SYSTEMIC EFFECTS OF 2 NASALLY ADMINISTERED GLUCOCORTICOSTEROIDS

Two topical corticosteroids, budesonide (BUD) and beclomethasone dipro pionate (BDP), both administered as suspensions in water, were investi gated in healthy volunteers regarding influence on cortisol in plasma and urine (U-cortisol) after nasal application. In the first study, si ngle doses of 200, 400, and 800 mu g of BDP and BUD were given at 10:0 0 pm. In the second study, 100, 200, and 400 mu g were given mornings and evenings for 4 days. In the single-dose study, none of the drugs o r doses showed any significant influence on cortisol in plasma. Howeve r, U-cortisol decreased significantly after BUD 400 and 800 mu g. In t he multidose study, U-cortisol values were significantly reduced after all doses of BUD and the highest dose of BDP. The compounds tested sh owed different ability to cause measurable systemic effects after nasa l application. The clinical implication is that the prescriber, when c hoosing a compound, should take the application site into consideratio n and should also be encouraged to find the lowest effective dose.