Budesonide (Oral)

Budesonide is a medication used in the treatment of Crohn's disease, by reducing inflammation within the intestine as well as preventing certain symptoms of the disease.

Overview

Budesonide is a form of medication used in the treatment of Crohn's disease, which is a medical condition in which the patient's body can attack the lining of the digestive tract, which can result in painful symptoms including diarrhea, weight loss, and fever. It is also used as a treatment for Ulcerative Colitis.

This medication belongs to a class of drugs under the name corticosteroids. These types of medications work by decreasing swelling and inflammation, with Budesonide in particular acting on the digestive tract. By reducing swelling, this drug can alleviate the symptoms of Crohn's disease.

When used for Ulcerative Colitis, this medication can provide relief from symptoms and help to establish remission for patients. The oral route of Budesonide is used primarily to treat these conditions, but other forms of this medication, including aspirated forms, can be used for treating conditions such as asthma.

Budesonide is a common short-term treatment for both of these conditions, but is not recommended for a long-term solution for the alleviation of symptoms and physical issues related to these conditions. It is generally only used for a short period of time per treatment, between 8 weeks and three months, before a full evaluation is taken by a professional.

Due to the nature of corticosteroids, patients undergoing treatment with this medication are likely to become immunosuppressed, making them vulnerable to other illnesses and infections.

Budesonide is known by the US brand names Entocort EC and Uceris, or by the Canadian brand Pulmicort or Pulmicort Spacer. The oral version of this medication is available in delayed-release and extended-release capsules or tablets.

Conditions Treated

Budesonide is used as a treatment medication for the following conditions or illnesses:

Type of Medicine

  • Capsule, Delayed Release
  • Tablet, Extended Release
  • Capsule, Extended Release
  • Corticosteroid

Side Effects

As well as the intended and needed effects of Budesonide, this medication can result in other side effects that vary in degrees of seriousness.

Not all, or even not any, of the side effects may occur during the treatment period of this medication. However, should any of the listed side effects occur, it is imperative that the patient should get in contact with a relevant medical professional as soon as possible. Some of the listed side effects may require medical intervention.

Check with a medical professional or expert as soon as possible if any of these side effects happen during treatment:

  • Abdominal or stomach pain
  • Bladder pain
  • Bleeding after defecation
  • Bloody or cloudy urine
  • Blurred vision
  • Bruising easily
  • Bulging soft spot on the head of an infant
  • Burning while urinating
  • Burning, itching, 'crawling', numbness, prickling, tingling feelings or "pins and needles"
  • Change in the ability to see colors, especially blue or yellow
  • Chest pain
  • Chills
  • Colds
  • Convulsions
  • Cough or hoarseness
  • Cough producing mucus
  • Decreased urine
  • Diarrhea
  • Difficult/labored breathing
  • Difficult/painful urination
  • Difficulty when swallowing
  • Feelings of dizziness
  • Prevelent dry mouth
  • Eye pain
  • Fast, irregular, pounding, or racing heartbeat/pulse
  • Feeling of warmth
  • Fever
  • Flu-like symptoms
  • Feelings of discomfort/illness
  • Headache
  • Heartburn
  • Hives, itching, or skin rash
  • Increase in body movements
  • Increased thirst
  • Increased need to urinate during the night
  • Irregular heartbeat
  • Severe or slight Joint pain
  • A loss of appetite
  • Lower back/side pain
  • Changes in mood
  • Aching or painful muscles
  • Nausea/vomiting
  • Feelings of nervousness
  • Numbness/tingling in the feet, hands or lips
  • Pain or discomfort in the chest, upper stomach, or throat
  • Pounding perceived as being within the ears
  • Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • Rectal bleeding
  • Redness of the face, neck, arms, and occasionally, upper chest
  • Runny nose
  • Severe constipation
  • Shakiness in the legs, arms, hands, or feet
  • Shivering
  • Slow/fast feeling heartbeat
  • Constant sneezing
  • Sore or scratchy throat
  • Stomach cramps
  • Increased sweating
  • Swelling of legs and feet
  • Swelling or puffiness of the face
  • Feeling of tightness in the chest
  • Trouble sleeping
  • Uncomfortable swelling around the anus
  • Unusual tiredness/weakness
  • Upper abdominal or stomach pain
  • Waking to urinate at night
  • Weight gain
  • Weight loss

