If you have IBD then you have probably had to take, or been offered corticosteroids by your doctor. The most common one I've seen prescribed is Prednisone. Drugs like this are majorly effective at reducing inflammation. Unfortunately, while it is pummelling the inflammation, it's wreaking havoc across the rest of your body too. Several months ago when my doctor suggested that I go on Prednisone for the second time, I asked about another related drug called Entocort (generic name: Budesonide). I had heard that Entocort has fewer side effects versus Prednisone. My doctor was in favour of trying it. So I have the benefit of being able to compare them. Predisone comes in tablets while Entocort comes in a capsule which is more targeted to your small intestine. Unfortunately I can't compare their effectiveness because my flare ups were very different situations. But here at least is a list of the side-effects which I experienced. Both drugs were only taken for a couple of months then tapered off.
Prednisone (max dose 40mg - 8 x 5mg tablets)
- Increased appetite
- Insomnia / increased energy
- Thinning hair / hair loss
- Acne
- Sweats
- Fluttering / irregular heart beats*
- Oral thrush
- Joint pain (moderate)
* This one really worried me and was the main reason I did not want to take it again.
Entocort (max dose 9mg - 3 x 3mg capsules)
- Increased appetite (slight)
- Insomnia / increased energy
- Acne (minor)
- Sweats
- Oral thrush
- Joint pain (minor)
Ultimately the main difference is that Entocort did not make my hair thin or my heart beat irregular. Also, Entocort required fewer pills to be taken, although the Entocort capsules did float which made them tricky to swallow. In the end, I much preferred Entocort. My doctor even told me that Entocort is known to cause fewer side effects.
Each person is different and you might have a totally opposite experience, but I thought this might be helpful to someone. If you have taken either of these drugs, please share your feedback too!
my boyfriend found your blog and i'm so in love hahh well not really but you suffer from crohns of the ileum just like meeee and you had surgery.
ReplyDeleteok so i was actually allergic to entocort and got all these weird side effects. my joints swelled up and i got hives all over. i was on prednisone for a good 5 months or so back in 04 before my GI realized that it wasnt working and the last resort was to have the resectioning.
i havent had to be on long doses of steroids since the surgery and i was lucky enough to have zero complications after. i wonder if the level of treatment is different in the states vs canada? i've always wondered. i had an incredible surgeon and he did a great job with the scar.
Michelle
Have you heard of or considered a medication called remicaid? Worked wonders for me with absolutely zero side effects and only one treatment every two months.
ReplyDeleteI am new to your site. I had Cohn's for over 30 years. I had numerous of bowel resection and finally ended up with colostomy non-reversal, thinking that would be the end of flare up. I have been on Remicade which made me so sick like I had the flu and felt like I was having a heart attack. I been Humana worked wonders, my body got used to it, then I ended up with Cimzia. Another wonder drug I was on Cimzia for a few years then my liver started to fail and ended up having liver transplant a year ago. Now I started having Cohn's flare and was put on Entocort EC. Hope it works till I see my transplant GI doc. People don't realize that these drugs cause all sorts of problems. I know someone with Cohn's had a kidney and liver transplant. Be careful out there
DeleteThanks for the comment, very timely because my doctor is pushing Remicade... Eek.
DeleteBright Side
I would definitely ask your doc about Humara or Cimzia.
DeleteThere are Humara and Cimzia prescription card to help the cost. Ask your doc about them.
DeleteHi!
ReplyDeleteYes, when I made the decision for surgery I had weighted the pros and cons of Remicaid. I decided to save that for the future since... if I go off it to have children, I could become immune to it. Better to save it if I need it after having kids.
I have the worst side effects from prednisone. It wreaks havoc on my life: I sleep only 2-3 hours per day, I bloat, I am an emotional wreck, I get acne, my hair falls out, and my joints hurt. Going on Entocort helped me feel better while I transitioned onto Imuran.
ReplyDeleteRED
After taking Sulfasalazine for 20 years and then Pentasa (masalamine)for 5 years, neither could keep my Crohn's in remission any longer so I had a 2nd resection this last March 2010 after 25 years of having the 1st one.
ReplyDeleteTaking the last month 20mg of Prednisone 2x/day I did have minimal side efects like Bright Side did including:
- Increased appetite (slight)
- Increased energy
- Sweats maybe 1x week while sleeping
- Joint pain in finger(minor)
But I had taken early Entocort when I had flare ups with really no problems up until I had the resection in March 2010. Immuran seemed to work for me about a month but after having a piece of ear removed due to Melanoma, they would not prescribe me Immuran any longer since it is a strong immunosuppressant. Going to get my GI Doc to put me back on Entocort permanently this time with a taper of 9 mg month 1, 6mg month 2, 3mg month 3, and then cyle back to 9mg and see if that works. I'm saving biologics like Remicaid, Cimzia, and Humira as a last resort and will let you know how it goes on a monthly basis.
