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Dr. Andrew Rynne

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What Causes Chronic Fatigue While On Budesonide?

I have been on a maintenance dose of 3 mg a day of budesonide for about five years for collagenous colitis. For about a year or more, I have had chronic fatigue, easy bruising, and my left calf is larger than my right. As I investigate the cause of all this, I suspect budesonide. Without it I have chronic diarrhea. What do you suggest? Is there a test for adrenal insufficiency? Can I taper off budesonide and take Imodium every other day?
posted on Wed, 3 May 2017
Twitter Fri, 9 Jun 2017 Answered on
Twitter Fri, 9 Jun 2017 Last reviewed on
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Diabetologist,  's  Response
Hello,

As suspected by you, Budesonide does lead to easy bruising, unexplained tiredness, and weakness. There can also be muscle aches and pains.

You can switch to Loperamide in place of Budesonide. While stopping that drug, do not stop it abruptly. Taper the dose to half for next 3 to 4 days, later half of that and then discontinue. Simultaneously, Loperamide can be introduced. Use it intermittently instead of every day. That is when diarrhea is more watery and more in frequency. There is no need to do any adrenal testing when dosage is tapered.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Prabhakar Laxman Jathar
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What Causes Chronic Fatigue While On Budesonide?

Hello, As suspected by you, Budesonide does lead to easy bruising, unexplained tiredness, and weakness. There can also be muscle aches and pains. You can switch to Loperamide in place of Budesonide. While stopping that drug, do not stop it abruptly. Taper the dose to half for next 3 to 4 days, later half of that and then discontinue. Simultaneously, Loperamide can be introduced. Use it intermittently instead of every day. That is when diarrhea is more watery and more in frequency. There is no need to do any adrenal testing when dosage is tapered. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Prabhakar Laxman Jathar