From the Guidelines
Entocort, a brand name for budesonide, is recommended for the induction of clinical remission in patients with active mild-to-moderate Crohn’s disease limited to the ileum and/or ascending colon, as well as for patients with mild to moderate ulcerative colitis who have failed or are intolerant to 5-ASA therapy, at a standard dosage of 9 mg taken once daily in the morning for up to 8 weeks, followed by a gradual reduction to maintain remission 1.
Key Points
- Entocort works through its anti-inflammatory properties, reducing inflammation in the intestinal tract.
- Unlike traditional corticosteroids, Entocort has a high first-pass metabolism in the liver, which means it has fewer systemic side effects while maintaining effectiveness in the gut.
- Common side effects may include headache, nausea, respiratory infections, and abdominal pain.
- Patients should take this medication with food and swallow the capsules whole without crushing or chewing them to preserve the special coating that targets drug release to the intestines.
- If you're prescribed Entocort, don't stop taking it suddenly without medical supervision, as this can cause withdrawal symptoms.
Usage and Dosage
- The standard dosage for active Crohn's disease is typically 9 mg taken once daily in the morning for up to 8 weeks, followed by a gradual reduction to maintain remission, usually 6 mg daily for 2 weeks and then 3 mg daily for 2 weeks 1.
- For ulcerative colitis, Entocort can be used as an alternative to conventional steroids, with a dosage of 9 mg daily for up to 8 weeks 1.
Important Considerations
- Entocort is not recommended for maintenance therapy due to the potential for corticosteroid-related adverse effects 1.
- Patients with extensive ulcerative colitis may not benefit from Entocort, as the medication is more effective for left-sided disease 1.
From the FDA Drug Label
Budesonide extended-release tablets are a glucocorticosteroid indicated for the induction of remission in patients with active, mild to moderate ulcerative colitis. The FDA drug label does not answer the question about Entocort.
From the Research
Entocort (Budesonide) Overview
- Entocort, also known as budesonide, is an oral corticosteroid used in the management of active Crohn's disease and ulcerative colitis in adults 2, 3, 4.
- It has a high degree of topical activity and low systemic bioavailability, making it a favorable option for treating inflammatory bowel disease with reduced side effects 2.
Efficacy in Crohn's Disease
- Budesonide has been shown to be effective in inducing remission in patients with active, mild to moderate Crohn's disease, with similar efficacy to prednisolone and superior to mesalazine slow release 2.
- It is particularly effective in treating Crohn's disease involving the ileum and/or ascending colon 2.
Efficacy in Ulcerative Colitis
- Budesonide MMX, a novel formulation, has been found to be effective and safe in inducing clinical and endoscopic remission in patients with mild to moderate ulcerative colitis who had an inadequate response or were intolerant to first-line conventional therapy 3.
- Topical budesonide may be used to treat ulcerative colitis with predominantly distal disease, while oral controlled-release formulations can treat the entire colon 4.
Safety and Tolerability
- Budesonide is generally well-tolerated, with an incidence of adverse events similar to that of placebo and mesalazine slow release 2.
- The rate of glucocorticoid-related adverse effects is significantly less frequent with budesonide compared to prednisolone 2.
Treatment Guidelines
- Budesonide is considered a first-line therapy for inflammatory bowel disease, along with 5-aminosalicylates, systemic steroids, and other medications 5, 6.
- Treatment recommendations vary depending on disease severity and location, with budesonide being a suitable option for certain clinically frequent situations in patients with Crohn's disease and ulcerative colitis 6.