Budesonide Rectal Foam and Enemas

What are budesonide rectal foam and enemas?

Budesonide rectal foam and enemas are prescription-only corticosteroids designed for local treatment of inflammation in the lower bowel. Administered directly into the rectum, they act on the lining of the rectum and sigmoid colon to reduce symptoms in conditions such as ulcerative colitis and proctitis. Common brand names include Budenofalk and Entocort[1]. 

You can also find advice here on budesonide nasal spray, budesonide for skin, and budesonide tablets, capsules, & granules.

What are budesonide rectal foam and enemas used for?

These preparations are used to treat specific forms of inflammatory bowel disease[1]: 

• Ulcerative colitis (especially mild to moderate flare-ups) 

• Proctitis (inflammation of the rectum) 

• Distal colitis (inflammation in the lower part of the colon) 

They can help alleviate symptoms including[1]: 

• Rectal bleeding 

• Diarrhoea 

• Urgency 

• Abdominal discomfort 

How do budesonide rectal foam and enemas work?

Budesonide is a glucocorticoid steroid that reduces inflammation by acting directly in the bowel[1]: 

• Suppresses immune responses in the bowel lining 

• Decreases the release of inflammatory substances 

• Reduces swelling and irritation 

Because these products are locally acting, they tend to cause fewer systemic side effects than oral steroids. 

Who can take budesonide rectal foam and enemas?

These medicines are suitable for many adults aged 18 and over but not for everyone. 

Speak to your doctor first if you have[1]: 

• Have an allergy to budesonide 

• Have been in contact with someone who has chickenpox, shingles, or measles 

• Have an infection, or recently had one 

• Have other bowel or rectum problems 

• Have ever had a stomach or intestinal ulcer 

• Have mental health problems, like depression or psychosis 

• Have high blood pressure, diabetes, liver issues, or osteoporosis 

• Have ever had tuberculosis 

• Have glaucoma or a cataract 

• Have recently had a vaccination or due to have one 

• Are pregnant, trying to get pregnant, or breastfeeding 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

What is the typical dosage of budesonide rectal foam and enemas?

The usual dose of budesonide rectal foam or budesonide enema is 2mg, used once a day for up to 8 weeks, but dose and duration may be adjusted based on your condition[1]. 

How do you take budesonide rectal foam and enemas?

To ensure proper use of the foam, follow these steps[1]: 

• Empty your bowels before applying 

• Shake the canister for 15 seconds 

• Attach the applicator and remove the safety lock 

• Lie on your side with one leg extended and the other bent 

• Insert the applicator fully into the rectum 

• Press the pump dome and release slowly 

• Keep the applicator in place for 10-15 seconds 

• Avoid bowel movements until the next morning if possible 

Enemas are administered in a similar way, but they use a liquid solution rather than foam. 

Always consult the product literature for full instructions. 

Can you stop taking budesonide rectal foam and enemas?

Do not stop without medical advice. Sudden withdrawal may lead to worsening symptoms. Your pharmacist or doctor may suggest tapering the dose gradually[1]. 

What do you do if you take too much budesonide rectal foam and enemas?

Occasional overuse is not usually harmful, but repeated high doses may cause[1]: 

• Hormonal imbalances 

• Cushing’s syndrome 

• Bone weakening 

Seek medical advice if you are unsure or concerned. 

What do you do if you forget to take budesonide rectal foam and enemas?

If you miss a dose[1]: 

• Use it as soon as you remember 

• If it’s close to the next dose, skip the missed one 

• Do not double the dose 

How do you store budesonide rectal foam and enemas?

Proper storage helps preserve the medicine’s safety and effectiveness[1]: 

• Store below 25°C 

• Keep away from direct sunlight and heat 

• Do not freeze 

• Keep out of reach of children 

• Dispose of used applicators properly 

What medicines can’t you take with budesonide rectal foam and enemas?

Speak to your doctor first if you take or have recently taken any of the following[1]: 

• Other medicines that contain steroids 

• Antifungals (e.g. ketoconazole, itraconazole) 

• HIV medications (e.g. ritonavir, cobicistat) 

Also avoid grapefruit juice, as it may alter how budesonide works in your body. 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of budesonide rectal foam and enemas?

As with all medicines, some people may experience side effects. Common (up to 1 in 100 people) side effects include:[1] 

• Burning or pain in the rectum 

• Diarrhoea 

• Nausea 

• Indigestion 

Uncommon or rare side effects include[1]: 

• Cushing’s syndrome (moon face, weight gain in upper back or belly) 

• Adrenal insufficiency (upset stomach, dizziness, fainting, muscle weakness, tiredness, mood changes, loss of appetite, and weight loss) 

• Skin reactions including rash and delayed healing 

• Signs of an infection (high temperature, chills, sore throat, ear or sinus pain, a cough, phlegm, pain peeing, mouth sores, wounds not healing) 

• Visual disturbances such as blurred vision or glaucoma 

• Pancreas problems (severe stomach pain, severe back pain, upset stomach, or vomiting) 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about budesonide rectal foam and enemas

Can I use budesonide rectal foam during pregnancy? 
Only if prescribed by your doctor[1]. 

Can I use budesonide rectal foam while breastfeeding? 
Yes, but only under medical supervision[1]. 

Can I use budesonide rectal foam with other IBD medications? 
Often yes but always check with your doctor[1]. 

Does budesonide rectal foam work immediately? 
It may take a few days to begin relieving symptoms[1]. 

Can I use budesonide rectal foam long-term? 
It is usually for short-term use unless advised otherwise[1]. 

Can I drive or operate machinery? 
Yes, unless you experience visual disturbances[1]. 

Can I use budesonide rectal foam with oral steroids? 
Yes, in some cases and only under medical supervision[1]. 

Can I use it if I have diabetes? 
Yes, but you may need to monitor your blood sugar more closely[1]. 

What if symptoms return after stopping? 
Speak to your doctor, as further treatment may be necessary[1]. 

For the official NHS guide to budesonide rectal foam and enemas, visit their website.