A nasal wash containing the corticosteroid budesonide appears to reduce symptoms of chronic rhinosinusitis without suppressing the function of the adrenal glands, a known complication of this type of drug that would indicate absorption throughout the whole body, according to a report in the March issue of Archives of Otolaryngology-Head & Neck Surgery.
Chronic rhinosinusitis-a persistent inflammation of the nose and sinuses behind the nose-affects up to 14 percent of the U.S. population, according to background information in the article. An aqueous nasal spray containing budesonide has been shown to be safe and have a benefit for those with chronic rhinosinusitis and recurring allergies. The medication is also available in respules-small, plastic liquid-containing devices that can be opened and mixed with saline to produce a nasal wash. According to the authors, no previous studies have been conducted to demonstrate the safety of such a preparation.
Neil S. Sachanandani, B.S., and colleagues at the Washington University School of Medicine, St. Louis, assessed the effects of budesonide on adrenal function in nine patients between 2005 and 2006. Participants were instructed to use a nasal wash composed of 0.25 milligrams of budesonide and 5 milliliters of saline in each nostril once daily for 30 days. At clinic visits before and after the treatment period, participants completed a questionnaire assessing their rhinosinusitis symptoms and related quality of life. Their cortisol levels were measured after injection with cosyntropin, a compound that stimulates the release of cortisol by the adrenal glands-a standard method of testing adrenal function.