When Uceris Isn't Available, You Still Have Options

If you've been trying to fill your Uceris prescription and keep running into dead ends, you're probably wondering: What else can I take?

The short answer is that several effective alternatives exist for treating ulcerative colitis. But switching medications isn't something you should do on your own — it's a conversation you need to have with your doctor.

In this post, we'll cover what Uceris is, how it works, and walk through the most common alternatives your doctor might consider if Uceris isn't available.

What Is Uceris and How Does It Work?

Uceris is the brand name for Budesonide, a locally-acting corticosteroid. It's FDA-approved for inducing remission in adults with mild to moderate ulcerative colitis (UC).

Uceris comes in two forms:

• Extended-release tablets (9 mg) — taken orally once daily for up to 8 weeks
• Rectal foam (2 mg per actuation) — applied rectally for distal UC affecting the lower colon

What makes Budesonide special is its high topical activity with low systemic absorption. When you take Uceris, the medication works directly on the inflamed tissue in your colon. About 90% of it is metabolized by the liver before it reaches the rest of your body. This means you get strong anti-inflammatory effects where you need them with fewer of the whole-body side effects that come with steroids like Prednisone.

Uceris reduces inflammation by suppressing pro-inflammatory chemicals (cytokines), preventing immune cells from migrating to the inflamed area, and reducing the leakiness of blood vessels in the colon wall.

Why You Might Need an Alternative

There are several reasons you might need to look beyond Uceris:

• Supply shortages: Uceris, particularly the rectal foam, has experienced intermittent shortages since 2022
• Insurance issues: Your plan may not cover Uceris, or may require step therapy with another drug first
• Cost: Brand-name Uceris can cost $1,200 to $1,800 per month without insurance
• Side effects: Some patients don't tolerate Budesonide well
• Inadequate response: Uceris may not control your UC symptoms sufficiently

Whatever the reason, it's important to know your options.

Alternative #1: Mesalamine (5-ASA Medications)

Brand names: Lialda, Apriso, Pentasa, Delzicol, Canasa (suppositories), Rowasa (enema)

Mesalamine is the first-line treatment for mild to moderate ulcerative colitis and is the most commonly prescribed alternative to Uceris. In fact, many insurance plans require you to try Mesalamine before they'll approve Uceris.

How it works: Mesalamine is a 5-aminosalicylic acid (5-ASA) that works locally in the colon to reduce inflammation. It has a different mechanism than corticosteroids — it blocks the production of prostaglandins and leukotrienes, which are chemicals that drive the inflammatory process in UC.

Key differences from Uceris:

• Not a steroid — can be used long-term for maintenance therapy
• Available in many formulations: oral tablets, capsules, rectal suppositories, and enemas
• Generally better tolerated with fewer side effects
• More widely available and less expensive
• May be less potent for acute flares compared to a corticosteroid like Budesonide

Typical cost: $50 to $400 per month depending on formulation and whether you use generic or brand-name.

Best for: Patients with mild UC who need a long-term maintenance medication, or those who haven't tried a 5-ASA drug yet.

Alternative #2: Hydrocortisone Rectal Foam or Enema

Brand names: Cortifoam (foam), Cortenema (enema)

If you've been using Uceris rectal foam specifically, Hydrocortisone rectal products are the most direct alternative.

How it works: Hydrocortisone is a corticosteroid that works similarly to Budesonide by suppressing the immune response and reducing inflammation. However, Hydrocortisone has more systemic absorption than Budesonide, meaning more of the drug reaches your bloodstream and the rest of your body.

Key differences from Uceris:

• Greater systemic absorption — higher risk of steroid side effects with extended use
• Available as foam and enema formulations for distal UC
• Has been on the market longer and may be easier to find
• Less expensive than brand-name Uceris in many cases

Typical cost: $200 to $600 per month.

Best for: Patients who need a topical rectal corticosteroid and can't find Uceris foam. Usually recommended for short-term use during flares.

Alternative #3: Prednisone or Prednisolone

Brand names: Deltasone, Prelone, and various generics

Prednisone is the go-to systemic corticosteroid for moderate to severe UC flares. It's widely available, inexpensive, and very effective at controlling acute inflammation.

How it works: Prednisone is a powerful anti-inflammatory that suppresses the immune system throughout the entire body. Unlike Budesonide, it has high systemic bioavailability, which makes it very effective but also causes more side effects.

Key differences from Uceris:

• Works throughout the whole body, not just the colon
• More potent for severe flares
• Significantly more side effects: weight gain, mood changes, insomnia, increased blood sugar, bone loss, increased infection risk
• Not suitable for long-term use — typically prescribed for short courses (2-8 weeks) with a gradual taper
• Very affordable: often under $20 per month for generics

Typical cost: $5 to $20 per month (generic).

Best for: Patients experiencing a moderate to severe UC flare who need fast, reliable relief. Not a long-term solution.

Alternative #4: Entocort EC (Budesonide Delayed-Release Capsules)

Generic available: Yes

Entocort EC contains the same active ingredient as Uceris — Budesonide — but it's formulated differently. The delayed-release capsule is designed to release the drug in the ileum (the last part of the small intestine) and the right side of the colon.

How it works: Same mechanism as Uceris, but the release site is different. Entocort EC is primarily FDA-approved for Crohn's disease affecting the ileum and ascending colon, not ulcerative colitis. However, some doctors prescribe it off-label for UC, particularly when it involves the right colon.

Key differences from Uceris:

• Releases drug higher in the GI tract (ileum vs. colon)
• FDA-approved for Crohn's disease, not UC (off-label for UC)
• Generic versions widely available and more affordable
• May be easier to find in stock

Typical cost: $100 to $400 per month (generic).

Best for: Patients who respond well to Budesonide and whose UC affects the right colon. Discuss with your gastroenterologist.

How to Choose the Right Alternative

The right alternative depends on several factors:

• Where your UC is located: Distal (left-sided) UC may respond well to rectal formulations; more extensive UC typically needs oral medication
• Severity of your symptoms: Mild UC may respond to Mesalamine alone; moderate flares may need a corticosteroid
• Your treatment history: What you've tried before and how you responded
• Insurance coverage: What your plan covers and at what tier
• Side effect tolerance: Steroids carry more risks; 5-ASA drugs are gentler

This is a conversation to have with your gastroenterologist. Don't switch medications on your own, and never stop Uceris abruptly without medical guidance — corticosteroids need to be tapered gradually to avoid adrenal crisis.

Still Want to Try Finding Uceris?

If Uceris is the medication that works best for you, don't give up on finding it. Use Medfinder to search for pharmacies with Uceris in stock near you. You can also read our guide on how to find Uceris in stock for more tips.

And if cost is a barrier, check out our post on saving money on Uceris — there are manufacturer coupons and patient assistance programs that can significantly reduce your out-of-pocket cost.

Final Thoughts

Not being able to fill your Uceris prescription is stressful, especially when you're managing a condition like ulcerative colitis where uncontrolled inflammation can lead to serious complications.

The important thing is to keep treating your UC. Whether that's with Mesalamine, Hydrocortisone, Prednisone, or another Budesonide formulation, effective options exist. Work with your doctor to find the right fit, and use tools like Medfinder to stay on top of medication availability.

Your health comes first — and there's always a path forward.