Lecapusa (Budesonide)

• Budesonide is used to treat inflammatory conditions of the gastrointestinal tract and related disorders.
• Crohn's disease: reduces intestinal inflammation and helps maintain remission in patients with mild to moderate disease.
• Ulcerative colitis: controls colonic inflammation and alleviates symptoms in mild to moderate cases.
• Eosinophilic esophagitis: decreases eosinophilic infiltration and improves swallowing function.

• Budesonide binds to intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus and modulates gene transcription. This interaction suppresses pro‑inflammatory cytokine production, inhibits leukocyte migration, and stabilises lysosomal membranes, resulting in potent anti‑inflammatory and immunosuppressive effects in target tissues.

Budesonide may cause a range of adverse reactions, most of which are dose‑related and reversible upon discontinuation.

Common Side Effects

• Oral candidiasis: fungal infection of the mouth.
• Nausea: feeling of stomach upset.
• Headache: mild to moderate intensity.
• Dyspepsia: indigestion or upper abdominal discomfort.
• Upper respiratory tract infection: cold‑like symptoms.
• Fatigue: general tiredness.

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 mineral density with long‑term use.
• Hyperglycaemia: elevated blood glucose levels.
• Anaphylaxis: rare severe allergic reaction.
• Psychosis or mood changes: rare psychiatric disturbances.

• Before initiating therapy, clinicians should evaluate patient‑specific risk factors and monitor for potential complications.
• Assess adrenal function: monitor for signs of suppression, especially with prolonged use.
• Screen for infections: treat active infections before starting therapy.
• Use lowest effective dose: limit exposure to reduce systemic effects.
• Avoid abrupt discontinuation: taper gradually to prevent withdrawal.
• Pregnancy and lactation: consult a healthcare professional before use.
• Store at ambient temperature: keep in the original container, protect from moisture and light.

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

Major Interactions (Avoid)

• Ketoconazole: may increase systemic budesonide exposure.
• Rifampin: may markedly reduce budesonide effectiveness.
• Strong CYP3A4 inducers (e.g., phenytoin, carbamazepine): may lower drug levels.

Moderate Interactions (Monitor Closely)

• Anticoagulants (e.g., warfarin): may enhance anticoagulant effect.
• Antidiabetic agents: may affect glucose control.
• Live vaccines: may have reduced efficacy; consider timing of administration.