The Pulmicort Turbohaler 400 is a daily preventer inhaler. AstraZeneca UK makes it. Each metered dose contains 400 micrograms of budesonide. Firstly, budesonide is an inhaled steroid. Additionally, it calms the underlying swelling in your airways. As a result, it reduces the twitchiness that causes asthma symptoms. The NHS lists budesonide as a first-line preventer for asthma.
Why the high-strength option matters
The 400 microgram strength is the highest in the Pulmicort range. Meanwhile, the range also includes 100 and 200 microgram versions. In particular, the 400 microgram version suits adults with more severe asthma. Additionally, it works well when lower Pulmicort strengths haven’t held control. Furthermore, 2 puffs a day at 400 micrograms gives a medium ICS dose. As a result, 4 puffs a day pushes into the high ICS dose range.
A preventer, not a reliever
Above all, Pulmicort is a preventer. It works quietly in the background over weeks. However, it will not open your airways quickly during an asthma attack. As a result, always keep a short-acting reliever with you. NICE NG245 makes the reliever-alongside-preventer point clearly.
Key features and specifications
Active ingredient: budesonide 400 micrograms per metered dose
A high-strength steroid preventer for more severe asthma
If your asthma needs a higher daily steroid dose, or you’re stepping up from Pulmicort 200, the Pulmicort Turbohaler 400 is often the next move. Firstly, it delivers 400 micrograms of budesonide per puff. Additionally, it uses the same breath-actuated dry powder device as the lower strengths. . At Courier Pharmacy, we help you make sense of whether this high-strength option fits your control needs.
Five key takeaways
The Pulmicort Turbohaler 400 is the high-strength budesonide preventer in the Pulmicort range.
It’s a breath-actuated dry powder inhaler with a built-in dose indicator.
Budesonide is one of the most-studied inhaled steroids worldwide.
Highest strength steroid in the Pulmicort ranges.
The Pulmicort Turbohaler 400 is a Prescription Only Medicine. A UK-qualified prescriber reviews every request at courierpharmacy.co.uk.
What is Pulmicort Turbohaler 400 inhaler: overview
What makes Pulmicort different
The Pulmicort Turbohaler 400 stands out for one reason above all others. Notably, it contains no additional ingredients.
How budesonide works in the body
Budesonide is a synthetic steroid. Firstly, it binds to steroid receptors inside airway cells. Then, it switches off the genes that produce inflammatory chemicals. As a result, airway swelling reduces over 1 to 2 weeks. Additionally, the airways become less twitchy. Peer-reviewed studies have shown budesonide reduces asthma flare-ups significantly.
The device design and dose indicator
The Turbohaler device is white with a brown base. Meanwhile, a dose indicator window shows how many doses remain. Additionally, it shows a red mark when 10 doses are left in the 50-dose device. As a result, you get a clear signal to reorder before you run out. The Pulmicort Patient Information Leaflet describes this indicator in detail.
Who Pulmicort Turbohaler 400 is licensed for
Pulmicort Turbohaler is licensed for adults, adolescents, and children aged 5 and over. However, the Turbohaler needs a strong steady inhalation. As a result, very young children may not suit this device. Similarly, the 400 microgram strength is typically used in older children and adults. Your prescriber will assess the best device and strength for you.
Why choose Courier Pharmacy for your Pulmicort Turbohaler 400
Registered, independent, and patient-led
Courier Pharmacy is a UK-registered independent pharmacy. The General Pharmaceutical Council regulates us. Firstly, respiratory disease looks different for every patient. Additionally, your triggers, history, and device preferences all matter. As a result, our prescribers ask about those things. Getting your preventer right is about the fit.
Dr Ada Jex-Cori, our brand pharmacist
Our brand pharmacist is Dr Ada Jex-Cori. She represents the spirit of what we do. Named for Ada Lovelace, Sophia Jex-Blake, and Gerty Cori, she stands for evidence-led, unafraid-of-questions medicine. Her message is straightforward. You’re not broken. The system is. We’re here to change that.
Care that keeps showing up
We don’t disappear after we’ve dispensed. Furthermore, if your control shifts, we’re here. Additionally, if a side effect appears, we help you make sense of it. For patients navigating MCAS, chronic fatigue, or fibromyalgia alongside respiratory care, that continuity matters. Care that fits you means care that keeps showing up.
Buy Pulmicort Turbohaler 400 (Prescription Only) from Courier Pharmacy
The Pulmicort Turbohaler 400 is a Prescription Only Medicine. You can request it at courierpharmacy.co.uk. Firstly, complete an online consultation. Then, a UK-qualified prescriber reviews your answers. If approved, we dispense and deliver discreetly.
