How do budesonide rectal foam and enemas work?
Budesonide is a steroid (corticosteroid) medicine.
Steroids closely copy the effects of natural hormones produced in your adrenal glands. The adrenal glands are above your kidneys. Steroids work by reducing the activity of your immune system and decreasing swelling (inflammation).
Budesonide rectal foam and enemas work by reducing swelling (inflammation) in the lining of your bowel and bottom (rectum). This helps relieve symptoms like stomach (abdominal) pain and diarrhoea with blood in it.
When will I feel better?
Budesonide rectal foam and enemas do not work right away.
Your symptoms will usually start to improve within 1 or 2 weeks. It can take 2 to 4 weeks for the medicine to reach its full effect.
Do I need to be careful of infections?
Using budesonide rectal foam or enemas makes you more likely to catch infections such as flu, coronavirus (COVID-19), a cold, urinary tract infections (UTIs) and chest infections. Tell your doctor if you get symptoms of an infection or test positive for COVID-19.
Try to avoid having any contact with infectious diseases, especially measles, chickenpox or shingles. If you get any of these illnesses they could make you very ill.
Tell your doctor straight away if you come into contact with someone who has chickenpox, shingles or measles. Your doctor may be able to prescribe a medicine to protect you.
Can I still have vaccinations?
If you need any vaccinations, tell the doctor or nurse that you're using a steroid.
Using budesonide rectal foam or enemas may mean that you need an annual flu vaccine.
The flu, COVID-19 and Shingrix shingles vaccines are non-live (inactivated) vaccines. They can be given while you're using steroid medicine.
Live vaccines are different, and you may not be able to have one if you're using budesonide rectal foam and enemas. This is because your immune system may not be strong enough and it could cause an infection. These live vaccines include the:
- Zostavax shingles vaccine
- BCG (tuberculosis) vaccine
- yellow fever vaccine
- MMR (measles, mumps and rubella) vaccine
- nasal spray flu vaccine
Do I need a steroid card?
Red steroid emergency card
If you're prescribed steroid medicines such as budesonide, your adrenal glands may not make as much of some of the hormones your body needs such as cortisol (known as the stress hormone). This is known as adrenal insufficiency.
It's more likely to happen if you either:
- take high doses for a long time, especially tablets and injections
- regularly use different kinds of steroids at the same time, such as a steroid nasal spray and a steroid inhaler
Your doctor or pharmacist will assess your risk of adrenal insufficiency based on the type and dose of steroids you're taking, and may recommend that you carry a red steroid emergency card. This card is the size of a credit card and fits in your wallet or purse.
Important
If you need any medical or dental treatment, or are having surgery or an invasive procedure, show your steroid emergency card to your doctor or dentist. This is important so they know you're having steroid treatment and can give you extra steroids as needed.
Blue steroid card
If you're on a high dose of budesonide, your doctor or pharmacist will also give you a blue steroid treatment card. It tells you how you can reduce the risks of side effects. It also gives details of your doctor, how much budesonide you take and how long the treatment will last for.
If you need any medical or dental treatment, show your blue steroid card to the doctor or dentist.
Will it affect my contraception?
Budesonide rectal foam and enemas do not affect any type of contraception, including the combined pill and emergency contraception.
However, if you're having a flare-up of ulcerative colitis that causes severe diarrhoea, your contraceptive pills may not protect you from pregnancy. Check the pill packet for more information.
Find out more:
Can I drive or ride a bike?
For most people, budesonide rectal foam and enemas will not change their ability to drive a car or cycle.
However, if it affects your eyesight in any way, do not drive, cycle or use tools or machinery.
It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.
Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while using budesonide rectal foam or enemas. GOV.UK has more information on the law on drugs and driving.
Can I drink alcohol while using budesonide rectal foam or enemas?
Yes, you can drink alcohol when using budesonide rectal foam or enemas.
However, drinking alcohol can make the symptoms of ulcerative colitis worse.
Is there any food or drink I need to avoid?
Do not eat grapefruit or drink grapefruit juice while you're using budesonide rectal foam or enemas. Grapefruit can increase the level of budesonide in your blood. This can increase the risk of side effects of budesonide or change how it works.
Apart from this, you can eat and drink normally.
However, if you have ulcerative colitis you may need to avoid certain foods to help your symptoms.
Read about living with ulcerative colitis for more advice.