Skip to main content

Bioavailability of Budesonide Delivered by the Clickhaler® and Turbuhaler® Dry Powder Inhalers in Healthy Volunteers

A Pilot Study

Abstract

Objective: To compare the pharmacokinetic profile and bioavailability of budesonide after inhalation from the Clickhaler® dry powder inhaler with the Turbuhaler® as standard.

Design: Randomised, placebo-controlled, double-blind, double-dummy, crossover pilot study.

Subjects: Six healthy adult males aged 19 to 44 years (mean age 28 ± 9 years).

Methods: Each subject received budesonide 1000μg from the Clickhaler® or Turbuhaler® inhaler devices, and oral charcoal was administered to block gastrointestinal absorption. Plasma levels of budesonide and cortisol were determined at timepoints up to 8 hours postdose. Cortisol was also determined 24 hours postdose.

Results: The ratio of the plasma budesonide area under the concentration-time curve (AUC) calculated to 8 hours for the Clickhaler® to Turbuhaler® was 1.17 [90% confidence interval (CI) 0.90 to 1.54], indicating that pulmonary bioavailability was similar following inhalation from the two devices. Likewise, the time to the highest plasma concentration and maximum plasma concentration of budesonide following delivery from the Clickhaler® were similar to those following delivery of budesonide from the Turbuhaler®, with ratios of 0.95 (90% CI 0.51 to 1.77) and 1.14 (90% CI 0.76 to 1.72), respectively. The corresponding ratio for plasma cortisol AUC was 1.03 (90% CI 0.77 to 1.39).

Conclusion: Budesonide Clickhaler® and budesonide Turbuhaler® dry powder inhalers demonstrated similar pharmacokinetic profiles, pulmonary bioavailability and systemic activity. As this was a small pilot study, it was not possible to determine the clinical implications of these results, but they suggest that the Clickhaler® and the Turbuhaler® achieve similar drug delivery.

This is a preview of subscription content, access via your institution.

Table I
Fig. 1

References

  1. Global initiative for asthma. Bethesda (MD): National Institutes of Health, National Heart, Lung and Blood Institute, 1995: Publication no. 95-3659

  2. Hannemann LA. What is new in asthma: new dry powder inhalers. J Pediatr Health Care 1999; 13: 159–65

    PubMed  Article  CAS  Google Scholar 

  3. Newhouse MT, Nantel NP, Chambers C, et al. Clickhaler (a novel dry powder inhaler) provides similar bronchodilation to pressurized metered dose inhaler, even at low flow rates. Chest 1999; 115(4): 952–6

    PubMed  Article  CAS  Google Scholar 

  4. Morice AH, Andrews B, Taylor M. Comparison of the effect on bronchial hyperresponsiveness of beclomethasone dipropionate (BDP) administered via a novel multidose dry powder inhaler (DPI) or a conventional pressurised metered dose inhaler. Respiration 2000; 67(3): 298–305

    PubMed  Article  CAS  Google Scholar 

  5. Brogden RN, McTavish D. Budesonide: an updated review of its pharmacological properties, and therapeutic efficacy in asthma and rhinitis. Drugs 1992; 44(3): 375–407

    PubMed  Article  CAS  Google Scholar 

  6. Ganderton D, Kassem NM. Dry powder inhalers. In: Ganderton D, Jones T, editors. Adv Pharm Sci. London: Academic Press, 1992; 6: 165–91

    Google Scholar 

  7. Derendorf H, Hochhaus G, Mollmann H. Evaluation of pulmonary absorption using pharmacokinetic methods. J Aerosol Med 2001; 14 Suppl 1: S9–11

    PubMed  Article  CAS  Google Scholar 

  8. Parry-Billings M, Boyes RN, Clisby LM, et al. Design, development, and performance of a novel multidose dry-powder inhaler. Med Device Technol 1999; 10(9): 24–34

    PubMed  CAS  Google Scholar 

  9. Thorsson L, Edsbacker S, Conradson TB. Lung deposition of budesonide from Turbuhaler® is twice that from a pressurized metered-dose inhaler P-MDI. Eur Respir J 1994; 7: 1839–44

