Entocort Capsules

Brand Name:Entocort Capsules, Entocort Enema, Gen-Budesonide AQ, Pulmicort Nebuamp, Pulmicort Turbuhaler, Rhinocort Aqua, Rhinocort Turbuhaler, Symbicort Turbuhaler

Prescription needed: Yes

What is this drug used for?

Budesonide belongs to a class of drugs called “corticosteroids” and is used most commonly for medical conditions that involve inflammation.

This medication is available in many different forms.

  • When used inside of an inhaler, budesonide is used to prevent wheezing and breathing difficulties caused by asthma and other lung diseases.
  • As a nasal spray, it is used to treat symptoms of allergic rhinitis.
  • As an enema, it is used to treat the symptoms of ulcerative colitis and other rectal problems, including hemorrhoids.
  • As a slow-release capsule, it is used to treat the symptoms of Crohn’s disease.

Is there any reason not to take this drug?

You should not take this drug if you are allergic to budesonide or if you have a fungal infection in some place other than on your skin. Before taking this medication, tell your doctor if you have or have ever had:

  • problems with your kidney or liver
  • problems with stomach ulcers, bleeding of the stomach or heartburn
  • diabetes
  • congestive heart failure
  • problems with swelling of your feet or ankles
  • high blood pressure
  • osteoporosis
  • problems with frequent infections
  • low thyroid hormone (hypothyroidism)
  • problems with depression, hallucinations or other mental illness
  • myasthenia gravis
  • herpes eye infection or shingles (herpes zoster infection)
  • tuberculosis
  • previous nasal surgery
  • nosebleeds
  • sinus or any other infection
  • glaucoma or cataracts
  • problems with low potassium or calcium in the blood
  • side effects to other corticosteroid medications

What about possible side effects?

The side effects to this type of corticosteroid seem to be less than compared with other drugs in the same class. As well, the side effects to this medication will depend on the type of medication you are taking. For example, side effects that involve the rest of the body will be more common with the capsules and less so with the enema, spray and inhalers. As well, some of the other side effects will only be at the site of where the drug is being given (e.g. the nose or rectum).

The most common side effects seen with budesonide include:

  • upset stomach, vomiting, heartburn
  • headache
  • changes or absence of menstrual periods
  • rapid heart beat
  • rash and itching
  • changes in vision
  • diarrhea, gas, bloating

Specific to nasal spray or inhaler:

  • dry mouth
  • hoarseness
  • nose irritation
  • nosebleeds
  • white patches in the throat, mouth, or nose

Other side effects that have been reported with other corticosteroids are less likely but still possible and include the following:

  • increase in appetite with possible weight gain
  • swelling of the feet and ankles
  • swelling of the face
  • dizziness
  • difficulty falling or staying asleep, nightmares
  • feeling depressed, anxious or restless
  • feeling “high” or euphoric
  • acne
  • changes in the skin (easy bruising, skin thinning, increased hair growth over body, presence of small blood vessels)
  • decrease in bone strength and osteoporosis
  • high blood pressure
  • increase in blood sugars
  • feeling weak in the muscles
  • stopping your body’s own ability to produce its natural hormone, cortisone (with high doses and long-term use)
  • a condition called avascular necrosis of bone
  • increase chances of infection or slow recovery from an infection (call your doctor)
  • decrease growth rate in children

Some of these side effects are more likely with higher doses and some are more likely with long-term use. As well, special instructions can be given to decrease some of these side effects. Talk to your doctor or pharmacist.

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

The risk for drug interactions will be greater with the oral capsules than with the enema, spray or inhaler.

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact and may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as these are the most common interactions and he/she may need to make changes or monitor you more closely:

  • other pain medications that include ASA & other anti-inflammatories (e.g. ibuprofen, naproxen, voltaren, diclofenac) (this can increase your chances of having side effects, especially those in the stomach)
  • digoxin (potassium levels in the blood may need to be monitored)
  • ketoconazole, itraconazole, amiodarone, clarithromycin and other medications that interfere with the body’s ability to get rid of the drug (may increase the amount of budesonide in the blood)
  • phenobarbital, phenytoin, rifampin (may decrease the amount of budesonide in the body)
  • live vaccines

If you are taking medications for diabetes, this medication may increase your blood sugars and interfere with how well your medications can work. Talk to your doctor.

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications.

Other information:

Special instructions:

  • This drug makes you more susceptible to illnesses, including chicken pox, measles, and tuberculosis. Talk to your doctor if you are exposed to any of these infections.
  • Do not have a vaccination, other immunization, or any skin test while you are taking budesonide without first talking to your doctor.
  • You may need to take extra doses of budesonide or other corticosteroid during periods of stress (injuries, infections, and severe asthma attacks), especially if you have recently stopped taking the medication.
  • If you need to take this medication for a long period of time, you may be at risk for osteoporosis. Talk to your doctor or pharmacist about taking calcium (1000mg-1500mg/day) and vitamin D (400-800 IU/day). As well, your doctor may prescribe a different medication to prevent this side effect from happening.
  • It is extremely important that you do not stop taking this medication without talking to your doctor first. Since this medication can cause your body to stop producing its own natural hormone after long-term use, stopping the medication could cause severe side effects (feeling weak, tired, dizzy, nauseous, low blood pressure, muscle pains).
  • Always follow your doctor’s advice when taking rectal corticosteroids. If you take them too often or in larger doses than prescribed, they may be absorbed through the lining of the rectum, increasing the risk of side effects.
  • This medication does not work immediately to stop an asthma attack or symptoms of allergic rhinitis. It must be taken on a daily basis to decrease or prevent the symptoms from occurring

Lab and Other Tests:

  • Your doctor may send you for periodic bone mineral density scans to check your bones while taking this medication.
  • You may need to check your blood sugar more often while taking this medication since this medication can increase your blood sugar.

Children: Can be used. The lowest effective dose is used to decrease the chances for long-term side effects.

Seniors: Lower doses may be necessary to decrease the chances for side effects.

Pregnant women: Talk to your doctor.

Women who are nursing: Talk to your doctor.

People who drive or operate machinery: No known problems.

Alcohol: May increase the risk of stomach irritation and side effects to budesonide. Try to limit alcohol consumption.

Overdose: If you notice any unusual symptoms, call your doctor immediately.

Stopping the drug: If you stop taking this drug, underlying symptoms may recur. In some cases, your doctor may want to wean you off the drug gradually.

If you miss a dose: Take the missed dose as soon as they remember it unless it is almost time to take the next scheduled dose. In that case, take the missed dose and then skip the next scheduled dose. Never take a double dose of this medicine.

Storage conditions: Closed container; cool, dry location away from excess moisture (not in the bathroom) and direct light; always out of reach of children.

Dietary precautions: If you are taking budesonide oral capsules for an extended period of time, your doctor may advise you to follow a low-sodium, high-potassium, and high-calcium diet. You may want to take this medication with food to decrease the feeling of upset stomach.