In addition to the side effects that require immediate medical contact, Budesonide can also result in side effects that may be caused by the body adjusting the medication, or are not likely to require immediate medical attention unless they become troublesome to the patient.

The following side effects should not require medical intervention unless they become uncomfortable or worse over time:

  • Accumulation of pus
  • Acid or sour stomach
  • Agitation
  • Belching
  • Blemishes on the skin
  • Blistering, itching, irritation, crusting, or reddening of the skin
  • Bloated or full feeling
  • Change in hearing
  • Changes in vision
  • Cracked, scaly, or dry skin
  • Cracks in the skin at the corners of mouth
  • Difficulty having a bowel movement (stool)
  • Difficulty with moving
  • Dizziness or lightheadedness
  • Ear drainage
  • Earache/pain in the ear
  • Excess air or gas in the stomach or intestines
  • Feeling of constant movement of self or surroundings
  • Hair loss or thinning of the hair
  • Heartburn
  • Increased appetite
  • Increased hair growth, especially on the face
  • Indigestion
  • Lack or loss of strength
  • Loss of memory
  • Muscle pains or stiffness
  • Nervousness
  • Pain/tenderness around the cheekbones or eyes
  • Pain, redness, or swelling of the joints
  • Passing gas
  • Pimples
  • Pinpoint red or purple spots on the skin
  • Pressure in the stomach
  • Problems with memory
  • Redness, swelling, or soreness of the tongue
  • Rounded or moon face
  • Sensation of spinning
  • Skin rash
  • Skin rash, encrusted, scaly, and oozing
  • Sleepiness/unusual drowsiness
  • Soreness or redness around the fingernails and toenails
  • Stomach discomfort, pain, or upset
  • Stuffy nose
  • Swelling of the abdominal or stomach area
  • Swollen joints
  • Uterine bleeding between menstrual periods

Budesonide is not designed to be a long-term medication, and as such side effects may occur if a larger non-prescription dose of this medication is taken, or if it is taken for too long an amount of time for the body. The patient should contact a medical professional as soon as possible is any of the following side effects are observed:

  • Darkening of the skin
  • Bad diarrhea
  • Feelings of dizziness
  • Fainting
  • Increased loss of appetite
  • Experience of mental depression
  • Intense nausea and vomiting
  • Skin rash
  • Unusual tiredness/weakness

Due to the nature of Budesonide, and the fact that it has an active effect on the patients' immune system, it may lower the ability of the patient to fight infections. This can make the patient statistically more likely to get a serious infection, or for any infection present to become worse than it otherwise would. A medical professional should be informed immediately of any sign infection (including a cough, sore throat, fever, chills).

It is not common for Budesonide to trigger an allergic reaction. However, any signs of an allergic reaction to the drug such as hives, swelling of the face, lips, tongue, or throat, or difficulty breathing are present, the patient should try to receive emergency medical attention as soon as possible. Budesonide can cause anaphylaxis as part of an allergic reaction, which requires immediate medical attention and can be fatal if not treated in time.

The most serious symptoms of an anaphylactic reaction to medication can include:

  • Changes in color of the skin of the face
  • Fainting
  • Gasping for breath
  • Hive-like swellings on the skin
  • Puffiness/swelling of the eyelids or around the eyes
  • Very fast but irregular heartbeat or pulse
  • Very fast or irregular breathing

Dosage

Budesonide in oral form is available as a capsule to be taken by mouth. The usual treatment plan of this medication is to take the drug once per day in the morning, at the same time every day. The doctor who diagnoses Budesonide will decide on the course of medication, including the amount and time the patient takes the drug.

