation to treat asthma and severe chronic obstructive pulmonary disease (COPD). EMA approvals (2014) are for products containing budesonide and formoterol. May be used to treat Crohn's disease (inflammatory bowel disease) [3], inflammatory skin disorders, allergic rhinitis and in an extended release formulation, ulcerative colitis [1]. Symbicort® inhalers contain a fixed-dose formulation of budesonide and the β2-adrenoceptor bronchodilator formoterol.
Oral formulations of this drug were granted EMA orphan disease approval to treat graft-versus-host disease (2006) and eosinophilic oesophagitis (2013). Takeda's oral solution formulation of budesonide (Eohilia®, TAK-721) was FDA approved for the treatment for eosinophilic oesophagitis in February 2024.
In October 2014, the US FDA approved a rectal foam formulation containing budesonide (Uceris®) for the treatment of ulcerative colitis. In the EU, EMA approval for Stada Arzneimittel's micronised budesonide formulation (Kinpeygo, as orally administered capsules), for the treatment of primary immunoglobulin A nephropathy, was issued in 2022.
Mechanism Of Action and Pharmacodynamic Effects Click here for help
Budesonide binds to the glucocorticoid receptor (GR) and the drug-receptor complex translocates to the nucleus and acts as transcription factor for target gene expression. The antiinflammatory actions of budesonide are thought to involve phospholipase A2 inhibitory proteins such as the annexins (aka lipocortins), which control the biosynthesis of the major mediators of inflammation, prostaglandins and leukotrienes. Increased expression of the gene coding for annexin-1 is one of the mechanisms by which glucocorticoids inhibit inflammation.
Clinical Trials
Clinical Trial ID Title Type Source Comment References
NCT04416399 STerOids in COVID-19 Study Phase 2 Interventional University of Oxford 5
NCT04331470 Evaluation of Efficacy of Levamisole and Formoterol+Budesonide in Treatment of COVID-19 Phase 2/Phase 3 Interventional Fasa University of Medical Sciences
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