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Ortikos vs. Trexall

Reviewed on 9/26/2019

Are Ortikos and Trexall the Same Thing?

Ortikos (budesonide) and Trexall (methotrexate) are used to treat Crohn's disease.

Ortikos is used to treat mild to moderate active Crohn's disease involving the ileum and/or the ascending colon, in patients 8 years and older; and for maintenance of clinical remission of mild to moderate Crohn's disease involving the ileum and/or the ascending colon for up to 3 months in adults.

rexall is sometimes used for people with Crohn's disease who don't respond well to other medications. Trexall is also used to treat some cancers, severe skin diseases such as severe psoriasis, and to treat forms of rheumatoid arthritis.

Ortikos and Trexall belong to different drug classes. Ortikos is a corticosteroid and Trexall is an antimetabolite drug.

Side effects of Ortikos and Trexall that are similar include headache, nausea, vomiting, abdominal pain, dizziness, and tired feeling/fatigue.

Side effects of Ortikos that are different from Trexall include respiratory infection, back pain, indigestion/heartburn, gas (flatulence), and pain.

Side effects of Trexall that are different from Ortikos include inflammation of the mouth and lips, upset stomach, dizziness, bleeding gums, blurred vision, and leukopenia (low number of white cells in blood).

Ortikos may interact with CYP3A4 Inhibitors (e.g., ketoconazole, grapefruit juice, itraconazole, ritonavir, indinavir, saquinavir, erythromycin, and cyclosporine).

Trexall may interact with azathioprine, chloramphenicol, hydroxychloroquine, retinol, tretinoin, isotretinoin, steroids, sulfa drugs, phenytoin, probenecid, tetracycline, theophylline, gold treatments, oral diabetes medications, penicillin antibiotics, medicines that reduce stomach acid, nonsteroidal anti-inflammatory drugs (NSAIDs), and salicylates such as aspirin and others.

What Are Possible Side Effects of Ortikos?

Common side effects of Ortikos include:

  • headache,
  • respiratory infection,
  • nausea,
  • back pain,
  • indigestion/heartburn,
  • dizziness,
  • abdominal pain,
  • gas (flatulence),
  • vomiting,
  • fatigue, and
  • pain

What Are Possible Side Effects of Trexall?

Common side effects of Trexall include:

  • inflammation of the mouth and lips,
  • nausea,
  • vomiting,
  • upset stomach,
  • abdominal pain,
  • dizziness,
  • tired feeling,
  • headache,
  • bleeding gums,
  • blurred vision, and
  • leukopenia (low number of white cells in blood).

Tell your doctor if you have serious side effects of Trexall including:

  • dry cough,
  • shortness of breath,
  • diarrhea,
  • white patches or sores inside your mouth or on your lips,
  • blood in your urine or stools,
  • urinating less than usual or not at all,
  • fever,
  • chills,
  • body aches,
  • flu symptoms,
  • sore throat and headache with a severe blistering/peeling/red skin rash,
  • pale skin,
  • easy bruising or bleeding,
  • weakness,
  • stomach pain,
  • loss of appetite,
  • dark urine,
  • clay-colored stools, or
  • jaundice (yellowing of the skin or eyes).

Severe side effects occur more frequently in patients taking the high doses of Trexall.

What Is Ortikos?

Ortikos (budesonide) is a corticosteroid indicated for treatment of mild to moderate active Crohn's disease involving the ileum and/or the ascending colon, in patients 8 years and older; and maintenance of clinical remission of mild to moderate Crohn' disease involving the ileum and/or the ascending colon for up to 3 months in adults.

What Is Trexall?

Trexall (methotrexate) is an antimetabolite drug that is used to treat some cancers, severe skin diseases such as severe psoriasis, and to treat forms of rheumatoid arthritis. Trexall is available in generic form as methotrexate.

QUESTION

What is Crohn's disease? See Answer

What Drugs Interact With Ortikos?

Ortikos may interact with CYP3A4 Inhibitors (e.g., ketoconazole, grapefruit juice, itraconazole, ritonavir, indinavir, saquinavir, erythromycin, and cyclosporine). Tell your doctor all medications and supplements you use. Tell your doctor if you are pregnant or plan to become pregnant before using Ortikos; it may harm a fetus.

What Drugs Interact With Trexall?

Trexall may interact with azathioprine, chloramphenicol, hydroxychloroquine, retinol, tretinoin, isotretinoin, steroids, sulfa drugs, phenytoin, probenecid, tetracycline, theophylline, gold treatments, oral diabetes medications, penicillin antibiotics, medicines that reduce stomach acid, nonsteroidal anti-inflammatory drugs (NSAIDs), or salicylates such as aspirin and others. Tell your doctor all medications and supplements you use. This drug should not be used in pregnant or breastfeeding women due to likely harm to the fetus or infant.

Trexall may interact with allopurinol, methotrexate, blood thinners, olsalazine, sulfasalazine, sulfamethoxasole, trimethoprim, or ACE inhibitors.

How Should Ortikos Be Taken?

The recommended adult dosage of Ortikos for mild to moderate active Crohn's disease is 9 mg once daily for up to 8 weeks; repeat 8-week treatment courses recurring episodes of active disease. The recommended dosage of Ortikos for pediatric patients 8 to 17 years who weigh more than 25 kg is 9 mg once daily for up to 8 weeks, followed by 6 mg once daily in the morning for 2 weeks.

How Should Trexall Be Taken?

Trexall is supplied in 5, 7.5, 10, and 15 mg tablets. The dose is designed for each patient's problem and can range from about 7.5 mg per week to 30 mg per day, depending on the disease process and the doctor's judgment. Trexall has been used in children with juvenile rheumatoid arthritis, but most doses were individualized.

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References

FDA. Ortikos Drug Information.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211929s000lbl.pdf

Dailymed. Trexall Product Monograph.

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e942f8db-510f-44d6-acb5-b822196f5e8c&audience=consumer

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