The capsules should always be swallowed whole; never split, chewed, or crushed.

Stand dosages for Budesonide are as follows:

Usual Adult Dose for mild to moderate active Crohn's Disease (Acute):

  • Coated capsules
  • 9 mg orally once a day in the morning for up to 8 weeks
  • Course may be repeated for recurring episodes of active disease

This dosage is generally used for the treatment of mild-moderate Crohn's disease that involves the ileum and/or the ascending colon.

Usual Adult Dose for mild to moderate Crohn's Disease (Maintenance):

  • Coated capsules
  • 6 mg orally once a day in the morning for up to 3 months
  • If symptoms are maintained at 3 months into treatment, this dosage will be reduced slowly over time to nothing.

This dosage is generally used for the maintenance of clinical remission from mild to moderate Crohn's disease that involves the ileum and/or the ascending colon, for 3 months minimum.

Usual Adult Dose for mild to moderate distal Ulcerative Colitis:

  • Extended-release tablets
  • 9 mg orally once a day in the morning for up to 8 weeks

This dosage is generally used for the induction of remission where patients are diagnosed with active, mild to moderate ulcerative colitis.

Budesonide is used as a form of control for the symptoms of Crohn's disease, as well as treatment for Ulcerative Colitis, but it will not cure this condition. If the symptoms of Crohn's disease appear to be controlled, the treatment team of the patient may decide to decrease the dosage of Budesonide. After 3 months, a decision may be made to slowly decrease the dose and then stop treatment with this drug.

It is important that the patient should take a missed dose as soon as they remember within a reasonable amount of time. If it is nearly time for their next dose of Budesonide, the patient should instead skip the dose and continue their regular medication schedule. It is important to never take a double dose in order to make up for a missed one as this can result in further issues including potential overdose. If you're unsure if you've taken your medication for that day, do not take a second dose just in case.

If the patient is experiencing any of the following symptoms and believes they have taken more Budesonide than prescribed, then the patient may have taken an overdose and it is critical request emergency medical support as soon as possible:

  • Blurred vision
  • Diarrhea
  • Dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • Indigestion
  • Pain or weakness in the hands or feet
  • Passing of gas
  • Stomach fullness or discomfort
  • Sweating
  • Trembling

Interactions

Many drugs can interact with other medications in the body, whether currently prescribed or taken previously. This interaction can lead to changing effects of medication thanks to reacting substances, and can even cause more side effects that can result in the medication becoming ineffective or harmful to the patient.

Patients and doctors should keep a completely up-to-date record of all medications and drugs currently being used, and those recently used, to prevent issues with drug interaction. This allows a doctor to build a fully realized picture of the whole of the patient's medical history, as well as a record of any current or past reactions to drugs. This may influence the medical professional's decision to prescribe Budesonide as a viable medication.

It's critical that the patient's physician is knowledgeable of every medication within their system, from over the counter drugs to long-term treatment, and makes their doctor aware of their current and recent medication usage.

The following medications can cause a severe interaction when taken with Budesonide, and it is recommended for the patient to get in contact with their healthcare professional urgently if already taking one of these medications:

  • Clarithromycin
  • Erythromycin
  • Indinavir
  • Itraconazole
  • Ketoconazole
  • Nefazodone
  • Nelfinavir
  • Ritonavir
  • Telithromycin

The following medications can cause a moderate interaction when taken with Triamterene, and it is recommended for the patient to content their healthcare professional if already taking one of these medications or if both medications are taken together unintentionally:

  • Aldesleukin
  • Antiplatelet drugs such as Clopidogrel
  • Blood thinners such as dabigatran/warfarin
  • Mifepristone
  • Nsaids such as aspirin/celecoxib/ibuprofen

Certain medications should generally not be used with certain types of foods. In addition, using alcohol or tobacco with certain drugs may also cause interactions to occur. It is important to discuss this with a medical professional prior to taking Budesonide.

