Eosinophilic Esophagitis (EoE) - Topical Corticosteroids
• Liquid - Budesonide - 1 mg PO BID - Mix with sucralose or honey to increase viscosity (1mg of drug + 5 packets of sucralose)
• Powder - Fluticasone 1 mg PO BID - Can use blister packets within fluticasone diskus
• Inhaled - Fluticasone 880 mcg BID - Do not inhale, do not use spacer
General Considerations:
- Considered off-label use, FDA approved steroid formulations for treatment of EOE are currently unavailable
- Administering the second dose at bedtime increases esophageal exposure time
- Avoid eating/drinking 30 minutes after use
- Avoid rinsing mouth immediately following ingestion unless oral Candidiasis occurs
Long-Term Maintenance:
- Limited data on optimal dosage, and side effects of long-term use
- Consider periodic monitoring for adrenal insufficiency and bone density until more safety data is available
Gastroenterology Review @GIreview
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