Complete a quick online consultation
A UK prescriber reviews your answers
If approved, a prescription is issued
We dispense and deliver discreetly to your door
If it isn’t suitable for you, we’ll explain why and suggest the next best option.
Summary
A daily preventer inhaler containing budesonide, a well-established inhaled steroid.
A breath-actuated Turbohaler device with a built-in dose indicator.
Designed for the maintenance of asthma in adults, adolescents, and children aged 5 and over.
Made by AstraZeneca UK, and one of the most-studied ICS medicines worldwide.
Prescription only, and the high-strength option in the Pulmicort range.
Active ingredient in Pulmicort Turbohaler 400 inhaler
Budesonide at a glance
The active ingredient is budesonide. Each metered dose contains 400 micrograms. In particular, budesonide is a synthetic inhaled steroid. It binds to steroid receptors in airway cells and calms the swelling that drives asthma. As a result, the underlying inflammation reduces over weeks.
What is Pulmicort Turbohaler 400 for?
Licensed for asthma maintenance
The Pulmicort Turbohaler 400 is licensed for the maintenance treatment of asthma. In particular, this means using it every day as a preventer. Additionally, it reduces airway swelling over weeks of steady use. As a result, asthma symptoms become less frequent. Furthermore, flare-ups reduce in number and severity.
Where the 400 strength fits in the treatment ladder
At 400 micrograms per puff, this strength suits higher daily dosing. Meanwhile, 2 puffs a day gives a medium ICS dose (800 micrograms). Additionally, 4 puffs a day gives a high ICS dose (1,600 micrograms). As a result, it suits adults with more severe asthma. Furthermore, it also helps patients coming off oral steroids by keeping inhaled cover strong.
When you'll still need a reliever
Pulmicort is not a rescue inhaler. Above all, it won't open your airways fast enough during an attack. As a result, always keep a short-acting reliever like salbutamol with you. However, if you're using your reliever more than 3 times a week, that's a signal. Contact your prescriber for a review.
How does Pulmicort Turbohaler 400 work?
Budesonide calms airway swelling
Budesonide binds to steroid receptors inside airway cells. Firstly, this switches off genes that produce inflammatory chemicals. As a result, airway swelling reduces gradually. Additionally, the airways become less twitchy over 1 to 2 weeks. Think of it as turning down the alarm system in your airways.
How the Turbohaler device fires
In a pMDI, a propellant pushes the medicine out as a spray. However, a Turbohaler has no propellant. Meanwhile, your own airflow draws the powder from the device. As a result, the device only works well with a firm, steady inhalation. Patients with very reduced inspiratory flow may need a different device.
How long until you feel the full effect
You may notice some improvement in the first 3 to 7 days. However, the full anti-inflammatory benefit takes 1 to 2 weeks. Furthermore, maximum control usually shows within 4 to 6 weeks of consistent daily use. As a result, sticking with the daily routine matters. Above all, take it even when you feel well.
What Pulmicort does not do
Pulmicort does not open your airways quickly. Meanwhile, it does not act on airway muscle in the way a reliever does. Instead, it works on the underlying swelling. As a result, it needs time to build up its effect. Furthermore, it needs to keep working with regular use.
How to use Pulmicort Turbohaler 400 inhaler
Step-by-step technique
Firstly, unscrew the white cover. Hold the Turbohaler upright with the brown base pointing down. Then, twist the brown base fully in one direction, then back until it clicks. That loads one dose. Next, breathe out gently, away from the mouthpiece. Now breathe in as hard and deep as you can. The NHS provides an inhaler technique guide for reference.
Mouth care after use
Rinse your mouth and spit afterwards, or brush your teeth. Additionally, inhaled steroids can cause oral thrush or a hoarse voice. Meanwhile, rinsing removes any medicine that hasn't reached your lungs. As a result, this reduces the risk of common side effects. In particular, mouth care matters more at higher steroid strengths.
Storage and dose indicator
Store the inhaler below 30 degrees Celsius with the cover on. Additionally, keep it dry and away from steamy bathrooms. Meanwhile, check the dose indicator regularly. A red mark appears when 10 doses remain in the 50-dose device. As a result, you have notice to reorder.
Warnings and precautions for Pulmicort Turbohaler 400
Who should not use it
Firstly, don't use Pulmicort if you're allergic to budesonide. Additionally, tell your prescriber about any active lung infection, tuberculosis, or fungal chest infection. Similarly, mention any liver or kidney problems. As a result, these conditions may change how the prescriber weighs the treatment decision.