Using Budesonide with any or all of the following is usually not recommended, as it can increase the amount of the medication within the body. If used together, a medical professional may offer special directions about the use of this medication with this food type.

  • Grapefruit
  • Grapefruit Juice

The presence of other pre-existing medical conditions may also affect Budesonide's level of effectiveness, or may be the cause other unintended side effects that may or may not cause risk to the patient. Ensure a medical professional is fully informed of your health if you have any pre-existing medical problems, as this medication can make these illnesses recurrent or worse:

Warnings

Before the patient and doctor makes the decision to choose to take Budesonide as a course of treatment, there are several things to be considered.

If the patient is due to undergo any surgery, including but not limited to dental surgery, during the time period they are taking the medication, the medical professional or dentist performing the surgery should be informed that the patient is currently undergoing treatment with this medication to help prevent issues or complications.

If the patient is planning on becoming pregnant, their doctor should be informed prior to the decision to take Budesonide. Should you become pregnant while on the medication, a medical professional should be informed immediately, as the use of Budesonide during pregnancy is not researched fully, and may result in unforeseen issues or problems. Breastfeeding when taking this medication is not recommended, and actively discouraged due to possible harm to the infant as a result as this drug may harm a nursing baby.

Budesonide is not approved for use in patients under the age of 18.

During treatment with Budesonide, it is important for the patient to avoid being around people who have an infection or are otherwise unwell. Call the patient's medical professional as soon as possible for preventive treatment if they are exposed to measles or chicken pox. These illnesses can have serious side effects or can even be deadly in people who are using Budesonide due to the immunosuppressive nature of the medication, which makes patients undergoing this treatment highly vulnerable.

Storage

Budesonide should be stored in the form it is dispensed in, in a tightly closed container, and kept out of reach of children and pets. This medication should be kept away from areas of excess moisture and variable heat (such as bathrooms and kitchens), and kept safe and dry at all times.

Budesonide is dispensed in a tight, light-resistant container and should be kept at a temperature of 25°C (77°F); with temperatures between 15° - 30°C (59° - 86°F) within the acceptable 'room temperature' range suggested for correct storage of this medication.

Extra, unused or not needed drugs should be thrown away in the correct way. This ensures that children, pets, and others cannot take them accidentally, as this can cause harm. However, you cannot flush this or any other medications. The best way to get rid of unused medication is through a medicine take-back scheme. Talk to your pharmacist or a local government department to learn more about the programs offered in the local community.

All medication, including Budesonide, should be kept out of sight of children and pets at all times as a best practice, as many non-dispensed containers are not made to be child-resistant. To save both pets and young children from experiencing poisoning or other medication-related illness caused by taking medication that is not safely stored, always ensure safety caps are kept locked and place the medication in a suitable location after use.

Summary

Budesonide is a medication used to manage the symptoms related to Crohn's disease, including inflammation and pain, as well as an effective treatment for Ulcerative Colitis. Primarily used during active Crohn's disease episodes, it is also used as a way to reduce symptoms during medical remission for the first three months.

This medication is a corticosteroid, which often comes with a side effect resulting in immunosuppression. This means patients taking this medication may be more susceptible to any form of infection, as well as becoming more ill from conditions such as chicken pox, which may be life-threatening.

This medication is available in capsules and tablets, and are recommended to take once a day in the morning. During the course of this medication, it is not recommended to consume anything containing or based off of grapefruit as this can cause complications with medication, including exacerbating its effects.

For patients looking to reduce life-altering symptoms, Budesonide is a recommended medication to help manage Crohn's disease. Though it does not cure this illness, it helps alleviate the symptoms and reduce digestive issues related to this condition.

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Last Reviewed:
December 25, 2017
Last Updated:
April 27, 2018