Tarpeyo
Tarpeyo, the brand name for budesonide delayed-release capsules, is a corticosteroid. It helps lessen the worsening of kidney function in adults with a kidney condition called immunoglobulin A nephropathy (IgAN). Tarpeyo (budesonide) is taken by mouth once daily in the morning on an empty stomach. Some possible side effects include swelling in the arms and legs, high blood pressure, and weight gain.
What is Tarpeyo (budesonide)?
What is Tarpeyo (budesonide) used for?
Lessening the worsening of kidney function in adults with a kidney condition called immunoglobulin A nephropathy (IgAN)
How Tarpeyo (budesonide) works
Tarpeyo (budesonide) is a corticosteroid, or also known as a "steroid." It stops certain immune cells in the body from making proteins called immunoglobulin A (IgA) antibodies. This helps stop protein buildup in the kidneys, which helps prevent more damage to the kidneys and worsening of immunoglobulin A nephropathy (IgAN).
Drug Facts
What are the side effects of Tarpeyo (budesonide)?
Common Side Effects
- Swelling in arms, legs, or feet (17%)
- High blood pressure (12%)
- Muscle spasms (12%)
- Acne (11%)
- Headache (10%)
- Upper respiratory tract infection (8%)
- Facial swelling (8%)
- Weight gain (7%)
- Indigestion (7%)
Other Side Effects
- Skin irritation
- Joint pain
- High white blood cell count
Serious Side Effects
- Infection: unexplained fever, chills, tiredness, nausea, vomiting, pain, aches, infections that don't get better
- Hormone changes: bruising easily, rounding of the face, fatty lump or hump between the shoulders or back of the neck, weak muscles
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Cushing syndrome—increased fat around the midsection, upper back, neck, or face, pink or purple stretch marks on the skin, thinning, fragile skin that easily bruises, unexpected hair growth
- High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
- Increase in blood pressure
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Low adrenal gland function—nausea, vomiting, loss of appetite, unusual weakness or fatigue, dizziness
- Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
- Stomach bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds
- Swelling of the ankles, hands, or feet
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Acne
- General discomfort and fatigue
- Increase in appetite
- Headache
- Nausea
- Trouble sleeping
- Weight gain
Pros and cons of Tarpeyo (budesonide)
Pros
A possible option for people who've already tried other therapies
Taken once per day
Taken by mouth
Cons
Must take 4 capsules for each dose
Should take in the morning on an empty stomach
Can cause unpleasant side effects (e.g., weight gain, muscle spasms)
Pharmacist tips for Tarpeyo (budesonide)
Take Tarpeyo (budesonide) in the morning, at least 1 hour before your meal.
You'll need to take 4 capsules of Tarpeyo (budesonide) for each dose. Swallow each capsule whole. Don't open, crush, break, or chew them because it can damage the medication and affect how it works in your body.
You'll typically need to take Tarpeyo (budesonide) for 9 months. But depending on your kidney condition and any side effects you might have from the medication, your prescriber might tell you to take Tarpeyo (budesonide) for a different length of time.
Take Tarpeyo (budesonide) exactly as prescribed. Don't stop taking your medication unless your prescriber tells you to. Stopping Tarpeyo (budesonide) suddenly can cause withdrawal symptoms, such as nausea, weakness, and body aches. Speak with your prescriber if you'd like to stop treatment for more instructions.
Avoid grapefruit and grapefruit juice while you're taking Tarpeyo (budesonide). Grapefruit can raise the levels of the medication in your body, which can put you at risk for side effects like headache or acne.
Avoid alcohol while you're taking Tarpeyo (budesonide). Both alcohol and Tarpeyo (budesonide) can weaken your immune system, which can raise your risk for infections. If you drink alcohol regularly, talk to your prescriber or a healthcare professional. They can recommend ways to quit alcohol.
Share an up-to-date medication list with your care team. They can check that your medications are safe to take with Tarpeyo (budesonide). Examples of medications that can interact with Tarpeyo (budesonide) include those that weaken your immune system, ritonavir, erythromycin, and cyclosporine (Neoral).
Frequently asked questions about Tarpeyo (budesonide)
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What are the risks and warnings for Tarpeyo (budesonide)?
