Steroids to Treat IBD

Prednisone and Prednisolone

What is Prednisone and What is it Used For?

• Prednisone is a steroid with anti-inflammatory effects. It is used to treat inflammation in ulcerative colitis and Crohn’s disease. However, steroids do not prevent symptoms from returning and have many side effects.
• Sometimes, it is necessary to use steroids to treat IBD, especially during “flares.”

What Do I Need to Know Before Taking Prednisone?

• Prednisone can be taken with or without food.
• The tablets may be crushed, and there is a liquid solution available.
• You should take extra calcium and vitamin D because prednisone affects bone strength.

What Do I Do If I Miss a Dose?

• If you are only taking prednisone once a day, take it as soon as you remember that day. If you don’t remember until the next day, just take one dose; do not double up on your dose.
• If you are taking Prednisone twice a day, take the missed dose as soon as you remember and resume your regular schedule.
• It is very important that you do not stop taking this drug suddenly. Doing this can have very bad side effects.

What Are the Food or Drink Interactions?

There are no known food or drink interactions. Prednisone may cause your body to retain more sodium/salt, so stay away from foods high in sodium/salt like potato chips, etc.

Are There Any Drug Interactions with Prednisone?

Prednisone may increase or decrease the effects of the following medicines:

• Birth control pills
• Aspirin
• Rifampin
• Amphotericin B
• Estrogen
• Barbiturates (Phenobarbital®, Donnatal®)
• Carbamazepine (Tegretol®)
• Cyclosporine
• Ketoconazole
• Coumadin
• Phenytoin (Dilantin®)

Is It Safe to Take Prednisone for Long Periods of Time?

It is best to be on the lowest dose of Prednisone that is effective for the shortest period of time because of the side effects. However, this is not always possible when treating IBD, so it is important for you to talk regularly with your doctor while on prednisone.

What Are the Side Effects of Prednisone?

Minor

• Acne
• Weight gain
• Facial roundness
• Rash
• Nervousness/mood swings

Major

• Abdominal pain
• Blurred vision
• Bloody or black stools
• Painful joints
• Osteoporosis
• Depression
• Infections
• Severe fatigue
• Stretch marks
• Headaches (pseudotumor cerebri)

Budesonide

Also called Entocort EC® and Uceris®

What is Budesonide and What Is It Used For?

• Budesonide is a steroid drug.
• Entocort works mainly at the end of the small intestine (ileum) and at the beginning of the colon (cecum) to reduce inflammation from Crohn’s disease.
• Uceris is a newer form of the same medicine that treats inflammation in the colon in Ulcerative Colitis.
• Budesonide is different than other steroids such as prednisone because very little medicine reaches the bloodstream. This causes fewer side effects than other steroids.

• Swallow the whole capsule; do not crush or chew.
• This medicine is usually taken in the morning.
• It should not be stopped suddenly and usually requires a “tapering period” (slowly lowering the dose).
• Notify your doctor if you are exposed to or develop chicken pox or measles.

What Are the Food or Drink Interactions?

Grapefruit juice may increase the effects of budesonide and should be avoided.

Are There Any Drug Interactions with Budesonide?

Budesonide may increase the effects of the following drugs:

• Erythromycin
• Ketoconazole and itraconazole
• HIV treatment

Is It Safe to Take Budesonide for Long Periods of Time?

It is FDA-approved for eight weeks. However, budesonide may be used longer in certain cases.

Minor

• Acne
• Nausea
• Headache
• Respiratory infections
• Skin striae or markings
• Swollen or moon face

Major

• Depression
• Knee or hip pain