Uceris vs entocort vs pred?

Hi, Discussed with doc what new med to add as son is in flare (while on remicade). Doc suggested short course of prednisone (40 mg for 2 weeks with no taper). Other options - Uceris (steroid that releases in colon), or entocort? Anyone have personal experience with Uceris or Entocort? I prefer these newer steroids to standard prednisone if they are more effective. Looking for effectiveness and side effect profile from personal experience? Thanks!

Entocort and Uceris are both Budesonide. But Entocort is more for asthma or general inflammation in the body. It has to work systemically, but you use less then pred because it has stronger receptor affinity. Uceris is Budesonide formulated to release in colon, where much less is absorbed, and it mostly works topically.

My co-pay on 30 tablets of this brand name drug would be $470.

I don't think 2 weeks of pred is going to hurt unless there is extreme sensitivity. With such a short period the taper is not really needed, but you could do 20mg for a week, then 10mg for a week. You do hear stories here from those who have had trouble. Long term steroids hurt bones and organs. BUT, over 1 million people in the US take high doses of pred on a short term basis, and quite a few on lower doses for longer term. It does the job it is supposed to do.

Two weeks of pred will cost about $5. Unless there is strong concern, I am not sure you want to spend hundreds of dollars for such short term use.

Never had any luck with Uceris or Entocort at all

I thnk it is worth a try, my doc gave me some uceris samples and I did better on those then this budesonide so see if you can actually get that maybe.

I did Uceris and Pred at the same time and am certain the Pred is what did it.

If it were my son, I'd ask to do a 10 day steep taper starting high, maybe 60 mg. You can knock out a flare quickly with high doses without side effects. I'd do days 1 and 2 at 60, days 3-4 at 50, days 4-5 at 40, --evaluate results -- if symptoms were improving, I'd then do day 6 at 30, day 7 at 20, day 8 at 10, day 9-10 at 5 mg.

Im a big believer in hitting the inflammation with high doses of Pred early. Lower doses of Pred, or Uceris, will drag it out too long making healing harder.

Have you considered hydrocortisone enemas? They can work very well with or without oral Pred.

I thought you have to taper pred if on it more than 5 days. I am so considering it if the liada doesn't work after a couple weeks. I want the shortest dose for the shortest amunt of time. Good luck BV keep us posted

Thank you,

Uceris worked great for me for a while but then it did absolutely nothing. I don't know what happened. At that point, I had to start prednisone to get things under control. Right now I am on a very low dose of pred - under 5mg, tapering, and I am taking uceris as a back up. I prefer uceris because the side effects are not noticeable but I am not sure it keeps my inflammation in check. I am hoping I can get off all this stuff by the end of the month.

iPoop said...
Rectal steroids in enema or suppository form might be the better choice. They are both 90 percent topical and 10 percent systematic (as is uceris)...........Uceris is a delayed release steroid, with a ph based coating (similar to asacol hd, lialda). It can be pricey, call before getting your prescription filled.

Thanks for the advice, @ipoop. My son is freaked out about enema option so trying uceris first as both are topical steroids.

Any significant side effects with Uceris that people have had?

BV: One thing you should know is that all the studies done regarding Uceris were two months long. For this reason doctors usually prescribe Uceris for two months only and then quit. In my mind this is stupid because there have been many who benefited from Uceris and then (like any steroid) once you quit you are back to square one. Almost totally pointless in my mind to have something that works good and then after two months you quit and then, surprise, you are right back where you started. Now being a steroid, it is not advisable to take it long term on a constant basis but, prednisone is a much worse med and doctors seem to have no qualms about prescribing it for months and months on end. If I were the doc, and Uceris worked well in my patient, I would continue prescribing it after that initial two month period by cutting it back to every other day and then maybe every third day, possibly down to just once a week for a very long time. You may want to see if you could try this if you find Uceris does indeed work for you. Otherwise, shortly after your two months is up you will be scrambling around trying to figure out what to do next (assuming it worked in the first place).

Having quite a bit of burning in gut area (below navel) after 3 days of uceris. Could be because of the iron coating on it, my son is quite intolerant to iron supplements so possibly that's causing it or some other Uceris contents. Has anyone observed this? Will talk to doc and may have to switch to pred.

Having significant burning discomfort, has also complained about nausea feeling though not quite as much. Its been 4 days, thinking of pausing uceris to confirm that this is due to the med. Will discuss with doc on Monday and switch to pred if needed - as in this condition he doesn't feel like eating much.

Maybe a week? I don't remember. And I stopped it without a taper because it was just making my symptoms worse.