Tarpeyo (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.
Changes in stress hormone levels in the body
Risk factors: Taking Tarpeyo (budesonide) for a long time | Liver problems
Steroids such as Tarpeyo (budesonide) act like the stress hormone cortisol that your body naturally makes. When you take steroid medications for a long time, your body can start to make less of its own cortisol and rely more on the steroid medication instead. This can cause changes in the stress hormone levels in your body.
When you're taking steroid medications for a long period of time, it's possible for you to have symptoms that look like you have too much stress hormone in the body. These symptoms include easy bruising, rounding of the face, more fat between the shoulders or back of the neck, weak muscles, and weight gain.
And if you stop taking Tarpeyo (budesonide) all of a sudden, you might have symptoms of low stress hormone levels, such as weakness, nausea, and body aches. These symptoms happen because the body hasn't had enough time to start making its own cortisol again. But they should go away over time as your natural cortisol level returns to normal. Your prescriber will give you instructions to safely stop Tarpeyo (budesonide), if needed.
Higher risk of infections
Tarpeyo (budesonide) can weaken your immune system and raise your risk of infections. Let your prescriber know if you currently have any infections or if you've recently traveled (some areas have a high risk for infections). Also tell them if you've had tuberculosis (TB) or hepatitis B in the past because these infections might come back while you're taking Tarpeyo (budesonide).
Contact your primary care provider or call urgent care if you start to have any symptoms of an infection while you're taking Tarpeyo (budesonide). Look out for fever, tiredness, chills, cough, and trouble breathing.
Worsening of certain medical conditions
Risk factors: High blood pressure | High blood sugar (diabetes) | Osteoporosis (weakened bones) | Stomach ulcer | Glaucoma | Cataracts | Family history of diabetes or glaucoma
Steroids like Tarpeyo (budesonide) can worsen certain medical conditions and cause unwanted effects. It can raise blood pressure and blood sugar. It can also raise the risk for bone weakening (osteoporosis), stomach ulcers, and eye problems (e.g., glaucoma, cataracts).
Make sure your prescriber knows about all the medical conditions you have before you start Tarpeyo (budesonide). They check that the medication is safe for you to take.
Tarpeyo (budesonide) dosage forms
Typical dosing for Tarpeyo (budesonide)
Each Tarpeyo delayed-release capsule contains 4 mg of budesonide.
The typical dose is 4 capsules by mouth once daily in the morning at least 1 hour before breakfast. It's recommended to take Tarpeyo (budesonide) for 9 months.
Tarpeyo (budesonide) contraindications
Allergic reaction to any other budesonide medications
What are alternatives to Tarpeyo (budesonide)?
Lessening the worsening of kidney function in adults with a kidney condition called immunoglobulin A nephropathy (IgAN)
Lower urine protein levels in adults with immunoglobulin A nephropathy (IgAN)
Tarpeyo (budesonide) images
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References
Best studies we foundCalliditas Therapeutics. (2023). Calliditas Therapeutics announces full FDA approval of Tarpeyo®, the only FDA-approved treatment for IgA nephropathy to significantly reduce the loss of kidney function.
Calliditas Therapeutics AB. (2024). Tarpeyo- budesonide capsule, delayed release [package insert]. DailyMed.
Caster, D. J., et al. (2023). The treatment of primary IgA nephropathy: Change, change, change. American Journal of Kidney Diseases.
IgA Nephropathy Foundation. (n.d.). IgAN FAQs.
MedlinePlus. (2024). White blood count (WBC).
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Cushing’s syndrome.
National Kidney Foundation. (2024). IgA nephropathy.
U.S. Food and Drug Administration. (2021). FDA approves first drug to decrease urine protein in IgA nephropathy, a rare kidney disease.
Your and Your Hormones. (2019). Cortisol.
Zeng, Q., et al. (2023). Diagnostic and prognostic value of galactose-deficient IgA1 in patients with IgA nephropathy: An updated systematic review with meta analysis. Frontiers in Immunology.
Zhang, H., et al. (2024). Efficacy and safety of Nefecon in patients with IgA nephropathy from mainland China: 2-year NefIgArd trial results. Kidney360.
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