Are swollen face and bitter side effects of Budesonide?

Question

Hi doctor,

My mother was diagnosed with autoimmune hepatitis last year, and her treatment is going very well. Currently, she is taking Budesonide 6 mg and Azoran 75 mg. She also takes Insulin, Actrapid Flexpen, and Basalog One to control her blood sugar fluctuations, as she has diabetes also. I have attached all her test reports, and the test reports show significant improvements. My query is regarding the side effects of the steroids. Apart from a slightly swollen face, my mom also complains about a very bitter taste in her mouth like she has chewed neem leaves. That bitter taste comes and goes. My mom said that this bitter taste is the same that she experienced even before she was diagnosed but now that her SGPT is normal, why does she get this bitter taste? Is it because of the side effects of the steroids? Is there any way to reduce the side effects? Can you recommend any medicine?

Answer 1

Hi,

Welcome to icliniq.com.

I have seen all the test reports (attachment removed to protect patient identity).

Yes, swelling of the face is a prominent side effect of long term use of steroid therapy. This she has to face if the use of steroids is indispensable. However, if in any case, it can be stopped, the swelling would disappear within a few months.

Diuretics like Torsemide helps in reducing the swelling, but they help only transiently and not permanently. So, I personally give Torsemide 5 mg twice weekly to my patients on chronic steroid therapy, which helps in reducing facial puffiness to some extent.

The second side effect that she is the feeling of bitterness in the mouth occurs as a result of steroids-induced gastritis and reflux. This is a very common problem seen with steroid therapy and the best treatment for this is the use of a combination of Pantoprazole and Domperidone, once a day.

I hope it helps you. If you have any further query, please ask me.

For further queries consult an internal medicine physician online.