Steroid effects at higher doses
Inhaled steroids can affect the body's natural steroid production. In particular, this matters more at higher doses used for a long time. As a result, the 400 microgram strength carries a slightly higher systemic effect risk than lower Pulmicort strengths. Above all, tell any healthcare team you're on Pulmicort, especially before surgery. Furthermore, you may need a steroid safety card if you're on high daily doses.
Growth in children
Long-term inhaled steroid use can slightly slow growth in children. Additionally, this effect is more relevant at higher doses. However, your prescriber will monitor your child's growth if they're on Pulmicort 400 for a long time. Meanwhile, uncontrolled asthma itself also affects growth. As a result, the benefit of treatment usually outweighs the small growth effect.
Paradoxical bronchospasm
Very rarely, inhalers cause paradoxical bronchospasm. This is when airways tighten straight after use. Firstly, if this happens, stop Pulmicort and use your reliever. Additionally, contact your prescriber urgently. Above all, don't continue with the same inhaler until reviewed.
Pregnancy and breastfeeding
Budesonide has been used widely in pregnancy for many years. Additionally, it is generally considered safe. However, it does pass into breast milk in small amounts. If you're pregnant, planning pregnancy, or breastfeeding, mention it during your consultation.
Side effects of Pulmicort Turbohaler 400
Common side effects
The most common side effects affect up to 1 in 10 people. These include oral thrush, hoarse voice, sore throat, and cough. Meanwhile, mild throat irritation can also occur. As a result, good technique and mouth care reduce these effects. Rinsing your mouth after use helps significantly.
Uncommon side effects
Uncommon side effects (up to 1 in 100) include muscle cramps and tremor. Furthermore, blurred vision and cataract can occur with long-term high-dose use. Additionally, some patients notice bruising more easily. Your prescriber may monitor these effects during regular reviews.
Rare and very rare side effects
Rare side effects (up to 1 in 1,000) include changes in behaviour, anxiety, and sleep problems. Very rare side effects (up to 1 in 10,000) include serious allergic reactions. Additionally, effects on adrenal gland function and reduced growth in children are possible. Above all, high-dose users need periodic review for these effects.
When to seek urgent help
Seek urgent help for sudden worsening breathlessness after a puff. Similarly, seek help for facial swelling or difficulty breathing. Additionally, get help for signs of a severe allergic reaction. Meanwhile, any widespread rash or wheezing after use needs immediate attention.
Yellow Card reporting
You can report any suspected side effects directly via the MHRA Yellow Card Scheme at https://yellowcard.mhra.gov.uk. Reporting side effects helps provide more information on the safety of this medicine.
Drug interactions with Pulmicort Turbohaler 400
CYP3A4 inhibitors
Firstly, strong CYP3A4 inhibitors can raise blood levels of budesonide. In particular, this includes ketoconazole, itraconazole, and ritonavir. Additionally, clarithromycin and telithromycin matter. Meanwhile, this raises the risk of systemic steroid side effects. Above all, this matters more at the 400 microgram strength than at lower doses.
Other steroids
Meanwhile, other steroids can add to systemic effects. Firstly, oral steroids like prednisolone matter. Additionally, injected steroids and topical steroids can also add up. As a result, disclose all steroid use during your consultation. Furthermore, your prescriber will consider the combined dose.
Other airway medicines
Additionally, other inhalers can be used alongside Pulmicort under prescriber guidance. In particular, a short-acting reliever like salbutamol is often used together. However, other ICS-containing inhalers should not be added without review. Above all, tell your prescriber about every medicine you take.
Frequently asked questions about Pulmicort Turbohaler 400 inhaler
How quickly does the Pulmicort Turbohaler 400 work?
You may notice some improvement in the first 3 to 7 days. However, the full anti-inflammatory benefit takes 1 to 2 weeks. Furthermore, maximum control usually shows within 4 to 6 weeks. Stick with it every day, even when you feel well.
Is Pulmicort a preventer or a reliever?
Pulmicort is a preventer. As a result, it works quietly in the background over weeks. However, it will not open your airways during an asthma attack. Meanwhile, always keep a short-acting reliever with you for immediate symptom relief.
What's the difference between Pulmicort 100, 200, and 400?
All three contain budesonide in the same Turbohaler device. However, they differ in strength per puff. Firstly, Pulmicort 100 gives 100 micrograms per puff. Additionally, Pulmicort 200 gives 200 and Pulmicort 400 gives 400. Your prescriber picks based on the daily dose you need.
Is 400 micrograms a high dose?
It depends on how many puffs you take. Meanwhile, 2 puffs a day (800 micrograms total) counts as a medium ICS dose. Additionally, 4 puffs a day (1,600 micrograms total) counts as a high ICS dose. As a result, the 400 strength covers both medium and high daily dosing.