    PubMed  Article  CAS  Google Scholar 

  10. Pedersen S, Steffensen G, Ohlsson SV. The influence of orally deposited budesonide on the systemic availability of budesonide after inhalation from a Turbuhaler®. Br J Clin Pharmacol 1993; 36: 211–4

    PubMed  Article  CAS  Google Scholar 

  11. Brus R. Effects of high-dose inhaled corticosteroids on plasma cortisol concentrations in healthy adults. Arch Intern Med 1999 Sep 13; 159(16): 1903–8

    PubMed  Article  CAS  Google Scholar 

  12. Lipworth BJ, Seckl JR. Measures for detecting systemic bio-activity with inhaled and intranasal corticosteroids. Thorax 1997; 52: 476–82

    PubMed  Article  CAS  Google Scholar 

  13. Brown PH, Matusiewicz SP, Shearing C, et al. Systemic effects of high dose inhaled steroids: comparison of beclomethasone dipropionate and budesonide in healthy subjects. Thorax 1993; 48: 967–73

    PubMed  Article  CAS  Google Scholar 

  14. Clark DJ, Grove AM, Cargill RI, et al. Comparative adrenal suppression with inhaled budesonide and fluticasone propionate in adult asthmatic patients. Thorax 1996; 51: 262–6

    PubMed  Article  CAS  Google Scholar 

  15. Lindberg C, Blomqvist A, Paulson J. Determination of (22R, S)-budesonide in human plasma by automated liquid chromato-graphy /thermospray mass spectrometry. Biol Mass Spectrom 1992; 21: 525–33

    PubMed  Article  CAS  Google Scholar 

  16. Johansson S-A, Andersson K-E, Brattsand R, et al. Topical and systemic glucocorticoid potencies of budesonide, beclomethasone dipropionate and prednisolone in man. Eur J Respir Dis 1982; 63 Suppl 122: 74–82

    Google Scholar 

  17. Ryrfeldt A, Tonnesson M, Nilsson E, et al. Pharmacokinetic studies of a potent glucocorticoid (budesonide) in dogs by high performance liquid chromatography. J Steroid Biochem 1978; 10: 317–24

    Article  Google Scholar 

  18. Faouzi M, Dine T, Luyckx M, et al. High-performance liquid Chromatographic method for the determination of budesonide in bronchoalveolar lavage of asthmatic patients. J Chromatogr 1995; 664: 463–7

    Article  CAS  Google Scholar 

  19. Padfield PL, Teelucksingh S. Inhaled corticosteroids: the endo-crinologist’s view. Eur Respir Rev 1993; 3(15): 494–500

    Google Scholar 

  20. Warren S, Taylor G. Gamma scintigraphic evaluation of a novel budesonide dry powder inhaler (Clickhaler™). [Abstract.] Pharm Sci 1998; 1(1 Suppl): S208

    Google Scholar 

  21. Kirkpatrick C, Ellis S, Buck H. Hypothalamic-pituitary-adrenal (HPA) axis suppression as a marker of delivery of budesonide: a comparison of two dry powder inhaler (DPI) devices. Eur Respir J 2000; 16(31 Suppl): 278S–9S

    Google Scholar 

Download references

Acknowledgements

The authors gratefully acknowledge the funding support of Innovata Biomed Ltd, Respiratory Division of ML Laboratories PLC. The expert assistance of Jane Mitchell and Laura Baines in the preparation of the manuscript is gratefully acknowledged.

Author information

Affiliations

Authors

Additional information

Use of tradenames is for product identification only and does not imply endorsement.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Godfrey, C., Buck, H. & Ellis, S. Bioavailability of Budesonide Delivered by the Clickhaler® and Turbuhaler® Dry Powder Inhalers in Healthy Volunteers. Clin. Drug Investig. 22, 119–124 (2002). https://doi.org/10.2165/00044011-200222020-00006

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00044011-200222020-00006

Keywords

  • Budesonide
  • Plasma Cortisol
  • Plasma Cortisol Level
  • Beclomethasone Dipropionate
  • Inspiratory Flow Rate