budesonide (bu DESS on ide)
What is budesonide?
Budesonide is a steroid drug. It works mainly in the intestine to reduce the inflammation of Crohn’s disease. Unlike other steroids (prednisone, cortisone) very little budesonide reaches the bloodstream. Therefore, this drug should cause fewer of the severe side effects usually associated with the use of steroids.
What is it used for?
This drug is used to treat mild to moderate Crohn’s disease of the intestine.
How do I take it?
Budesonide is usually taken in the morning. Swallow whole. Do not crush or chew. Keep all medications away from children. Never share your medications with anyone else.
What do I do for a missed dose?
If you miss a dose of this medicine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and return to your regular schedule. Do not double up on this medicine.
Are there interactions with food or beverages?
Grapefruit and grapefruit juice should be avoided while taking this medication.
Are there interactions with other drugs?
An interaction generally means that one drug may increase or decrease the effect of another drug. Also, the more medications a person takes, the more likely there will be a drug interaction. Always tell your physician all the drugs you are taking.
Interactions may occur with the following:
- ketoconazole (Nizoral)
- itraconazole (Sporanox)
- erythromycin (E-Mycin)
- many AIDS drugs
Is there a problem if I have another disorder or disease?
At times, a drug may have a different or enhanced effect when other diseases are present. At other times, the drug may worsen or effect another disease. With this drug, the following disorders may be a problem:
- chronic liver disease
What about allergies?
People who have known allergies or asthma may be at an increased risk for a reaction from any new medication. The physician should always know a patient’s allergy history. Signs of an allergic reaction are skin rash, hives and itching. Of course, a person should not take budesonide if there has been a previous reaction to this or a similar drug.
What if I’m pregnant, considering pregnancy or breast-feeding?
Most females now know that, if possible, no drug, including alcohol, should be taken during pregnancy or lactation. The potential danger, of course, is an injury to the baby. However, some drugs are much safer than others in this regard. So, the FDA has a grading system for each drug which reflects what is known medically. It ranks. drugs from A, where medical studies show no evidence for danger to the fetus or mother, to B, C, D and X, where the medical evidence indicates that the risk to the fetus outweighs any benefit to the mother. Budesonide is ranked C. Always consult your physician before taking any drug during or when planning pregnancy.
What are the effects on sexual function?
There are no known adverse effects of budesonide on sexual function.
Are there other precautions?
- When budesonide is used to replace other steroids it must be done carefully. Steroids should not be stopped suddenly as an adjustment period is necessary. Follow the physician’s instructions.
- Avoid people with infections such as chicken pox or measles.
- Advise physician of any conditions that suppress the immune system.
- Even though the level of budesonide in the blood is low, it is still there and steroid side effects can occur (although less frequently).These include psychological changes such as depression and insomnia, swelling of the face, and loss of bone (osteoporosis). Rarely severe bone damage may occur in the hip or knee requiring surgery.
- Patients with advanced liver disease or cirrhosis need to discuss the use of budesonide with their physician.
How long is it safe to take budesonide?
The FDA has approved budesonide for use up to 8 weeks. However, other steroids are used much longer than this. Discussion with the physican is required.
How about side effects?
Adverse reactions can occur with any drug, even over-the-counter medications. Some of these are mild such as a stomach upset, which may be avoided by taking the medication with food. Minor reactions may go away on their own but if they persist, contact the physician. For major reactions, the patient should contact the physician immediately.
For budesonide, the following are the observed side effects:
- respiratory infection
- swollen or moon face
- skin striae or markings
- hip or knee pain
A physician’s comment…
Budesonide is a new type of steroid. It acts locally on the intestinal tract in Crohn’s disease, and then gets largely metabolized by the liver before it reaches the main circulation. The hope is that long-term side effects of steroids can thereby be avoided.