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Cortiment vs entocort

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Ulcerative Colitis
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Posted 5/12/2021 12:58 AM (GMT 0)
So I'm currently on 9mg of cortiment to try and achieve remission while Imuran starts to work again, and my dr wants me to start tapering. So because cortiment doesn't come in less than 9mg he has prescribed Entocort 6mg for 4 weeks, then 3mg for 4 weeks.
I know they're both budesonide, but I understand they release at different parts of the digestive tract.
I mentioned that to both my doctor and pharmacy and both said "no they're the same drug"
Everything I see online says not to use entocort for Ulcerative Colitis, but for Crohns.
I just finished my last cortiment and start 6mg of entocort tomorrow but am nervous they've made a mistake.
Any thoughts?
Posted 5/12/2021 1:38 AM (GMT 0)
It is confusing!

Yes, they are the same drug, exactly the same. So they are right to say it's the same drug.

The issue is the coating. One releases at a pH of 5.5. That is in the duodenum.
The other releases at a pH of 7. That is in.the colon.


So they will be delivered to different areas, even though they are the same drug.

Technically you want the one that releases in the colon (cortiment) and not entocort. But hopefully, in practice, it won't make a big difference. A lot of the drug should still be absorbed in the colon.

Sorry it is stressful. See how you go. The problem is that you can't split the cortiment as it only comes in 9mg.

Good luck.
Posted 5/12/2021 4:44 AM (GMT 0)
ambling, isn't entocort formulated to release beginning at the terminal ileum, not the duodenum?
Posted 5/12/2021 6:50 AM (GMT 0)
Yes it is Beave.
The capsule begins breaking down when pH rises above 5.5, ( up to 7) which is the duodenum. The pH of the small bowel rises slowly (becoming less acidic) as the capsule travels along and continues to break down. There is actually an increase in acidity in the caecum, before meeting the large intestine where it is more or less neutral.

It's tricky to target that area, but they figured the optimal breakdown pH was that of the duodenum, where there is a sharp change from the high acidity of the stomach.
Posted 5/12/2021 11:59 AM (GMT 0)
Thank you! I'm sure I will know in 24-48 hours. Fingers crossed I can continue to taper.
Posted 5/12/2021 10:23 PM (GMT 0)
Have you thought about taking Cortiment every other day? i.e. 4.5 mg/day on average.
Posted 5/12/2021 10:55 PM (GMT 0)
I'm going to ask about that Bruce. I am calling the pharmacy tonight to see what they think.
The only thing that gives me pause is that my last scope did show my inflammation on the right side only which is odd, but the entocort should reach there?
I'll be keeping a close eye.
Posted 5/12/2021 11:07 PM (GMT 0)
Pharmacy seems comfortable that it can be used for ulcerative colitis as well.
I guess I'll have to wait a couple of days and see what happens.
This disease can be so frustrating at times, esp when we do research and feel like we know better (which isn't always true but...)
Posted 5/12/2021 11:23 PM (GMT 0)
You can stop cortiment cold turkey as there is little systemic absorption (the main reason for tapering with systemic steroids is to give your adrenals time to recover). Your dr is probably being extra cautious in prescribing entocort.
Posted 5/12/2021 11:32 PM (GMT 0)
Thanks! That helps me relax a little.
I'll keep an eye on myself next couple days.
Thank you 🙏
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