From the Guidelines
Budesonide is a corticosteroid medication that should be used at a dose of 9 mg once daily for up to 8 weeks to treat inflammatory bowel diseases like Crohn's disease or ulcerative colitis, then tapered to minimize side effects and prevent steroid dependency. The medication works by reducing inflammation through suppression of inflammatory mediators and immune cell activity. For asthma, it's typically administered via inhaler at doses of 180-360 mcg twice daily for adults and 180 mcg twice daily for children. For nasal allergies, the usual dose is 1-2 sprays in each nostril once or twice daily.
Uses of Budesonide
- Inflammatory bowel diseases like Crohn's disease or ulcerative colitis: oral budesonide is prescribed at 9 mg once daily for up to 8 weeks, then tapered 1
- Asthma: administered via inhaler at doses of 180-360 mcg twice daily for adults and 180 mcg twice daily for children
- Nasal allergies: the usual dose is 1-2 sprays in each nostril once or twice daily
- Eosinophilic esophagitis: the dose is typically 1-2 mg swallowed twice daily
Side Effects and Precautions
- Side effects may include throat irritation, oral thrush, hoarseness with inhaled forms, and with higher doses or prolonged use, potential systemic effects like adrenal suppression 1
- To minimize side effects, rinse your mouth after using inhaled forms and follow the prescribed dosing schedule
- Prolonged steroid use (often defined as continuous therapy for more than 3 months) is associated with numerous side effects including increased infection risk, osteoporosis, suppression of the hypothalamic-pituitary-adrenal axis, diabetes, weight gain and cardiovascular disease 1
Preference Over Other Corticosteroids
- Budesonide is preferred over other corticosteroids for many conditions because it has high topical anti-inflammatory activity with lower systemic bioavailability 1
From the FDA Drug Label
Budesonide extended-release tablets are indicated for the induction of remission in patients with active, mild to moderate ulcerative colitis. The recommended dosage for the induction of remission in adult patients with active, mild to moderate ulcerative colitis is 9 mg taken orally once daily in the morning with or without food for up to 8 weeks.
The uses of Budesonide are for the induction of remission in patients with active, mild to moderate ulcerative colitis. The dosage is 9 mg taken orally once daily in the morning with or without food for up to 8 weeks 2. Key points to consider:
- Budesonide extended-release tablets should be swallowed whole and not chewed, crushed or broken.
- Patients should be closely monitored for increased signs and/or symptoms of hypercorticism when taking CYP3A4 inhibitors, such as ketoconazole 2.
From the Research
Uses of Budesonide
- Budesonide is used in the treatment of inflammatory bowel disease, including Crohn's disease and ulcerative colitis 3, 4, 5, 6, 7
- It is effective in inducing remission in active Crohn's disease, particularly in patients with ileal or ileocecal involvement 3, 6
- Budesonide can also be used to treat ulcerative colitis, especially in patients with distal disease 4, 5
Dosages of Budesonide
- The optimal daily dose of budesonide for active Crohn's disease is 9 mg 3
- For maintenance therapy, doses of 3 mg or 6 mg daily have been studied, but the effectiveness of these doses in sustaining remission is unclear 5, 7
- In some studies, budesonide was given in a controlled ileal release preparation, with doses ranging from 1 mg to 3 mg three times a day 6
Efficacy and Safety
- Budesonide has been shown to be effective in inducing remission in Crohn's disease, with response rates similar to those of prednisolone 3, 5
- The drug has a lower impact on serum cortisol levels compared to prednisolone, reducing the risk of systemic corticosteroid-related side effects 3, 5, 6
- Budesonide is generally well tolerated, with few serious side effects or significant corticosteroid-related side effects reported 3, 6, 7