Starting Uceris? Here's What to Expect

Your doctor just prescribed Uceris (Budesonide ER) for your ulcerative colitis. Before you start taking it, you probably want to know: what side effects should I watch for?

That's a smart question. Understanding what's normal and what's not can help you feel more confident during treatment — and know when something needs medical attention.

Uceris is a corticosteroid, but it's designed to work locally in the colon rather than throughout your entire body. This means it generally causes fewer systemic side effects than conventional steroids like Prednisone. But "fewer" doesn't mean "none."

In this guide, we'll cover the most common side effects, the serious ones to watch for, and clear guidelines on when to call your doctor.

How Uceris Is Different from Other Steroids

Before we get into side effects, it helps to understand why Uceris has a different side effect profile than steroids you may have taken before.

Uceris contains Budesonide, a synthetic corticosteroid with high topical anti-inflammatory activity. It's formulated as an extended-release tablet that targets inflammation in the colon. Because Budesonide undergoes extensive first-pass metabolism in the liver, less of the drug enters your general circulation compared to systemic steroids like Prednisone.

This is why your doctor may have chosen Uceris over Prednisone for mild to moderate UC — you get anti-inflammatory action where you need it with a lower risk of the classic steroid side effects like significant weight gain, moon face, and severe mood changes.

For more on how this medication works, see our article on how Uceris works: mechanism of action explained.

Common Side Effects of Uceris

The following side effects were reported in clinical trials and are considered relatively common. Most are mild to moderate and often improve as your body adjusts to the medication.

Headache

Headache is one of the most frequently reported side effects. It's usually mild and can often be managed with over-the-counter pain relievers like acetaminophen. If headaches are severe or persistent, let your doctor know.

Nausea

Some patients experience nausea, especially when starting treatment. Taking Uceris in the morning with food may help reduce this. If nausea continues after the first week, talk to your doctor.

Decreased Blood Cortisol Levels

Because Uceris is a corticosteroid, it can suppress your body's natural cortisol production. This is usually detected through blood tests rather than symptoms, but it's one reason your doctor may want to monitor your hormone levels during treatment.

Upper Abdominal Pain

Mild stomach discomfort or pain in the upper abdomen has been reported. Since you're taking this medication for a digestive condition, it can sometimes be hard to tell if this is a side effect of Uceris or a symptom of your UC. Track your symptoms and report changes to your doctor.

Fatigue

Feeling more tired than usual is common, especially during the first few weeks. Make sure you're getting adequate rest, staying hydrated, and eating well. Persistent or worsening fatigue should be reported.

Other Common Side Effects

• Flatulence (gas)
• Abdominal distension (bloating)
• Acne
• Urinary tract infection
• Joint pain (arthralgia)
• Constipation

Serious Side Effects: When to Call Your Doctor

While Uceris is generally well-tolerated, there are serious side effects that require prompt medical attention. Contact your doctor right away if you experience any of the following:

Signs of Infection

Uceris can suppress your immune system, making you more susceptible to infections. Call your doctor if you develop:

• Fever or chills that won't go away
• Persistent cough or sore throat
• Painful or frequent urination
• Wounds that won't heal
• Unusual fatigue combined with other symptoms

Important: While on Uceris, avoid close contact with people who have chickenpox or measles if you've never had these infections or been vaccinated against them. These infections can be much more serious in people taking corticosteroids.

Symptoms of Hypercorticism (Excess Cortisol)

Although less common with Uceris than systemic steroids, some patients may develop signs of too much cortisol activity:

• Rounding of the face (moon face)
• Unexplained weight gain, especially around the midsection
• Easy bruising
• Thinning skin
• Stretch marks
• Increased facial hair

Vision Changes

Corticosteroids can increase the risk of glaucoma and cataracts with prolonged use. If you notice:

• Blurred vision
• Eye pain or pressure
• Seeing halos around lights

See an eye doctor and contact your prescribing physician promptly.

Bone Pain

Long-term corticosteroid use can reduce bone density. While Uceris treatment courses are typically short (up to 8 weeks), report any new or unusual bone pain to your doctor, especially if you have other risk factors for osteoporosis.

Severe Allergic Reaction

Though rare, allergic reactions to Budesonide can occur. Seek emergency medical help if you experience:

• Difficulty breathing or swallowing
• Swelling of the face, lips, tongue, or throat
• Severe skin rash or hives
• Rapid heartbeat

What to Know About Stopping Uceris

One of the most important things to understand about Uceris is that you should not stop taking it abruptly after extended use. Because the medication suppresses your body's natural cortisol production, stopping suddenly can lead to adrenal insufficiency — a potentially serious condition.

Symptoms of adrenal insufficiency include:

• Extreme fatigue and weakness
• Dizziness or lightheadedness
• Nausea and vomiting
• Low blood pressure
• Joint and muscle pain

Your doctor will typically taper your dose gradually when it's time to stop. Always follow your doctor's instructions for discontinuation — never stop on your own, even if you're feeling better.

Drug Interactions That Can Affect Side Effects

Certain medications and even foods can increase Budesonide levels in your blood, which raises the risk of side effects. The most important ones to know about:

• CYP3A4 inhibitors — Medications like Ketoconazole, Itraconazole, Ritonavir, and Clarithromycin can significantly increase Budesonide exposure
• Grapefruit juice — Avoid grapefruit and grapefruit juice during treatment, as they can increase Budesonide blood levels

For a complete guide, read our article on Uceris drug interactions: what to avoid.

Tips for Managing Side Effects

Here are some practical strategies to help minimize side effects while taking Uceris:

• Take it in the morning — This aligns with your body's natural cortisol rhythm
• Swallow the tablet whole — Don't crush, chew, or break it. The extended-release coating is essential for proper drug delivery
• Stay hydrated — Helps with headaches, fatigue, and constipation
• Eat a balanced diet — Supports your immune system and helps manage GI-related side effects
• Keep a symptom diary — Track side effects so you can give your doctor accurate information at your next visit
• Don't skip doses — Consistent dosing helps maintain steady drug levels and reduces the chance of symptom flare-ups

Final Thoughts

Uceris is a well-studied medication that offers effective relief for mild to moderate ulcerative colitis with a generally manageable side effect profile. Most patients experience only mild effects like headache or nausea that improve over time.

The key is knowing what to watch for and staying in close communication with your doctor. If something feels off, don't hesitate to reach out — that's what they're there for.

If you're having trouble finding Uceris at your pharmacy, check out our guide on how to find Uceris in stock near you. And if cost is a concern, we've compiled all the savings options in our article on how to save money on Uceris.