7 mins read

Overview: Rectal budesonide is used to treat ulcerative colitis. It comes as a foam that is inserted into the rectum. Rectal budesonide is a corticosteroid and works by reducing inflammation in the rectum and the lower part of the large intestine. Nausea is a common side effect. Serious side effects include an increased risk of infections. Call your health care provider right away if you have an infection or symptoms such as fever, chills, aches, or tiredness.

Uses

What is rectal budesonide used for?

Rectal budesonide is used to treat ulcerative colitis.

Rectal budesonide may also be used for other conditions as determined by your health care provider.

How does rectal budesonide work (mechanism of action)?

Rectal budesonide belongs to a group of medicines called corticosteroids. It works by reducing inflammation in the lower part of your large intestine (colon) and rectum.

How is rectal budesonide supplied (dosage forms)?

Brands and other names

  • Uceris

Dosage forms and strengths

  • 2 mg/actuation (pump) rectal foam

See also: Budesonide (Entocort EC, Uceris), Budesonide for nebulization (Pulmicort Respules), Budesonide nasal, and Pulmicort Flexhaler (budesonide).

How should I store rectal budesonide?

Rectal budesonide should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Avoid storing rectal budesonide at temperatures above 120 F (49 C) or near fire or flame. Do not puncture, burn, or refrigerate it.

Side Effects

What are the most common side effects of rectal budesonide?

The most common side effects of rectal budesonide are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Changes in stress hormone (cortisol) levels (see below)
  • Reduced adrenal function (see below)
  • Nausea

There may be other side effects of rectal budesonide that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of rectal budesonide?

While less common, the most serious side effects of rectal budesonide are described below, along with what to do if they happen.

Severe Allergic Reactions. Rectal budesonide may cause allergic reactions, which can be serious. Stop using rectal budesonide and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Increased Stress Hormone (Hypercortisolism) Levels. Using rectal budesonide for a long time can lead to hypercortisolism, a condition that happens when your body has too much stress hormone, also called cortisol. Call your health care provider if you have any of the following symptoms of increased stress hormone levels.

  • Acne
  • Easy or frequent bruising
  • More or thicker hair on your body and face
  • Rounded or moon-like face
  • Ankle swelling
  • Hump or a fatty pad between your shoulders
  • Stretch marks on your stomach, thighs, breasts, or arms

Reduced Adrenal Function. Using rectal budesonide for a long time can cause your body’s adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. This is especially a concern if you have been taking a corticosteroid by mouth, such as prednisone, and you stop it and switch to rectal budesonide. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your health care provider if you have any of the following symptoms of adrenal insufficiency.

  • Nausea and vomiting
  • Weakness, tiredness, or lack of energy
  • Low blood pressure

Infections. Rectal budesonide may weaken your immune system and increase your risk of infections, including serious infections. Call your health care provider right away if you have an infection or any of the following symptoms.

  • Burning or stinging when you pee
  • Cough or coughing up blood
  • Fever, sweats, chills, or muscle aches
  • Shortness of breath
  • Diarrhea, stomach pain, nausea, or vomiting
  • Weight loss
  • Tiredness

Reactivated Infections. Some types of microbes that cause infections (such as bacteria or viruses) can remain in the body after you recover from that infection. When a microbe stays in the body but does not cause an infection, it is called a “latent” microbe. Rectal budesonide may increase your risk of a latent microbe becoming active again, causing an infection. Before you start treatment with budesonide, tell your health care provider if you have ever had tuberculosis (TB), hepatitis B, or any other serious infections.

Warnings & Precautions

Who should not use rectal budesonide?

Allergies to Ingredients. People who are allergic to any of the following should not use rectal budesonide.

  • Budesonide
  • Uceris
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific rectal budesonide products they stock.

What should I know about rectal budesonide before using it?

Do not use rectal budesonide unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share rectal budesonide with other people, even if they have the same condition as you. It may harm them.

Keep rectal budesonide out of the reach of children.

Avoid being around people who have chickenpox or measles while you are using rectal budesonide. If you think you have been exposed to chickenpox or measles, tell your health care provider right away.

This medicine is used rectally. Do not take rectal budesonide by mouth. Make sure that you or a caregiver understands how to properly use rectal budesonide. If you have any questions, talk to your health care provider.

Before using rectal budesonide, make sure you use the bathroom to empty your bowels. Warm the canister while shaking it well for 10-15 seconds.

You can use rectal budesonide while you are standing, lying, or in a sitting position (such as on the toilet). Use a new applicator for each dose. Use each applicator only once.

Rectal budesonide is flammable. Do not use it near a fire, flames, or while smoking.

Switching from another corticosteroid medicine by mouth (such as prednisone) to rectal budesonide may cause a worsening of certain symptoms, including allergies (such as a runny or stuffy nose or eczema). Follow any instructions from your health care provider about how to switch medicines. Tell your health care provider if any symptoms you have get worse while using rectal budesonide.

What should I tell my health care provider before using rectal budesonide?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if rectal budesonide is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have or have had any of the following.

Upcoming Surgeries or Procedures. Tell your health care provider if you are planning to have a surgery or procedure, including a colonoscopy.

Other Medicines and Supplements. Rectal budesonide may interact with other medicines and supplements. Before using rectal budesonide, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how rectal budesonide could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant, think you might be pregnant, or plan to become pregnant.

Breastfeeding. Rectal budesonide may pass into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop rectal budesonide.

Interactions

Does rectal budesonide interact with foods or drinks?

Do not eat grapefruit or drink grapefruit juice while you are using rectal budesonide. Grapefruit can increase the levels of budesonide in your blood and may increase your risk of side effects.

It is unknown if drinking alcohol will affect rectal budesonide.

Does rectal budesonide interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using rectal budesonide.

  • Fluconazole (Diflucan), itraconazole (Sporanox, Tolsura), ketoconazole, posaconazole (Noxafil), or voriconazole (Vfend), which are medicines used for fungal infections
  • A protease inhibitor, such as atazanavir (Reyataz), nelfinavir (Viracept), or ritonavir (Norvir), which is a medicine commonly used to treat HIV
  • Erythromycin (Ery-Tab and others), which is a medicine used for bacterial infections
  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine that suppresses your immune system
  • Any other medicine that contains a corticosteroid, such as for allergies or asthma

Some other medicines may alter the blood levels of rectal budesonide. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with rectal budesonide. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much rectal budesonide?

If you or someone else has used too much rectal budesonide, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of rectal budesonide?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.