Budesonide Caps

Budesonide capsules contain a corticosteroid designed to act on the lining of the gut rather than throughout the body. Budesonide is a potent anti-inflammatory, and the capsule is built so that it holds back its contents through the stomach and releases them further down, in the small intestine and colon. Most of the dose is then cleared by the liver on its first pass, so far less reaches the general circulation than with prednisolone. That is the whole point of the design: bowel inflammation is treated while whole-body steroid effects are kept lower. Budesonide capsules should not be confused with budesonide inhalers or nasal sprays, which contain the same molecule in a very different form for the lungs and nose.

The UK product information for Entocort CR 3 mg capsules covers the induction of remission in mild to moderate active Crohn's disease affecting the ileum and/or ascending colon, and also microscopic colitis. Budenofalk 3 mg gastro-resistant capsules share those uses and add autoimmune hepatitis. Budesonide is aimed at a flare of that particular part of the bowel; it is not suitable for Crohn's disease of the upper digestive tract, and it is not expected to help symptoms outside the gut, such as joint or skin problems. Because the two UK brands are formulated differently, one should not be swapped for the other without the prescriber's say-so.

This listing offers a single strength, 3 mg, in packs of 30, 60, 90, 120 or 180 capsules, which matches the strength of the UK capsules. The pack of budesonide capsules supplied here is an imported one and is not a UK-licensed product, so the leaflet inside may differ in wording from the UK patient leaflet. Pack size changes only how long the supply lasts; it does not change the amount you are advised to take.

For Crohn's disease in adults, Entocort CR is taken as 9 mg, three capsules, once a day in the morning for up to eight weeks, and its full effect is normally seen within two to four weeks. Budenofalk allows the same 9 mg either as one morning dose or as one capsule three times daily, about half an hour before meals. Capsules are swallowed whole with a glass of water and are never chewed. Treatment should not be stopped abruptly; the dose is tapered over the final couple of weeks. For microscopic colitis, a lower maintenance dose is described. Children are not usually treated with the 3 mg capsules because the data are limited.

Allergy to budesonide or any ingredient rules these capsules out, and Budenofalk is also contraindicated in cirrhosis of the liver. Both capsules contain sucrose, and Budenofalk contains lactose as well, so people with certain rare inherited sugar intolerances should avoid them. Care is advised with tuberculosis, high blood pressure, diabetes, thinning bones, peptic ulcer, glaucoma or cataracts. Steroids can mask infection, and anyone exposed to chickenpox or measles who is not immune should seek advice quickly. Strong CYP3A4 inhibitors such as ketoconazole, itraconazole, clarithromycin and ritonavir can raise budesonide levels sharply and are to be avoided, as is regular grapefruit juice. Carbamazepine and rifampicin can lower its effect. Colestyramine and antacids should be taken at least two hours apart from Budenofalk.

Even with its gut-focused action, budesonide capsules can cause steroid-type effects. The common ones include a rounded, puffy face, indigestion, abdominal pain, headache, muscle cramps, low potassium, palpitations, skin reactions, menstrual changes, and mood or sleep disturbance such as nervousness, irritability or low mood. Eye problems such as blurred vision, glaucoma and cataract are less common. Tell your GP about anything persistent or distressing, and call 999 or go to A&E for a severe allergic reaction. Whether budesonide suits you, which brand of budesonide capsules and for how long, is a decision for your prescriber.