If you're taking Budez CR for ulcerative colitis or Crohn’s disease, you’ve probably wondered: is this really the best option? Maybe your doctor switched you to it after another drug didn’t work. Or maybe you’re dealing with side effects and wondering if something else could be easier on your body. You’re not alone. Many people on budesonide ask the same thing - and the answer isn’t simple. It depends on your condition, your body, and what you’re trying to avoid: flares, steroids, or daily pills.
What Budez CR Actually Does
Budez CR contains budesonide, a synthetic corticosteroid designed to target inflammation in the gut without flooding your whole body with hormones. Unlike prednisone - a classic steroid that can cause weight gain, mood swings, and bone loss - budesonide is built to break down quickly after it does its job in the intestines. That’s why it’s called a "targeted" steroid.
It’s approved for mild-to-moderate active ulcerative colitis affecting the distal colon and for inducing remission in Crohn’s disease involving the ileum and ascending colon. The "CR" stands for controlled release, meaning it slowly releases the drug along the digestive tract instead of dumping it all at once. This reduces side effects and improves effectiveness.
Most people take one capsule a day in the morning. It usually starts working within a week, but full results can take 4 to 8 weeks. Studies show about 60% of people with ulcerative colitis go into remission after 8 weeks of treatment. That’s better than placebo, but not perfect.
Why People Look for Alternatives
Even though budesonide is safer than older steroids, it’s not harmless. Common side effects include headache, nausea, acne, and mild swelling. Less common but serious risks include adrenal suppression (your body stops making its own cortisol), increased infection risk, and elevated blood sugar. People with diabetes or osteoporosis need to be extra careful.
Some patients can’t tolerate the capsule form. Others find it expensive - especially without insurance. A 30-day supply of Budez CR can cost over $200 AUD in Australia, and many are looking for cheaper, equally effective options.
Then there’s the long-term problem: budesonide isn’t meant for maintenance. It’s for getting you into remission, not keeping you there. Once you stop, symptoms often come back. That’s why people start looking at drugs that can be taken long-term without the steroid risks.
Top Alternatives to Budez CR
Here are the most commonly used alternatives, grouped by how they work.
1. Mesalamine (Asacol, Pentasa, Lialda)
Mesalamine is the go-to first-line drug for mild ulcerative colitis. It’s not a steroid - it’s an aminosalicylate that reduces inflammation directly in the colon lining. It’s taken daily, often multiple times a day, and has very few serious side effects. The most common? Bloating, gas, and occasional headaches.
Compared to budesonide, mesalamine is slower to work - it can take 4 to 12 weeks to see results. But once it works, it’s excellent for maintenance. Many doctors start with mesalamine, then add budesonide if symptoms don’t improve.
Price-wise, generic mesalamine costs about $40-$70 AUD per month. That’s a big difference from Budez CR.
2. Corticosteroids: Prednisone and Hydrocortisone
Prednisone is the old-school steroid. It works fast - sometimes within days - and is used for moderate-to-severe flares. But it’s systemic: it hits your liver, bones, brain, and muscles. Long-term use leads to cataracts, diabetes, muscle wasting, and even osteoporosis.
Hydrocortisone suppositories or enemas are local options for rectal inflammation. They’re great if your disease is limited to the lower colon or rectum. You don’t get the full-body effects, but you need to use them daily for weeks.
Neither prednisone nor hydrocortisone enemas are long-term solutions. They’re bridges - meant to calm things down so you can start a safer maintenance drug.
3. Biologics: Humira, Remicade, Entyvio
If you’ve tried budesonide and mesalamine and still have flares, your doctor might suggest a biologic. These are injectable or IV drugs that block specific parts of your immune system causing inflammation.
Humira (adalimumab) and Remicade (infliximab) target TNF-alpha, a major inflammation driver. Entyvio (vedolizumab) is more selective - it only blocks immune cells from entering the gut. That makes it safer for long-term use, with fewer infection risks.
Biologics work for about 50-70% of people who don’t respond to steroids or mesalamine. But they’re expensive: $1,500-$3,000 AUD per month without subsidy. In Australia, many are covered under the PBS with strict eligibility rules (e.g., failed prior therapies, documented disease severity).
4. JAK Inhibitors: Xeljanz (tofacitinib)
Xeljanz is an oral pill that blocks JAK enzymes involved in immune signaling. It’s approved for moderate-to-severe ulcerative colitis after other treatments fail. It works faster than biologics - some people feel better in 2 to 4 weeks.
But it comes with warnings. The FDA added a black box warning for increased risk of serious infections, blood clots, and certain cancers, especially in people over 50 or with cardiovascular risk factors.
It’s cheaper than biologics - around $800 AUD per month - but still requires regular blood tests and close monitoring.
5. Immunomodulators: Azathioprine and 6-MP
These drugs suppress your immune system more broadly. They’re slow - it can take 3 to 6 months to work - but they’re great for long-term control. Many people take them with biologics to boost effectiveness.
Side effects include low white blood cell counts, liver stress, and nausea. You need monthly blood tests for the first few months. They’re not first-line, but they’re a solid option if you need to get off steroids entirely.
