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budesonide vs hydrocortisone

Side-by-side comparison of budesonide and hydrocortisone Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

Drug Class
budesonide Corticosteroid
hydrocortisone Corticosteroid
Type
budesonide Prescription
hydrocortisone Over-the-Counter
Summary
budesonide

Budesonide nasal spray is a steroid medicine. It helps to relieve allergy symptoms like sneezing and runny nose.

hydrocortisone

Hydrocortisone cream helps relieve itching and skin problems. It belongs to a class of drugs called corticosteroids.

What It Treats
budesonide

This medicine temporarily relieves allergy symptoms. It can help with nasal congestion, runny nose, itchy nose, and sneezing. These symptoms may be caused by hay fever or other upper respiratory allergies.

hydrocortisone

This medicine can help with itching, skin irritation, inflammation, and rashes. It can treat eczema, psoriasis, poison ivy, insect bites, and other irritations from soaps or jewelry. It can also relieve external anal and genital itching. Ask your doctor before using it for other conditions.

How It Works
budesonide

Budesonide is a corticosteroid. It reduces inflammation in the nasal passages. This helps to relieve allergy symptoms.

hydrocortisone

Hydrocortisone reduces inflammation, itching, and redness. It works by reducing the activity of the immune system. This helps to relieve discomfort.

Common Side Effects
budesonide
  • Headache
  • Cough
hydrocortisone
  • Rash
  • Itching
FAERS Reports
budesonide
  • Difficulty breathing 6,363
  • Medicine not working 6,020
  • Using the medicine for a purpose it's not approved for 5,695
  • Asthma 4,697
  • Tiredness 3,354
hydrocortisone
  • Using the medicine for something it's not approved for 11,314
  • The medicine did not work 10,321
  • Feeling tired 8,852
  • Pain 7,126
  • Condition got worse 6,709
Serious Warnings
budesonide

The growth rate of some children may be slower while using this product. Talk to your child’s doctor if your child needs to use the spray for longer than two months a year. Do not spray into eyes or mouth. If allergy symptoms do not improve after two weeks, stop using and talk to a doctor.

hydrocortisone

There are no boxed warnings for this medication.

Pregnancy
budesonide

Tell your doctor if you are pregnant or plan to become pregnant. Talk to your doctor about the risks and benefits of using budesonide nasal spray during pregnancy. It is not known if budesonide passes into breast milk.

hydrocortisone

Tell your doctor if you are pregnant or breastfeeding before using this medicine. It is not known if hydrocortisone can harm an unborn baby or pass into breast milk.

Also Compare — Nearby Drugs

How to Read This budesonide vs hydrocortisone Comparison

budesonide is classified in the Corticosteroid drug class, while hydrocortisone sits within the Corticosteroid class. Because both drugs share the same classification, they are often considered interchangeable in theory — but clinical outcomes rarely track that cleanly. Both drugs are split between OTC and prescription status, which affects access and supervision.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, budesonide has 26,129 submissions while hydrocortisone has 44,322. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between budesonide and hydrocortisone — always consult your physician or pharmacist first.

Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.