Intesticort (Budesonide)

• Budesonide is a glucocorticoid that modulates inflammatory pathways in the gastrointestinal tract.
• Crohn's disease: reduces intestinal inflammation and helps maintain remission.
• Ulcerative colitis: decreases colonic inflammation and promotes symptom relief.
• Eosinophilic esophagitis: diminishes esophageal eosinophilic infiltration and improves swallowing function.

• Budesonide binds to intracellular glucocorticoid receptors, altering gene transcription and suppressing the synthesis of pro‑inflammatory cytokines, chemokines, and adhesion molecules. This modulation reduces leukocyte migration and stabilises lysosomal membranes, leading to decreased inflammation in target tissues.

Budesonide may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Headache: mild to moderate pain in the head region.
• Nausea: feeling of sickness or urge to vomit.
• Abdominal pain: discomfort or cramping in the stomach area.
• Upper respiratory tract infection: symptoms such as sore throat or runny nose.
• Dyspepsia: indigestion or upset stomach.
• Mild insomnia: difficulty falling or staying asleep.

Serious or Rare Side Effects

• Adrenal suppression: reduced endogenous cortisol production.
• Severe infection: increased susceptibility to bacterial, viral, or fungal infections.
• Osteoporosis: loss of bone density leading to fractures.
• Hyperglycaemia: elevated blood glucose levels.
• Visual disturbances: blurred vision or cataract formation.
• Allergic reactions: rash, itching, swelling, or anaphylaxis.

Before initiating therapy, clinicians should evaluate patient‑specific risk factors and monitor for potential complications.

• Assess adrenal function: check cortisol levels if long‑term use is planned.
• Monitor for infection: watch for signs of bacterial or fungal infections.
• Use lowest effective dose: titrate to the minimal dose that controls disease.
• Avoid abrupt discontinuation: taper gradually to prevent withdrawal.
• Caution in hepatic impairment: dose adjustment may be required.
• Store at ambient temperature: keep in the original pack, protect from moisture.

Budesonide can interact with other medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may increase systemic exposure.
• CYP3A4 inducers (e.g., rifampicin, phenytoin): may reduce therapeutic effect.
• Live vaccines: risk of uncontrolled infection due to immunosuppression.

Moderate Interactions (Monitor Closely)

• Anticoagulants (e.g., warfarin): may enhance anticoagulant effect.
• Antidiabetic agents: possible hyperglycaemia requiring dose adjustment.
• Other systemic steroids: additive immunosuppressive risk.