Budesonide is a corticosteroid that's used to treat mild-to-moderate Crohn's disease in adults and children. It's available as capsules that are taken by mouth once daily. The most common side effects are headache and respirator infections. More rarely, it might cause weight gain too.
Mild-to-moderate active Crohn's disease in people ages 8 years and older
Maintenance of remission of Crohn's disease in adults
Budesonide is a corticosteroid. It works to lessen inflammation (swelling and irritation) in your intestines (bowels). This helps lessen symptoms of Crohn's disease.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Body aches or pain
chills
congestion
dryness or soreness of the throat
general feeling of discomfort or illness
headache
hoarseness
joint pain
loss of appetite
muscle aches and pains
pain or tenderness around the eyes and cheekbones
shivering
shortness of breath or troubled breathing
stuffy or runny nose
sweating
tender, swollen glands in the neck
tightness of the chest or wheezing
trouble with sleeping
trouble with swallowing
unusual tiredness or weakness
voice changes
vomiting
Less common
Bruising
darkening of the skin
dizziness
excessive muscle tone
fainting
fractures
large, flat, blue, or purplish patches in the skin
lower back or side pain
muscle stiffness
muscle tension or tightness
painful or difficult urination
redness or swelling in the ear
skin rash
sore mouth or tongue
white patches in the mouth or on the tongue
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Back pain
Less common
Acid or sour stomach
belching
change in taste or bad, unusual, or unpleasant (after) taste
difficulty with breathing
difficulty with moving
ear congestion
headache, severe and throbbing
indigestion
muscle cramping
neck pain
stomach discomfort, upset, or pain
swollen joints
unable to sleep
unexplained runny nose or sneezing
weakness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Works where you have symptoms in your intestines (gut)
Might cause fewer side effects than other steroids
Taken once a day
Available as a lower-cost generic
Might not work as well as other steroids like prednisone
Can raise your risk for infections
Can take a couple months to see full benefit from the medication
Take budesonide at the same time every day in the morning. You can take budesonide with or without food, but if it's hurting your stomach, try taking the medication with food to help.
Swallow budesonide capsules whole. Don't crush or chew them because this could make the medication work in a different way than intended.
If you have trouble swallowing the budesonide capsule whole, you can open the capsule, sprinkle the contents onto 1 tablespoon of applesauce, and mix them together in a clean container. Swallow the mixture (don't chew it) within 30 minutes of preparing. Drink a full glass (8 oz) of cool water right afterwards to make sure you've taken all of the medication.
Don't drink grapefruit juice while you're taking budesonide. Grapefruit juice can raise the amount of budesonide in your body, which can lead to more steroid side effects.
Make sure to tell your healthcare team and pharmacist about all of the medications you're taking. Some medications can interact with budesonide and these interactions can raise your risk for side effects.
Budesonide can weaken your immune system and raise your risk for infections. Let your gastroenterologist or primary care provider know about any night sweating, unexplained fevers, or infections that don't get better while you're taking this medication. Try to avoid people who are sick and regularly wash your hands to prevent infection.
Budesonide can potentially affect your bone density and raise your risk for osteoporosis. Discuss with your gastroenterologist or primary care provider about taking calcium or vitamin D supplements to keep your bones healthy.
Budesonide can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Taking budesonide for a long time | Taking higher doses of budesonide | Children | Liver problems
Corticosteroids such as budesonide act like the stress hormone your body naturally makes. When you take higher corticosteroid doses or take the medication for a long time, your body can start to make less of its own stress hormones and rely more on the corticosteroid medication instead. This can cause changes in the stress hormone levels in your body.
When you're taking corticosteroids at higher doses or for a long period of time, it's possible for you to have steroid side effects like acne, easy bruising, rounding of the face, swollen ankles, larger appetite, and weight gain.
And if you stop taking budesonide all of a sudden, you might have symptoms of low stress hormone levels, such as weakness, nausea, and diarrhea. These symptoms happen because the body hasn't had enough time to start making its own stress hormones again. But they should go away over time as your body's natural stress hormone level returns back to normal. Your prescriber will give you instructions to safely stop budesonide, if needed.
