Will Budesonide cause weight gain?

Corticosteroids such as budesonide are anti-inflammatory medications used to treat conditions like asthma, eczema, allergies, and autoimmune diseases (arthritis, lupus, ulcerative colitis). Like all steroids, they can cause side effects, including weight gain.

Risk of weight gain by dosage form

  • Entocort EC (oral budesonide): Fewer than 5% of people in clinical trials reported weight gain, a higher rate than placebo.
  • Budesonide tablets: No weight gain reported in trials.
  • Pulmicort inhalers: 1%–3% of users reported weight gain.
  • Nasal spray and rectal foam: No weight gain reported.

Higher doses and longer treatment increase the likelihood of weight gain.

Frequently Asked Questions

What is budesonide?

Budesonide (brands: Pulmicort, Entocort) is a steroid available as inhaler, nebulizer solution, pill, nasal spray, and rectal forms. It manages asthma, COPD, allergic rhinitis, nasal polyps, Crohn’s disease, and ulcerative colitis.

How does budesonide work?

Budesonide is a corticosteroid (like prednisone, methylprednisolone, prednisolone) that reduces inflammation and swelling in targeted tissues, making it effective for various conditions.

What is budesonide used for?

  • Asthma
  • Chronic obstructive pulmonary disease (COPD)
  • Inflammatory bowel diseases (active Crohn’s, ulcerative colitis, microscopic colitis)
  • Primary immunoglobulin A nephropathy
  • Nasal polyps
  • Hay fever and allergies

Common side effects of budesonide

  • Inhaler/nebulizer solution: Cold symptoms, viral respiratory infection, nausea, stomach virus
  • Nasal spray: Nosebleeds, sore throat
  • Oral tablets/capsules: Headache, respiratory infection, nausea, back pain, joint pain, dizziness, indigestion, gas, stomach pain, vomiting, mood changes, tiredness, pain

Other less serious side effects

  • Inhaler/nebulizer: Middle ear infection, oral thrush
  • Nasal spray: Cough, nasal irritation
  • Oral tablets/capsules: Acne, easy bruising, facial/leg swelling, abnormal hair growth, fast heartbeat, increased appetite, nervousness, trouble sleeping

Rare but serious side effects

  • Severe allergic reaction: hives, facial/tongue/throat swelling, shortness of breath—seek emergency care immediately.
  • Hormone changes: high-dose or long-term use mimics excess cortisol (weight gain, “moon face”, upper back swelling, limb fat loss); abrupt stop may cause low-cortisol symptoms (nausea, appetite loss, weakness, diarrhea).
  • Vision changes: increased eye pressure, worsening glaucoma, cataracts—report blurry vision or eye discomfort immediately.
  • Increased infection risk: weakened immunity may lead to fungal, bacterial, or viral infections—avoid sick contacts and seek care for fever, chills, cough, or breathing trouble.
  • Worsening other conditions: may exacerbate diabetes, high blood pressure, osteoporosis, glaucoma, stomach ulcers—monitor closely.
  • Delayed growth in children: use lowest effective dose for shortest duration; discuss growth concerns with a healthcare provider.

Drug interactions

Budesonide may interact with other medications or supplements. Inform your healthcare provider about all you take, including:

  • Antacids
  • HIV/hepatitis protease inhibitors
  • Erythromycin, clarithromycin
  • Ketoconazole, itraconazole
  • Cyclosporine
  • Cimetidine
  • Grapefruit juice

This list may not be exhaustive.

Warnings and precautions

Do not take budesonide if allergic to it or any inactive ingredients. Inhalation powder contains milk proteins—avoid if allergic. Inhalers are not for asthma attacks; keep a short-acting inhaler available.

Tell your provider if you have:

  • Diabetes
  • Active infection or tuberculosis exposure
  • History of chicken pox or measles
  • Stomach ulcers
  • Liver disease
  • Glaucoma or cataracts
  • Osteoporosis
  • High blood pressure
  • Adrenal insufficiency
  • Planned surgery
  • Pregnancy or planning pregnancy
  • Breastfeeding or planning to breastfeed

Why does budesonide cause weight gain?

Steroids suppress the immune system and alter water/electrolyte balance and metabolism of proteins, carbs, fats, and sugars. This can increase appetite, cause fluid retention, and promote fat deposits in the face, neck, and abdomen. Higher doses and longer use increase the risk; diet and sleep also play a role.

Related Medications

  • Entocort EC (budesonide)
  • Entocort Enema (budesonide)
  • Pulmicort Flexhaler (budesonide)
  • Rhinocort AQ Nasal Spray (budesonide)
  • Pulmicort Respules (budesonide)
  • Uceris (budesonide)
  • Tarpeyo (budesonide)

Sources

  • Budesonide inhaled (Rx). Medscape. Accessed July 16, 2024.
  • Budesonide rectal (Rx). Medscape. Accessed July 16, 2024.
  • Budesonide intranasal (Rx, OTC). Medscape. Accessed July 16, 2024.
  • Budesonide (Rx). Medscape. Accessed July 16, 2024.