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Entocort for kids?

My 8 y/o was just dx with Colitis. Doc offered to phone in an rx for him or we could wait till our consult in a week, to start the meds. Since my little guy is hurting, we opted for the meds first. Seems like there was a comedy of errors getting the meds, and now I have a bottle of Entocort capsules here, and my son can't swallow pills! The doc and pharmacist said it was okay to break them open and mix in pudding.

Being the cautious sort, I started looking things up, and I'm seeing everywhere that it's recommended NOT to open the capsules, and that it's not approved for use in kids. I trust this GI, he's treated my older daughter and has been great. At this point we are going to wait to talk to him before giving these meds, but I would love to hear if anyone else has a kid on entocort. We were prescribed the standard adult dosage, and I can't find a recommended kid dosage, since it isn't approved for kids yet.

any words of wisdom?
 
We have used entocort many times and overseas it is used as an asthma medication in children called budesonide. I like entocort because even though it is a steroid it has fewer side effects then prednisone. It istays more in the gut and less is absorbed systemically.
 
Haven't used Entocort here, but I seem to remember reading quite a few children on this forum have taken it. Best double check the dosage though!!
 

my little penguin

Moderator
Staff member
Here is the thing the pill will probably work better whole same thing with pentasa but like you we were told it was ok to open an put in pudding/ applesauce since some kids haven't learned to swallow pills yet.
We did this with pentasa until DS could swallow a pill. It took almost two weeks . He was 7 at the time last year. CCfa has a PDF on teaching kids to swallow pills. You start small minin m&ms then slowly work your way up. A good toy as a prize also helped. A year later my Ibd 8 year can swallow better than most adults. It really is a much needed skill for them.
Let me know if you need more tips.
 
I'm not quite sure but I don't believe entocourt is used in oral form for UC but more for CD (I believe it's released in the small intestine and particularly effective in the ileum). This could be wrong and we have used entocourt enemas for my daughter with UC with some results but none of our GIs have rxed entocourt and we were told it was because she has UC.
 
thanks all. after opening a capsule this morning, I saw that the drug is in little "balls" instead of a powder--that made me more confident. I was thinking that this was a slow release, and emptying powder into his little gut would be way too much. Looks like these little guys will slowly release, and as someone mentioned, I was told by several people that it would be okay, so we went for it.

Did tons more research too, and I'm feeling good about starting the meds, but still looking forward to hearing what the GI says at our consult next week. He is really good about telling us what trends are going on with treatment across the country, and in the past has mentioned that he doesn't offer certain meds until he is comfortable with what he has heard others report. I did read that Entocort is supposed to work on the entire large intestine, and the terminal ileum, which makes me feel better too. His disease is supposed to be only in the large intestine, but they didn't look any farther either. My daughter's disease is in the terminal ileum.

Thanks again--so hard to decide what "the right thing" is sometimes--especially when your kid is hurting!!
 
Here is the thing the pill will probably work better whole same thing with pentasa but like you we were told it was ok to open an put in pudding/ applesauce since some kids haven't learned to swallow pills yet.
We did this with pentasa until DS could swallow a pill. It took almost two weeks . He was 7 at the time last year. CCfa has a PDF on teaching kids to swallow pills. You start small minin m&ms then slowly work your way up. A good toy as a prize also helped. A year later my Ibd 8 year can swallow better than most adults. It really is a much needed skill for them.
Let me know if you need more tips.
Been reading tips all day :ybiggrin: I appreciate them!! We are going to continue practicing (M&M's and chocolate chips so far), since he says that the pudding/med mix leaves a nasty taste in his mouth!! My 16 yr old couldn't swallow pills last year when she was diagnosed. After being in the hospital 11 days, she was a pro! Truly a good skill to have!
 
Nancy,
I've read it works best in the terminal ileum and the right side of the colon but then I believe it has worked for others with colonic disease so it might work. Where is your son's UC (rectal, pancolitis etc?) I hope he feels better soon - it's so very stressful but hopefully he will respond to his meds and go into a long, solid remission.
 

David

Co-Founder
Location
Naples, Florida
Here's the summary of a Cochrane review for Entocort in Ulcerative Colitis. A snippet:

Although the side-effect profile of budesonide is better than that of prednisolone, there is no evidence to recommend the use of oral budesonide for active UC. There are 2 large ongoing trials which will provide further information regarding the potential effectiveness of oral budesonide for the treatment of active UC. One of the included studies compared budesonide with mesalamine (a 5-ASA drug). This study provides high quality evidence that mesalamine is superior to budesonide for the treatment of active ulcerative colitis.
*edit* And here is the full paper.
 
Thanks for posting that David. Our GI is one of the reviewers - explains why she has refused entocourt instead of pred in our case. I have heard it works for some with UC though. Good luck Nancy!
 
The little beads inside are what makes Entocort time release, not the capsule shell, which dissolves in about a minute. So you can definitely break it open. The warning is not to crush the beads, because that messes up the time release mechanism. Anyway looks like you figured it out, I hope the Entocort works! I believe that one may take anywhere from 1-3 capsules per day, I take as needed. Good luck, and I hope your son feels better!
 
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