Eohilia Side Effects: What You Need to Know

If you've been prescribed Eohilia (Budesonide oral suspension) for eosinophilic esophagitis (EoE), you're probably wondering what side effects to expect. Knowing what's normal — and what's not — can help you feel more confident during your 12-week course of treatment.

Eohilia is a corticosteroid that works by reducing inflammation in your esophagus. It was approved by the FDA in February 2024 for patients 11 years and older. Like all corticosteroids, it comes with some possible side effects. Here's what you should know.

Common Side Effects of Eohilia

The most frequently reported side effects during clinical trials were mild to moderate. They include:

• Respiratory tract infections — Upper respiratory infections (like a cold) were among the most common side effects reported.
• Oral and esophageal candidiasis (thrush) — This is a fungal infection in the mouth, throat, or esophagus. It's one of the most important side effects to watch for. Symptoms include white patches in your mouth, sore throat, or pain when swallowing.
• Headache — Some patients experience headaches during treatment.
• Gastroenteritis — Stomach or intestinal infection causing nausea, vomiting, or diarrhea.
• Sore throat — Throat irritation can occur, sometimes related to the medication passing through the throat.

These side effects don't happen to everyone, and many patients complete their 12-week course without significant problems.

How to Reduce Your Risk of Thrush

Oral candidiasis (thrush) is one of the most common side effects of Eohilia because the Budesonide passes through your mouth and throat. Here are some tips to lower your risk:

• Do not eat, drink, or brush your teeth for at least 30 minutes after taking Eohilia. This allows the medication to coat your esophagus properly.
• Rinse your mouth with water (without swallowing) after the 30-minute waiting period.
• Watch for symptoms. White patches on your tongue or inside your cheeks, a cottony feeling in your mouth, or pain when swallowing can all be signs of thrush.
• Tell your doctor if you develop symptoms. Thrush is treatable with antifungal medications.

Serious Side Effects to Watch For

While most Eohilia side effects are mild, there are some serious ones you should know about. Call your doctor right away if you experience any of the following:

Adrenal Insufficiency

Eohilia is a corticosteroid, and taking it can affect your body's natural production of cortisol. If you stop taking Eohilia suddenly or if your body is under stress (like during surgery or illness), your adrenal glands may not produce enough cortisol on their own. Symptoms include:

• Extreme tiredness or weakness
• Dizziness or lightheadedness
• Nausea and vomiting
• Low blood pressure
• Body aches

Do not stop taking Eohilia without talking to your doctor first. If your doctor decides to end your treatment, they may need to taper your dose gradually.

Signs of Immunosuppression

Corticosteroids can weaken your immune system, making you more likely to get infections. Contact your doctor if you experience:

• Fever or chills that don't go away
• Unusual fatigue
• Signs of infection such as redness, swelling, or pus
• Cough that lasts longer than expected

Hypercorticism (Cushing's Syndrome Symptoms)

In rare cases, too much corticosteroid exposure can cause symptoms like:

• Round or puffy face
• Weight gain, especially around the midsection
• Easy bruising
• Slow wound healing
• Acne or skin changes

These symptoms are more common with long-term or high-dose steroid use, but they can happen with Eohilia, especially if you're also using other corticosteroid medications.

Esophageal Candidiasis

While mouth thrush is common, fungal infection can also occur deeper in the esophagus. Symptoms include:

• Pain when swallowing
• Difficulty swallowing (which may feel similar to your EoE symptoms)
• Chest pain behind the breastbone

If your swallowing problems get worse during treatment, don't assume it's just your EoE. It could be a sign of esophageal candidiasis that needs treatment.

Acid-Related Esophageal Damage

Some patients experience acid reflux or acid-related damage to the esophagus during Eohilia treatment. Tell your doctor if you develop new or worsening heartburn, regurgitation, or chest pain.

When to Call Your Doctor

Call your doctor right away if you experience:

• White patches in your mouth or throat that won't go away
• New or worsening difficulty swallowing
• Extreme fatigue, dizziness, or weakness
• Fever or signs of infection
• New chest pain or worsening heartburn
• Puffy face, unexplained weight gain, or easy bruising
• Any symptom that feels unusual or worrying to you

When in doubt, call. Your doctor would rather hear from you about a minor concern than miss something that needs treatment.

Drug Interactions That Can Affect Side Effects

Certain medications can increase the amount of Budesonide in your body, which may make side effects more likely. Tell your doctor if you're taking:

• CYP3A4 inhibitors such as ketoconazole, itraconazole, ritonavir, erythromycin, or cyclosporine
• Grapefruit juice — avoid it during treatment, as it can increase Budesonide levels

For more details, read our guide on Eohilia drug interactions.

Side Effects vs. EoE Symptoms: How to Tell the Difference

One tricky thing about Eohilia treatment is that some side effects can mimic EoE symptoms. For example:

• Difficulty swallowing could be your EoE flaring — or it could be esophageal candidiasis from the medication.
• Chest pain could be EoE-related — or it could be acid reflux worsened by treatment.
• Sore throat could be from the medication itself.

Keep track of your symptoms during treatment. Write down when they started, how severe they are, and whether they're new or different from your usual EoE symptoms. Share this information with your doctor.

What Happens After Your 12-Week Course?

Eohilia is FDA-approved for a 12-week treatment course. After finishing, your doctor will likely want to:

• Schedule a follow-up endoscopy to check your esophagus
• Discuss whether you need another course of treatment
• Monitor you for adrenal insufficiency if tapering is needed

Don't stop Eohilia early without talking to your doctor, even if you feel better. And don't assume all your side effects will disappear immediately after stopping — some effects of corticosteroids take time to resolve.

The Bottom Line

Most people tolerate Eohilia well during their 12-week treatment. The most common side effects are respiratory infections, thrush, and headache. Serious side effects are less common but important to recognize.

The key is to stay informed, follow the dosing instructions carefully, and communicate with your doctor about anything that seems off. For more information about this medication, visit our guide on what Eohilia is and how to take it or learn how Eohilia works.