Entocort VS. Prednisone

Entocort and Prednisone are both potent steroids that are used when there is a need to reduce the inflammation by suppressing the immune system. Let’s compare these two medications to get a better idea which one is good in your case.

How do they work?

Our bodies produce our own glucocorticoids or multifunctional hormones that can curb inflammation and regulate the way our cells use sugar and fat among other things. Entocort and Prednisone mimic the behavior of cortisol, the most crucial glucocorticoid which is made by adrenal glands. 

Medical conditions treated by Entocort and Prednisone

Entocort is mostly prescribed to cope with flare-ups of inflammatory bowel disorders of unknown origin such as Crohn’s disease and ulcerative colitis. The generic form of this drug, Budesonide, has been prescribed since 1983 mainly for asthma treatment. It’s still available for asthmatics in the form of jet nebulizers and inhalers under such brand names as Pulmicort, Symbicort, etc. As a nasal spray, budesonide (Rhinocort Aqua) is used for allergic rhinitis. The therapeutic benefits of this corticosteroid for people diagnosed with gastrointestinal disorders were discovered years later. As for the treatment of microscopic colitis, Budesonide has no rivals on the pharmaceutical market. 

Prednisone is a generic glucocorticoid that has been around since 1955 and is still one of the most widely prescribed drugs in the US. There is so much Prednisone can do that it truly can be viewed as a miracle drug. Unbelievably effective, it can bring dramatic relief to sufferers of many disorders, but at a cost since it’s very toxic. 

Here is just a small list of conditions (mainly autoimmune and inflammatory) that can be treated with Prednisone:

  • asthma
  • rheumatoid arthritis
  • COPD
  • hypercalcemia
  • thyroiditis
  • severe tuberculosis
  • multiple sclerosis
  • sarcoidosis
  • lupus
  • migraine headaches
  • lymphomas
  • multiple myeloma
  • lymphoblastic leukemia
  • ulcerative colitis
  • Crohn’s disease
  • myasthenia gravis
  • decompensated heart failure

When comparing Entocort to Prednisone, we should focus primarily on Crohn’s disease and ulcerative colitis. Both medications are used as the mainstay treatment in patients diagnosed with these inflammatory bowel disorders. 

What about side effects?

That’s where the problem lies. Corticosteroids, especially Prednisone, can do wonders, but their use is associated with a long list of grievous side effects. Doctors usually prescribe such medications only for short-term use or minimize the dosage to prevent the potential damage.

These are some of the side effects that can crop up when using Prednisone:

  • moon face
  • edema
  • ravenous hunger that leads to weight gain
  • insomnia
  • a severe fatigue after a burst of energy
  • increased blood pressure
  • fragile bones
  • eye problems
  • adrenal insufficiency
  • depression
  • gastrointestinal bleeding
  • adrenal insufficiency
  • thinning skin

The amount you take and the duration of treatment are very important. If the condition you’re suffering from is more detrimental to your health than the side effects of Prednisone, it will still be worth it.

Is Entocort the same when you compare its side effects to those of Prednisone?

Absolutely not. Generally, this medication is well tolerated because it gets metabolised by the liver with the minimal systemic absorption. Besides, 90% of the medication gets released in the intestine and proximal colon due to enteric coating that lets it resist gastric-acid degradation sooner. These are the major reasons why it’s not as toxic as Prednisone is. 

Side effects of Entocort:

  • tiredness
  • nausea
  • acne
  • fluid retention
  • vomiting
  • loss of appetite
  • skin rash

Long-term use taboo

Since both Entocort and Prednisone work by weakening the immune function of the body, this fact alone shows that they are usually not used over long-term. Any serious infection caught up during the treatment with one of these corticosteroids will not be met with all guns of the immune system blazing. It is important to avoid being around people who are sick, especially if they have chickenpox or measles as these infectious diseases can be fatal. 

Also, adrenal insufficiency should be prevented at all costs when using either Entocort or Prednisone. This condition develops once adrenal glands get used to these drugs to the point when they start producing less cortisol. For this reason when these medications are discontinued abruptly after long-term use, the body will be in a state of  shock. It is essential that you follow all your doctor’s instructions when weaning off either Prednisone or Entocort.

Still, Entocort can be used as a maintenance medication in lower doses (6 mg instead of 9 mg once daily) during the remission of Crohn’s disease in case no severe adverse effects were observed. After 3 months, it needs to be gradually discontinued. 

Clinical studies and the verdict

Budesonide and Prednisone have been around for a sufficient period of time to have them tested, studied, and compared inside out. For example, patients with Crohn’s disease were given either 9 mg of Budesonide once daily for 8 weeks or 40 mg Prednisone once daily for the first 14 days reduced slowly to 5 mg/day in a double-blind randomized study. What are the findings? There can be no doubt that Budesonide (Entocort) is at least as effective as Prednisone when used for the treatment of active mild to moderate Crohn’s disease. Still, it is superior to Prednisone since it doesn’t cause as many adverse effects and is a way better at preserving adrenal function. 

Entocort can also be used for some other gastrointestinal disorders like microscopic colitis with better success than Prednisone.

Thus, even though Entocort is much more expensive than Prednisone, it’s well worth it because it generally doesn’t eventually bring about negative consequences for the patient’s health. Still, like other corticosteroids, it should be used carefully and under your doctor’s supervision. 

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