Do I need a steroid safety card with Pulmicort 400?
Possibly. Steroid safety cards are usually recommended for patients on high daily inhaled steroid doses. Additionally, they alert healthcare teams that you may need extra steroid cover in illness or surgery. Above all, ask your prescriber whether you need one on your dose.
Can I stop Pulmicort if I feel well?
No. Pulmicort is a preventer, not a reliever. It works because you take it every day. As a result, stopping it allows swelling to build back up. Speak to your prescriber before any change. Any step-down should be planned, not sudden.
Why do I need to rinse my mouth after use?
Inhaled steroids can cause oral thrush, hoarse voice, or a sore throat. As a result, rinsing removes medicine that didn't reach your lungs. Additionally, it prevents these common side effects. Don't swallow the rinse water.
Does the Pulmicort Turbohaler 400 have a dose counter?
It has a dose indicator rather than a full counter. Meanwhile, this shows roughly how many doses remain. Additionally, a red mark appears when 10 doses remain in the 50-dose device. As a result, you have plenty of warning to reorder before running out.
Can Pulmicort Turbohaler 400 be used in children?
It is licensed for children aged 5 and over. However, the 400 microgram strength usually suits older children and adults. Additionally, lower Pulmicort strengths are often more suitable for younger children. Your prescriber will pick the right strength for your child.
Can I use Pulmicort with a spacer?
No. Spacers only work with pressurised inhalers. A Turbohaler is a dry powder device. It relies on you breathing in strongly through the mouthpiece. As a result, a spacer would prevent it from working correctly.
Can I use Pulmicort during pregnancy?
Budesonide has been widely used in pregnancy for many years. Additionally, it is generally considered safe. However, it does pass into breast milk in small amounts. Above all, mention any pregnancy or breastfeeding during your consultation.
Will Pulmicort 400 affect my adrenal function?
At high daily doses, inhaled steroids can affect the body's natural steroid production. In particular, this matters more with the 400 microgram strength. Meanwhile, your prescriber may monitor this if you're on high doses long-term. As a result, don't stop suddenly without medical advice.
Can Pulmicort cause thrush?
Yes. Oral thrush is a common side effect of inhaled steroids. Additionally, the risk rises with higher steroid strengths. Meanwhile, rinsing your mouth after each use reduces the risk. If you develop white patches in your mouth, tell your prescriber.
Can Pulmicort make me hoarse?
Yes. Hoarseness is a common side effect of inhaled steroids. Above all, it usually settles as your voice adjusts. Additionally, rinsing your mouth after use reduces the risk. If it persists, tell your prescriber.
Can I take Pulmicort 400 once a day?
Some patients on stable doses can move to once-daily dosing. In particular, the Pulmicort SmPC advises taking the once-daily dose in the evening. However, most people on the 400 strength take it twice daily. Your prescriber will guide the best pattern for you.
What happens if I miss a dose?
Take the missed dose as soon as you remember. However, if it's nearly time for the next dose, skip it. Never double up. Consistency over weeks matters more than any single missed puff.
How should I store Pulmicort Turbohaler 400?
Store below 30 degrees Celsius with the cover on. Additionally, keep it dry and away from steamy bathrooms. Never wash the mouthpiece or expose it to moisture. Keep it out of the reach of children. Don't use it past the expiry date.
Will I need a prescription from Courier Pharmacy?
Yes. Pulmicort Turbohaler 400 is a Prescription Only Medicine. A UK-qualified prescriber must review your suitability. You can complete the consultation at courierpharmacy.co.uk.
What if I'm on Pulmicort 400 and still not controlled?
If Pulmicort 400 doesn't hold your control at 4 puffs a day, other approaches may be needed. In particular, add-on therapies like a LABA or biologic treatment may help. Furthermore, this needs specialist review. Discuss any ongoing symptoms with your prescriber for referral if needed.
More than a prescription: our community
Free fortnightly drop-in clinics in Derby
Healthcare shouldn't only happen when you're paying for it. Every fortnight, we run free drop-in talks at Insomnia, Derby, from 12 to 1pm. Anyone can come. No appointment. No cost. No pressure.
Topics we cover
We cover asthma control and inhaler technique. Additionally, we discuss weight management and hormone health. Furthermore, we cover MCAS, chronic fatigue, and more. Learn more about our community talks at courierpharmacy.co.uk.
Disclaimer
Disclaimer: This information is for education only and isn't a substitute for personal medical advice. Always follow your prescriber's instructions.
National Institute for Health and Care Excellence (2024) Asthma: diagnosis, monitoring and chronic asthma management. NICE guideline NG245. Available at: https://www.nice.org.uk/guidance/ng245
