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 #Eosinophilic #Esophagitis #EoE #Topical #Corticosteroids #management #pharmacology
