Budesonide

[Joanbill13]

Having been diagnosed with colitis my doctor has taken me off pred overnight and put me on budesonide. Have tapered pred down to 2mg. Does anyone know of any problems doing this

[PMRpro Ambassador]

What form of budesonide? Oral? And what dose?

Kirwan tried it in RA - seemed to work ok. Have to see how it works in PMR

ard.bmj.com/content/63/6/688

[Joanbill13 in reply to PMRpro]

It’s prolonged release tablets 9mg for one month,6 for one month, 3mg for one month and stop. Thanks for the link

[Joanbill13 in reply to PMRpro]

I’ve read that thank you. Can always rely on you. I’m rather disappointed that I’ve had to go back to 9mg, steroids having got down to 1/2mgs Pred. Have lost a stone in weight and moonface is going away. It looks like it might all come back as side affects seem to be similar to pred. Worth getting rid of colitis though. Just wondering how I’ll feel stopping dead at 3mg. Will face that at the time.

[PMRpro Ambassador in reply to Joanbill13]

9mg budesonide is a lot more than 9mg pred though - but said to have far fewer side effects. Do hope so as I do see how disappointing it must feel.

Just watch those carbs!!!!

[Joanbill13 in reply to PMRpro]

Oh no. Didn’t realise that. Even more fed up then lol just as I was getting back to something like “normal”. Be good to get the tummy problem sorted though. It’s a mega problem now. Just coming up to three years since PMR started. Thanks for info. Thank goodness for this site. You all help so many of us in many different ways not just PMR problems.

[PMRpro Ambassador in reply to Joanbill13]

It's a short term use though - little different to being put on it if you weren't on pred at all. And if it sorts your colitis problem it will be worth it. Always difficult to balance out those downsides I know - but the doctor is using the better drug for the current problem. He could have sent you back to 40mg pred!

[Joanbill13 in reply to PMRpro]

You are so wise xx

[Bridge31 in reply to PMRpro]

Why aren’t we taking it if it has far fewer side effects ?

[PMRpro Ambassador in reply to Bridge31]

Because it is much harder to taper as we do because of the difference in equivalent dosage - they are equally effective but for the things it is used for it the side effects, especially adrenal suppression, over moderate duration use seem good. You have to look at the equivalent doses - 9mg budesonide compares with 40mg pred. So for PMR you would start with 20mg pred - but 4.5mg budesonide. Think about how you would taper slowly from that?

[Bridge31 in reply to PMRpro]

Understand thank you. I’ve never heard of it before.

[PMRpro Ambassador in reply to Bridge31]

Probably because it is quite limited use - mostly for asthma as an inhaled formulation I think,

[piglette]

There have been some trials comparing Budesonide and pred for Crohns. The trials have demonstrated that Budesonide was comparable to prednisolone in its efficacy.

[Joanbill13]

Thank you very helpful

[cranberryt]

Budesonide is not likely to help with PMR. It is localized to the gut. I have colitis and PMR. I am on 2mg of prednisone and 3 capsules of budesonide. There is no way I can do without my prednisone! The budesonide doesn’t help the PMR at all. I wouldn’t stop 2mg prednisone cold turkey as you still have adrenals to contend with. I have had to temporarily come off the budesonide because it causes me some severe bruising and I had a massive bruise that wasn’t healing. I tapered that by taking one less pill every couple days but admittedly didn’t get doctor’s advice before doing so. I have been off it 2 weeks and my bruise is finally starting to heal. I had been on budesonide 4 months.

[PMRpro Ambassador in reply to cranberryt]

Can't be that localised since I linked to a paper above where Prof Kirwan did a small comparison in RA and it worked OK. Tapering off it in PMR would be the main problem.

ard.bmj.com/content/63/6/688

[Joanbill13 in reply to PMRpro]

My doctor has told me to stop pred and start budesonide. I was on low does pred 2mg and from what I’ve read they sound similar so hope it’s ok to just stop pred ?

[PMRpro Ambassador in reply to Joanbill13]

In terms of adrenal function or lack of it I'm sure the budesonide will cover for that - and you will see how you get on.You SHOULDN'T need both but the proof of the pudding is in the eating!!

[Joanbill13 in reply to PMRpro]

Thank you - appreciated as usual

[cranberryt in reply to PMRpro]

I will read it. Thanks. My GI doctor told me that its effects were localized to the gut and thus had less side effects than other steroids. But he didn’t suggest I stop the prednisone for the PMR. However, I know not all docs know it all. I will read the article.