For the as-needed management or prophylaxis of bronchoconstriction and to lessen asthma episodes risk in asthma-affected people (18 years of age and older), the FDA has authorized a beta-2 adrenergic agonist (Albuterol) and corticosteroid (Budesonide) combination on 11 January 2023.

It is the first inhaled corticosteroid (ICS) and short-acting beta-agonist combination to receive approval in the United States. In addition, this is the first ICS-containing medicine to be authorized in the US as an asthma relief treatment (as opposed to a controller). In order to minimize the risk of severe asthma episodes, the medication aims to relax the muscles and mitigate inflammation in lung airways.

As needed for asthma symptoms, it is administered as two oral inhalations of a mixture of 90 mcg Albuterol and 80 mcg Budesonide each inhalation (total dose 180 mcg albuterol and 160 mcg budesonide). In MANDALA, a randomized, double-blind, multicenter research, individuals with moderate to severe asthma were evaluated for their use of  inhalation aerosol to minimize the risk of severe asthma attacks. Participants were randomly allocated to get either 180/160 mcg of Albuterol and Budesonide or 180 mcg of Albuterol, to be taken as needed for asthma symptoms. Participants in the variable-length exacerbation study MANDALA got treatment for at least twenty-four weeks.

The delay to the first severe asthma attack served as the key effectiveness outcome (characterized as deterioration or commencement of asthma symptoms that needed systemic corticosteroids for at least 3 days or an emergency room visit that resulted in usage of systemic corticosteroids for at least 3 days or hospitalization for at least twenty-four hours due to asthma). As measured by time to first severe asthma attack, treatment with Albuterol and Budesonide in patients showed a 28% decrease in the severe asthma attack risk when compared to Albuterol.

The most commonly noted adverse effects were difficulty speaking, oral candidiasis, cough, and headache. Individuals having hypersensitivity to Budesonide, Albuterol, or to any of the additional ingredients must avoid the use of this inhalation aerosol. In a twenty-four-hour period, individuals must take not more than six doses (twelve inhalations). Individuals having ketoacidosis effects, cardiovascular illness, convulsive diseases, hyperthyroidism, and diabetes mellitus must use it with caution.