Systemic effects eg, hypercorticism & adrenal suppression may occur. Monitor patients transferred from glucocorticosteroid treatment w/ high systemic availability to those w/ lower systemic availability (eg, budesonide) for symptoms of steroid w/drawal. Glucocorticosteroids should be used w/ caution in patients w/ active or quiescent TB infection, untreated fungal, bacterial, systemic viral or parasitic infections, or ocular herpes simplex. Monitor patients w/ infections, HTN, DM, osteoporosis, peptic ulcer, glaucoma or cataracts, or w/ a family history of diabetes or glaucoma, or w/ any other condition where use of glucocorticosteroids may be associated w/ an increased risk of adverse effects. Risk of visual disturbance. Avoid concomitant treatment w/ potent CYP3A4 inhibitors, including ketoconazole & cobicistat-containing products. Avoid regular ingestion of grapefruit or its juice w/ Nefecon administration. ACTH stimulation test for diagnosing pituitary insufficiency might show false results. Should not be taken by patients w/ rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrose-isomaltase insufficiency. Safety & efficacy in patients w/ hepatic impairment have not been studied. Monitor patients w/ moderate hepatic impairment (Child-Pugh class B) for increased signs &/or symptoms of hypercorticism. Do not use during pregnancy unless woman's clinical condition requires budesonide treatment. Discontinue breast-feeding or discontinue/abstain from therapy. Safety & efficacy in childn & adolescents <18 yr have not yet been established.
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