R. Patzer
Great way to take any capsule: Put capsule(s) in mouth and take large sip of water - bend head forward with chin towards chest and swallow (capsules go to back of throat and head straight down with the water). Works like a charm!
ReplyDeleteAbout me: 45, Crohn's for 26 years. Remicade can (quickly) lead to an adverse immune response to the mouse protein with which is it made - I went into complete anaphylaxis during the 3rd infusion. However, I ended up in a drug trial for Humira which worked incredibly well (from 12 bm x day to 2 and eventually complete remission). It is now on the market for regular use in Crohn's. It is a drug you inject yourself only once every 14 days, no pills, no infusions. Small price to pay.
ReplyDeleteI was told by Cleveland Clinic that I could not go on Remicade, Cimzia, or Humiria due to Melanoma from Immuran. I was on Prednisone forever, and now Entocort, and Immuran, but having horrible pain in my side and they do not have any idea what it is other than Crohns. I had my gall bladder out last August. And had dibilitating pain since February.
ReplyDeleteHi Anonymous. Have you had a colonoscopy to try and get a firm diagnosis? They can't really diagnose it unless they see the inflammation in your digestive tract. They can also take a sample and test it.
ReplyDeleteHi- Has anyone considered taking TSO? There is currently a US clinical trial enrolling patients at least 35 locations
ReplyDeleteI just started entocort for a flare but it wasn't working at all, so I'm back on prednisone for what feels like the hundredth time. I've done Imuran and Lialda, but prednisone is what really works for me. Does anyone know much about Humira? I wonder why my doctor has never brought it up? What are the cons?
ReplyDeleteI think that Humira is super expensive. Not sure what country you live in, and what your drug coverage is. Might be a factor your doctor is considering.
ReplyDeleteI have had Crohn's and Ulcerative Colitis for 20+ years. I used to take Prednisone but got off it due to the side effects. I have been able to control my flare-ups with natural healing, most of the time. I am currently having a flare-up that started after Thanksgiving and has progressed rapidly in a week. So, I called my GI and told him and he suggested Entocort. Should I take this? If so, what strength, considering I have medium flare-up?
ReplyDeleteThank you.
Sorry to hear about your flare up! I cannot give medical advice since I'm not a doctor. You will have to ask your doctor these questions.
ReplyDeleteThanks everyone. I just had to start taking entocort. Not exited. Hopefully this works. I've been sick for a while now. And then in the summer my weight started falling off like thirty pounds now. I've been for alkyl the tests. After a colonoscopy and scope they turned up gastritis. They put me on pantoprezole in September. With no results results. Still have diarrhea and major pain. Weight still falling off. Pound and a half a week. We are going to try enticort. I just started today. Hopefully all goes well. The Dr thinks microscopic type crowns. I'm worried. But thanks for all your comments. It helped.
ReplyDeleteGood luck and I hope you get some relief. Don't forget to keep eating! Even if you have to keep it ultra bland and low fibre. Some Ensure type shakes might help too. Your nutrition is vital to helping your body fight.
ReplyDeleteHey guys, Love all the posts. Not sure if any of you have tried 6-mp. I started it about 4 years ago. I started it while i was on pred. 6-mp takes 4-6 months to really start feeling results that is why they recommend that you stack. I eventually was down to 50mg/day and feeling great. So i stopped taking it about a year ago. Symptoms have started to come back, so back on it i go. I suppose i should have just kept taking it. thought i was in remission. From what i have read that if prednisone works well for you, there is a good possibility that 6-mp will as well. anyways, just thought I'd throw that out there. Keep living the good fight!
ReplyDeleteDiagnosis: Ulcerative Colitis at age 4. I came on here to find out about the combination of Prednisone and Entocort for my now 7 year old daughter. The Dr. recently added the Entocort after a flare this summer. Her bowels seem much better but she is paying the price. I see her swollen face, acne, increased weight gain, and moodiness. I TRY my best to help her...and be her advocate. We've tried everything mentioned above (except 6mp.) I wish there was an EASY answer to these diagnosis's.
ReplyDelete*FYI we find the Probiotics and fresh squeezed veggies and fruits help, too. Love and health to ALL of you out there. Amy~
BE CAREFUL WITH PREDNISONE. It worked very well for my microscopic colitis, but my eye doctor is convinced that it gave me glaucoma. He hoped the glaucoma would improve after stopping prednisone, but it hasn't.
ReplyDeleteIF USING PREDNISONE FOR MORE THAN A FEW MONTHS, PLEASE HAVE YOU EYE PRESSURE CHECKED. DON'T WAIT UNTIL YOU NOTICE PERMANENT VISION LOSS!
More points against Prednisone. I maintain that it's the worst medication I've ever taken. Thanks for your comment!
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