Budesonide for Inflammatory Bowel Disease

Aka: Budesonide for Inflammatory Bowel Disease, Rectal Budesonide, Oral Budesonide, Uceris, Enterocort EC

advertisement

II. Indications

  1. Ulcerative Colitis
  2. Crohns Disease
  3. Eosinophilic Esophagitis (off label, viscous suspension)

III. Mechanism

  1. Budesonide (oral, rectal) delivers local steroid primarily to Gastrointestinal Tract
  2. Each Budesonide formulation targets specific regions of the colon
  3. High first pass metabolism of Oral Budesonide significantly limits any Systemic Corticosteroid effects

IV. Dosing

  1. Background
    1. All budesonide forms are expensive ($700 to $1600 in 2023)
    2. Dosing is for adults unless otherwise specified
    3. Decrease dose in severe liver Impairment
  2. Budesonide Rectal Foam (Uceris Rectal Foam)
    1. Delivers 2 mg/actuation (with 14 doses per canister)
    2. Indicated for active disease in distal colon (induction)
      1. Affects only distal colon (last 15 to 20 cm)
    3. Dose
      1. Start 1 actuation (2 mg) twice daily (in am, and at bedtime) for 2 weeks
      2. Next 1 actuation (1 mg) once daily at bedtime for 4 weeks
  3. Budesonide Capsules (Enterocort EC)
    1. Available as 3 mg capsule
      1. May open capsules and sprinkle on soft food
    2. Indicated for active Crohns Disease in right colon (induction)
      1. Affects distal ileum and right colon
    3. Dosing: Adults and children age >= 9 years
      1. Take 9 mg orally daily for 8 weeks
      2. May repeat 8 week course if needed in adults
      3. May finish with taper dose at 6 mg for additional 2 weeks
    4. Dosing: Child age <8 years (off-label)
      1. Give 0.45 mg/kg up to 9 mg orally daily for 8 weeks
  4. Budesonide Extended Release Tablets (Uceris XR Tablets)
    1. Indicated for active disease throughout the colon (induction)
    2. Dosing: Adults and children age >= 9 years
      1. Take 9 mg orally daily each morning for up to 8 weeks
  5. Budesonide Viscous Suspension
    1. Indicated in Eosinophilic Esophagitis
    2. Dose 2 mg orally daily
      1. Decrease to 1 mg orally daily in age <10 years or height <5 feet

V. Safety

  1. Pregnancy Category C
  2. Unknown safety in Lactation

VI. Resources

  1. Budesonide Capsule (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=2c2ce3a8-7125-4ee0-afae-73a9cac8fd31
  2. Budesonide Extended Release Tablet (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=41d4fd39-81ee-41be-b34d-efb12b3a359d
  3. Budesonide Rectal Foam (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=230e4596-2a9b-4d55-b0a0-0cabbcff5289

VII. References

  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  2. (2022) Treatment of Mild to Moderate Ulcerative Colitis, Presc Lett, #350406
  3. (2023) Drugs for Inflammatory Bowel Disease, Med Lett Drug Ther 65: 105-12

Images: Related links to external sites (from Bing)

These images are a random sampling from a Bing search on the term "Budesonide for Inflammatory Bowel Disease." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images

Related Studies

Cost: Medications

uceris (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
UCERIS 2 MG RECTAL FOAM $10.92 per gram
UCERIS 9 MG ER TABLET Generic $28.48 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

advertisement