I just read an article stating FDA has approved Budesonide rectal foam for moderate distal ulcerative colitis. Being that I got my pouch for UC and entocort pills worked great for my pouchitis, would this be a viable option for pouchitis or does it not get high up enough into the pouch to be effective? Anyone try this?
Replies sorted oldest to newest
Yes, it should be effective for pouchitis, if that medication works for you. Being a more targeted application, the value is a more lical concentration of the drug and less systemic absorption. See the study below.
http://www.ncbi.nlm.nih.gov/pubmed/11856075
Jan 
The study says that the budesonide is as effective as oral metronidazole; that's fine but how does it compare to oral budesonide (entocort).
I'd also like to know if it still costs as much. I know it varies from health plan to health plan but for me entocort is wildly expensive. Almost as crazy as Xifaxan.
It should be as effective, if not more. This is because you get a more concentrated effect where you need it, without an increased dose.
As for expense, expect it to be high, since it is new and no generic available. I am not sure how your drug plan works, but I get brand name non-formulary drugs for the same co-pay as other brand name drugs. But, this is only true if my doctor writes the prescription with exception codes that allow for that coverage. I suppose it is easier for my doc, because I have Kaiser, and the pharmacy, medical care, and coverage provider are all integrated.
Have you considered hydrocortisone retention enemas or Cortifoam enemas as a more cost effective alternative? Yes, there is more systemic absorption compared to budesonide, but being topical over a smaller area, this is reduced. Once in remission, you just reduce to the lowest frequency that keeps you there. Could be once a week or less.
Jan
