Entocort (Budesonide)

What is it?

Entocort is a capsule containing Budesonide which is a glucocorticosteroid, previously successful in the treatment of asthma in an inhaled formula due to it’s anti-inflammatory properties. It is released above pH 5.5, (i.e. out of the stomach), and its optimum effect is in the terminal ileum and caecum (60-70%) before being distributed throughout the large intestine.

What is it used for?

Trials have shown it to be as effective as oral prednisolone in causing a remission of mild to moderate Crohn's disease affecting the ileum and/or ascending colon. Trials for usage in long-term maintenance are planned but, as yet, it is indicated for the acute phase only.

How do I take it?

Entocort is presented in a hard gelatin capsule protecting it from the acid in the stomach and allowing a controlled release. The tablets should be swallowed whole with plenty of water and is generally unaffected by food.

If taking cholestyramine (Questran) absorption may be affected, therefore it should be taken one hour before this.

Are there any precautions?

Blood levels of Entocort are significantly lower than they would be with conventional steroid treatment but should still be used with caution in certain circumstances, and you should let the doctor know if you have any of the following:

• tuberculosis
• high blood pressure
• diabetes
• osteoporosis (thinning of the bones)
• stomach ulcers
• eye problems such as glaucoma or cataracts
• chicken pox and measles
• someone in the family with diabetes or glaucoma

You should let the doctor know if you are pregnant or breastfeeding. It is not known whether Budesonide passes into breast milk.
No studies have been performed on usage in childhood Crohn's disease.

Are there any side effects?

Steroid side effects of Budesonide have been reported to be very much lower than conventional steroids as the dose is delivered in a controlled release and has a topical effect on a specific site (greater than 95% of the drug), rather than being absorbed into the blood stream first and thus having a general effect on the body. Once broken down in the liver, the amount of steroid available in the system is less than 10% of the original drug. Side effects are less that half those seen with conventional steroids.

However, some adverse reactions have been reported other than effects of steroids, and these could include:

• indigestion
• muscle cramps
• tremor
• palpitations
• nervousness
• blurred vision
• skin rashes
• period problems

However, many of these problems were also found in placebo treatment during clinical trials.