Budesonide belongs to the class of medications called corticosteroids. It is used to treat adults with eosinophilic esophagitis (EoE). After the initial treatment of an episode, it is also used to prevent further episodes of EoE from occurring.

Eosinophilic esophagitis is a long-term illness triggered by allergens, acid reflux, or foods that cause irritation to your esophagus, the tube that connects your mouth and throat to your stomach. This irritation can cause problems swallowing, if it is untreated.

Budesonide works to treat EoE by reducing swelling, inflammation, and irritation in the esophagus. After dissolving in your mouth, budesonide mixes with your saliva, which is slowly swallowed, and works directly by coating the esophagus.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

For treatment of an episode of eosinophilic esophagitis, the usual adult dose of budesonide orodispersible tablets is 1 mg taken 2 times a day. Treatment may last about 6 weeks.

For prevention of further episodes of eosinophilic esophagitis, the dose is 0.5 mg taken twice daily.

To take this medication, place a tablet on the tip of your tongue and gently press it against the roof of your mouth until it dissolves. The tablet should dissolve in approximately 2 minutes. While the tablet is dissolving, you can swallow the dissolved material in your saliva a little bit at a time.

This medication should be taken after a meal but not with liquid or food. Avoid brushing your teeth, eating or drinking, or rinsing your mouth for at least 30 minutes after taking the tablet. Do not use any oral solutions, sprays, or chewable tablets for 30 minutes before or after taking this medication. Do not chew or swallow the undissolved tablet.

Continue taking this medication even if you start to feel better. Do not stop taking this medication without checking with your doctor first.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor.

If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, in the original packaging to protect it from light and moisture, and keep it out of the reach of children.

0.5 mg
Each white or almost white, round, biplane, orodispersible tablet, embossed with "0.5" on one side, contains 0.5 mg of budesonide. Nonmedicinal ingredients: anhydrous monosodium citrate, disodium hydrogen citrate, docusate sodium, Macrogol 6000, magnesium stearate, mannitol, povidone K25, sodium hydrogen carbonate, and sucralose.

1 mg
Each white or almost white, round, biplane, orodispersible tablet, contains 1 mg of budesonide. Nonmedicinal ingredients: anhydrous monosodium citrate, disodium hydrogen citrate, docusate sodium, Macrogol 6000, magnesium stearate, mannitol, povidone K25, sodium hydrogen carbonate, and sucralose.

Do not take this medication if you:

• are allergic to budesonide or any ingredients of the medication
• have an uncontrolled infection
• have active tuberculosis

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• changed sense of taste
• constipation
• cough or dry throat
• dry eyes
• headache
• heartburn
• itching
• muscle or joint pain
• muscle weakness
• nausea
• stomach pain
• swollen lips
• tingling, burning, or numbness in the mouth
• tiredness
• weight gain

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• blurred or reduced vision or eye pain
• bone pain or fractures
• difficulty swallowing
• increased blood pressure
• mood or behaviour changes (e.g., aggression, rage, anxiety, or excitation)
• mouth or throat pain
• rash
• restlessness
• signs of a blood clot in the arm or leg (tenderness, pain, swelling, warmth, or redness in the arm or leg) or lungs (difficulty breathing, sharp chest pain that is worst when breathing in, coughing, coughing up blood, sweating, or passing out)
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of infection or increased frequency of infections (e.g., fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
• symptoms of chicken pox (e.g., red, itchy rash of fluid-filled blisters, fever, unusual tiredness)
• symptoms of decreased adrenal function (e.g., acne, fluid retention, tiredness, weakness, nausea, vomiting, low blood pressure)
• symptoms of a fungal infection in the mouth (e.g., white spots in the mouth or throat)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, increased urination at night)
• symptoms of shingles (e.g., patches of painful, red rash)
• wounds that heal slowly

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood pressure: Like other corticosteroids, budesonide can cause increased blood pressure. If you have high blood pressure, or are at risk of developing high blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

High blood sugar: Budesonide can cause high blood sugar. Your doctor may check your blood sugar levels with blood tests while you are taking this medication. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience increased thirst and urination while taking this medication, contact your doctor.

Infections: This medication may mask some signs of infection, and new infections may appear during its use. Viral infections such as chickenpox, measles, or herpes can be more serious for people who are taking budesonide. If you have not had these diseases you should take particular care to avoid exposure. Contact your doctor if you notice any symptoms of an infection (e.g., fever, chills, cough, sore throat), or if you are in contact with someone who has measles or chickenpox.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Mental health: Budesonide, like other corticosteroids, may cause behaviour and personality changes and mood swings. These reactions are most likely to occur when you first start taking this medication. If you experience these symptoms, or notice them in a family member who is taking this medication, contact your doctor as soon as possible.

Osteoporosis: This medication can increase the risk of osteoporosis (brittle bones). Talk to your doctor about ways to help prevent osteoporosis. Your doctor will monitor your bone density if you take this medication for a long period of time.

Stomach and intestinal problems: If you have or have had a stomach or intestinal ulcer, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Stress response: Budesonide can affect how your body reacts to stressful situations, such as surgery or trauma. Let all health care providers know that you are taking budesonide.

Tuberculosis: Corticosteroids, such as budesonide, can cause tuberculosis infection to flare up. If you have had tuberculosis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Vaccines: Live vaccines (e.g., BCG, yellow fever, measles, mumps, rubella) should not be given to people taking doses of this medication. Other vaccines such as inactivated vaccines may not be as effective for people who are taking this medication.

Vision problems: Long-term use of budesonide can cause glaucoma and cataracts. If you notice changes in your vision, such as faded colours, halos around lights, or blurred vision, contact your doctor as soon as possible. Glaucoma can cause permanent vision loss and should be treated as early as possible.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking budesonide, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children under the age of 18 years. Treatment with budesonide may cause slowed growth in children.

There may be an interaction between budesonide orodispersible and any of the following:

• aldesleukin
• antacids (e.g., aluminum hydroxide, magnesium hydroxide)
• aprepitant
• "azole" antifungals (e.g., fluconazole, itraconazole, ketoconazole, voriconazole)
• cholestyramine
• cobicistat
• colestipol
• conivaptan
• other corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
• digoxin
• diltiazem
• dronedarone
• grapefruit juice
• HIV protease inhibitors (atazanavir, darunavir, indinavir, lopinavir, nelfinavir, ritonavir)
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• mifepristone
• protein kinase inhibitors (e.g., ceritinib, crizotinib, idelalisib, imatinib, nilotinib)
• vaccines
• verapamil

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.