What is budesonide?

Budesonide (brand names: Entocort EC®, Uceris®, Pulmicort®, Rhinocort®) is a systemic glucocorticoid (steroid) used to treat inflammatory bowel disease (IBD) in dogs and cats, especially when other steroids are ineffective, or the pet cannot tolerate steroids. It may also be used to treat sinus inflammation or asthma.

Its use in cats and dogs to treat IBD is ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

How do give this medication to your pet?

Budesonide is given by mouth in the form of a capsule or tablet or administered as a nasal spray or inhalant. Do not open or crush the capsule or allow your pet to chew the capsule. Do not stop this drug abruptly unless instructed by your veterinarian. If your pet vomits or acts sick after receiving the medication, give it with food.

This medication will take a few days to have effects, although these effects may not be visibly obvious.

What if I miss giving my pet the medication?
If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?
The most likely side effects include increased appetite, increased drinking and urination, lethargy, muscle weakness, increased panting in dogs, skin and haircoat changes, weight increases, and a potbellied appearance.

This medication has a moderate duration, and therefore the effects may last for several days even after your pet has stopped the medication. These effects may be even longer in pets with liver and kidney disease.

Are there any risk factors for this medication?
Budesonide should be avoided in pets that are allergic to the medication. It should be used cautiously in pets that have conditions such as gastrointestinal ulcers, active infections, diabetes mellitus, or cataracts, as these conditions are negatively affected by steroids. It should be avoided in pets undergoing a surgical or other stressful procedure.

Budesonide should be avoided in pregnant and lactating pets, and if it must be used, the benefits should outweigh the risks.

Are there any drug interactions I should be aware of?
Budesonide should be used with caution when given with the following medications: erythromycin, cimetidine, ketoconazole, itraconazole, fluconazole, diltiazem, grapefruit juice powder, NSAIDs such as carprofen, deracoxib, or robenacoxib, and oral antacids.

Budesonide also interacts with intradermal skin testing for allergens, so a 2-week withdrawal period is recommended if your pet is undergoing skin allergy testing.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?
Monitor your pet for any adverse effects while on this medication. Your veterinarian may also monitor your pet to be sure that the medication is working.

How do I store budesonide?
The oral capsules should be stored at room temperature, in a tight container, and in a dark and dry place. Short excursions in temperatures between 15°C – 30°C (59°F – 86°F) are allowed.

What should I do in case of an emergency?
If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.