Taking budesonide can weaken your immune system and raise your risk of infections. Speak to a healthcare professional or your primary care provider if you think you might have a fungal, bacterial, or viral infection. Also, let them know if you've recently traveled to areas that have a high risk for any type of infections. Contact your primary care provider or urgent care if you start to have any symptoms of an infection, including fever, tiredness, chills, cough, or trouble breathing.
Risk factors: High blood pressure | High blood sugar (diabetes) | Osteoporosis (bone weakening) | Stomach ulcer | Glaucoma | Cataracts | Family history of diabetes or glaucoma
Corticosteroids like budesonide can worsen certain conditions, such as high blood pressure, diabetes, osteoporosis, stomach ulcers, and glaucoma. Tell your gastroenterologist about your full medical history so they're aware whether they need to monitor you more closely while you're taking budesonide. Your gastroenterologist will speak to you about what signs and symptoms to look out for and when to get medical care.
| Dosage | Quantity | Price as low as | Price per unit | 
|---|---|---|---|
| 3mg | 90 capsules | $38.70 | $0.43 | 
Active, mild-to-moderate Crohn’s disease:
Adults: The typical dose is 9 mg by mouth once a day in the morning for up to 8 weeks. You can repeat this 8-week course of treatment for recurring episodes of Crohn's disease.
Children ages 8 to 17 years who weigh more than 55 lbs: The typical dose is 9 mg by mouth once a day in the morning for up to 8 weeks, followed by 6 mg by mouth once a day in the morning for 2 weeks.
Maintenance of remission of Crohn's disease:
Adults: The typical dose is 6 mg by mouth once a day in the morning for up to 3 months. Then, follow your prescriber's instructions to safely lower your dose.
Your dose might differ if you have liver problems.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Mild-to-moderate active Crohn's disease in people ages 8 years and older
Maintenance of remission of Crohn's disease in adults
Allergies or allergic reactions
Conditions affecting certain hormones (e.g., low adrenal hormones)
Eye conditions
Lung conditions
Gut conditions (e.g., ulcerative colitis)
Conditions related to blood cells
Certain cancers (e.g., leukemia
Nervous system conditions (e.g., multiple sclerosis)
Joint conditions (e.g., rheumatoid arthritis)
Conditions affecting certain hormones (e.g., low adrenal hormones)
Joint conditions (e.g., rheumatoid arthritis)
Skin conditions (e.g., Stevens-Johnson syndrome)
Allergic reactions
Eye inflammation
Lung problems
Conditions related to blood cells
Cancer of blood cells (e.g., leukemia)
Gut conditions (e.g., ulcerative colitis)
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Amneal Pharmaceuticals LLC. (2023). Budesonide- budesonide capsule, delayed release [package insert]. DailyMed.
Beaulieu, D. B., et al. (2009). Budesonide induction and maintenance therapy for Crohn's disease during pregnancy. Inflammatory Bowel Diseases.
Centers for Disease Control and Prevention. (2024). Travel health notices.
Greenberg, G. R., et al. (1994). Oral budesonide for active Crohn's disease. The New England Journal of Medicine.
Lichtenstein, G. R., et al. (2018). ACG clinical guideline: Management of Crohn’s disease in adults. The American Journal of Gastroenterology.
McKeage, K., et al. (2002). Budesonide (Entocort EC capsules): A review of its therapeutic use in the management of active Crohn's disease in adults. Drugs.
MedlinePlus. (2024). Bone density.
Miehlke, S., et al. (2018). Oral budesonide in gastrointestinal and liver disease: A practical guide for the clinician. Journal of Gastroenterology and Hepatology.
O'Donnell, S., et al. (2010). Therapeutic benefits of budesonide in gastroenterology. Therapeutic Advances in Chronic Disease.
Restellini, S., et al. (2020). Update on the management of inflammatory bowel disease during pregnancy and breastfeeding. Digestion.
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