Morning everyone!

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. 

In this Note I want to talk about something that has been very useful over the last two years with Covid, in fact each of my family members have benefited from using it, and that is NEBULIZED BUDESONIDE. 


What is a Nebulizer? 


A nebulizer delivers medication down into the lungs. It’s basically a compressor machine that turns a liquid into an aerosol. It’s not just for kids with asthma. It’s for everyone, all ages, for many types of illnesses. 


Handheld or Nebulizer? 


The hand held is obviously more portable, but in general the medications get into your lungs better with a nebulizer. With handhelds only about 5% of people use them correctly. They just squirt the medication into their mouth and it never gets into the lungs. There is some coordination required. I recommend getting a spacer, which helps a lot. Kids under 5 need to use nebulizers. They usually require a face mask instead of a mouth piece. 


What is Budesonide? 


Budesonide is a corticosteroid (cortisone-like medicine) that works by preventing inflammation (swelling) in the lungs. Most often it is used for asthma in kids and adults. Pulmicort is the brand name.


Why Nebulized Budesonide? 


Reason 1: Nebulized Budesonide has a lot less side effects with the inhaled steroid because it’s not systemic. It doesn’t raise your blood sugars like prednisone can, which is another one of the great tools that we have to treat Covid.  

As you know, Covid is an infection of your lungs. You need to be proactive in making sure it doesn’t react in your lungs causing over inflammation (called the cytokine storm) thereby causing blood clots. So you want to tampen that down. I use nebulized budesonide early, sometimes along with other inhaler medications. 

Note: With Covid you want to attack it from all angles. From Ivermectin to Zithromax, Fluvoxamine, high dose vitamins, nebulized budesonide, even to steroids like Prednisone. Nebulized Budesonide is certainly one of my front line treatments. 

Reason 2: You can use Nebulized Budesonide with other inhalation medications, such as Albuterol. Most have a hand held for this. When you use this in combination with nebulized budesonide you want to use the Albuterol first (around 5 minutes before nebulizer treatment). This opens up the bronchial tubes so the inhaled steroid will get in better. You can even mix albuterol and the budesonide and inhale the mixture. 

Reason 3: You can also use a nebulizer with sterile saline to thin mucus out, as well as deliver antibiotics through it. 

Note: Atrovent is another bronchodilator. People with emphysema mostly use this. It works by relaxing the muscles around the bronchial tubes. This is not a rescue inhaler like Albuterol.  


How To Use Nebulized Budesonide


I’ve found this treatment to be a total game changer with Covid. It can really turn patients around.

Here is the step by step process for using Nebulized Budesonide: 


  • Wash your hands before you start. 


  • Hook the compressor into an outlet. 


  • Put the budesonide down into the chamber. 


  • Breathe in and out through your mouth to get it down into your lungs. I coach patients to try and take a deep breath for 10 seconds to really make sure it gets down there. 


  • Do this until the budesonide in the chamber is empty (it will start to sputter). 


  • After the treatment is done go to a sink and rinse your mouth out. 


  • Clean the machine after each use. 


  • Reattach the machine and turn it back on to dry it out. 


You can do this twice a day for mild Covid. For more severe cases you can do this up to 4 times a day. REMEMBER TO WASH YOUR HANDS BEFORE YOU START! 

Nebulized budesonide is an amazing and potent anti-inflammatory. It works great for the croup in kids as well as for any bronchial infection. If you are being proactive for Covid, I highly recommend that you get a nebulizer for your Covid Box and be ready for this game-changer treatment when you need it. .  

Note: A lot of times the most difficult thing to get when testing positive for Covid is the nebulizer. You can order it on Amazon, or try getting it from your favorite pharmacy. Many are stocking them.