Price: generic azathioprine costs about $20-$30 AUD per month under PBS.
How to Choose the Right Alternative
There’s no one-size-fits-all. Here’s how to narrow it down:
- If your disease is mild and limited to the colon → Start with mesalamine. It’s safe, cheap, and effective for maintenance.
- If you need quick relief from a flare → A short course of prednisone or hydrocortisone enemas might be necessary, then switch to a maintenance drug.
- If budesonide didn’t work or caused side effects → Try a JAK inhibitor like Xeljanz if you’re under 50 and healthy. Otherwise, consider a biologic.
- If you want to avoid injections → Oral options like Xeljanz or azathioprine are better than Humira or Remicade.
- If cost is a major issue → Generic mesalamine or azathioprine are the most affordable long-term choices.
Don’t switch on your own. Talk to your gastroenterologist. They’ll check your blood work, disease location, and past treatment history before making a move.
Real Patient Scenarios
Here are two cases from Australian clinics:
Case 1: Sarah, 34, diagnosed with ulcerative colitis
She started on Budez CR after a flare. It helped, but she gained 5 kg and had bad acne. Her doctor switched her to mesalamine. After 3 months, her symptoms were gone, and she lost the weight. She’s been stable for 18 months.
Case 2: Mark, 58, Crohn’s disease
He tried budesonide twice. Both times, his symptoms returned after stopping. His doctor added azathioprine. After 4 months, he was in remission. Now he takes azathioprine daily and only uses budesonide if he has a flare - and even then, just for 2 weeks.
These aren’t outliers. They’re common paths.
What About Natural Alternatives?
Some people turn to probiotics, turmeric, or cannabis oil. There’s limited evidence these work as well as prescription drugs.
Probiotics like VSL#3 may help maintain remission in ulcerative colitis, but they’re not strong enough to treat a flare. Curcumin (from turmeric) showed promise in small studies - one trial found it helped when added to mesalamine. But it’s not a replacement.
Cannabis oil is not approved in Australia for IBD. While some patients report symptom relief, there’s no solid data on safety or effectiveness. And it doesn’t reduce inflammation like budesonide does.
Think of these as supplements - not substitutes.
When to Consider Stopping Budez CR
You should consider switching if:
- You’ve been on it for more than 8-12 weeks and still have symptoms
- You’re experiencing side effects like mood changes, high blood pressure, or unexplained weight gain
- You need to take it more than once a year for flares
- Your doctor says you’re at risk for steroid-related bone loss
Stopping abruptly can cause a rebound flare. Always taper under medical supervision.
Final Thoughts
Budez CR is a useful tool - but it’s not the endgame. It’s a bridge, not a home. The real goal is to get into remission and stay there with a drug you can take safely for years.
For most people, that means starting with mesalamine. For others, it means moving to biologics or JAK inhibitors. The right choice depends on your body, your symptoms, and your life - not just what’s on the prescription pad.
If you’re tired of flares, tired of side effects, or tired of the cost - talk to your doctor. There are better long-term options out there. You just need to ask the right questions.
Is Budez CR the same as Entocort?
Yes, Budez CR and Entocort both contain budesonide and work the same way. The main difference is branding and price. Entocort is the original brand, while Budez CR is a generic version. In Australia, they’re both PBS-listed and considered interchangeable by most doctors.
Can I take Budez CR with other IBD meds?
Yes, it’s common to combine budesonide with mesalamine, azathioprine, or even biologics. Your doctor may use it short-term to control a flare while waiting for a slower drug to kick in. Never combine steroids without medical supervision - the risk of side effects increases.
How long does it take for alternatives to work?
It varies. Mesalamine takes 4-12 weeks. Biologics like Humira or Entyvio usually show results in 6-12 weeks. JAK inhibitors like Xeljanz can work in 2-4 weeks. Azathioprine takes 3-6 months. Budesonide is faster - 1-2 weeks for symptom relief - but it’s not meant for long-term use.
Are there cheaper generic versions of Budez CR?
Yes. Budesonide is available as a generic under several brand names in Australia, including Budez CR. The PBS subsidizes it for eligible patients, so out-of-pocket costs can be as low as $7.30 per script with a concession card. Always check with your pharmacist about the cheapest available generic.
What happens if I stop Budez CR suddenly?
Stopping abruptly can trigger a rebound flare - your symptoms may return worse than before. It can also cause adrenal insufficiency, where your body can’t produce enough cortisol. Always taper off under your doctor’s guidance. A typical taper is reducing the dose by 3 mg every 1-2 weeks until you’re off.
Next Steps
If you’re considering switching from Budez CR:
- Write down your symptoms, side effects, and what you’d like to change.
- Check your PBS prescription history - are you paying full price?
- Ask your doctor for a blood test to check your liver and immune markers.
- Request a referral to a gastroenterologist if you haven’t seen one in over a year.
- Bring this list of alternatives to your next appointment and ask: "Which of these is right for me?"
You don’t have to stay on a drug that doesn’t fit your life. There are better paths. You just need to start asking the right questions.
