Eosinophilic oesophagitis
For gastro-oesophageal reflux disease, usually 20mg daily for 4-6 weeks then reducing to the minimum dose which controls symptoms.
For gastro-oesophageal reflux disease, usually 20mg daily for 4-6 weeks then reducing to the minimum dose which controls symptoms.
For gastro-oesophageal reflux disease, usually 20mg daily for 4-6 weeks then reducing to the minimum dose which controls symptoms.
For gastro-oesophageal reflux symptoms, usually 30mg daily for 4-6 weeks then reducing to minimum dose which controls symptoms. This may include intermittent courses of 2-4 weeks.
For gastro-oesophageal reflux symptoms, usually 30mg daily for 4-6 weeks then reducing to minimum dose which controls symptoms. This may include intermittent courses of 2-4 weeks.
1mg twice daily for 6 weeks; treatment may be extended to up to 12 weeks if required, to be taken after food.
Prescribing Notes:
- Treatment with Jorveza should only be commenced under specialist initiation for eosiniphilic oesophagitis. SMC advice restricts its use to patients who have unsuccessfully been treated with proton pump inhibitors.
- It is recommended that the licensed formulations designed specifically for oesophageal delivery (e.g. budesonide (Jorveza) are favoured over utilising ingested inhaler formulations off-label (e.g. inhaled budesonide or fluticasone propionate). This involves metered dose inhalers (MDIs) being puffed into the mouth during end-expiration and swallowed rather than inhaled.
History Notes
15/12/2021
East Region Formulary content agreed.
Tablets are reserved for patients who cannot swallow capsules, or for doses less than 10mg. See prescribing notes.
Twice daily as per specialist.
Twice daily as per specialist.
Twice daily as per specialist.
Twice daily as per specialist.
Twice daily as per specialist.
Orodispersible tablets are reserved for patients who cannot swallow capsules and for administration via enteral feeding tubes, see prescribing notes for additional information.
Twice daily as per specialist.
Twice daily as per specialist.
Twice daily as per specialist.
Twice daily as per specialist.
As per specialist.
As per specialist.
Prescribing Notes:
Proton pump inhibitors
- PPIs are most effective when taken on an empty stomach, 20-30 minutes before breakfast.
- Omeprazole dispersible tablets can be dispersed in a small amount of water for 5-10 minutes and mixed well before administration. The 10mg tablets may be halved to give 5mg but must not be divided further. Proportionate doses CANNOT be administered accurately using the dispersion therefore any doses must be rounded to the nearest 5mg.
- Omeprazole dispersible tablets are suitable for patients with swallowing difficulties or who require a proton pump inhibitor via nasogastric (NG) or percutaneous endoscopic gastrostomy (PEG) tube.
- Lansoprazole orodispersible tablets should be reserved for patients with swallowing difficulties or who require a proton pump inhibitor via nasogastric (NG) or percutaneous endoscopic gastrostomy (PEG) tube.
- More information on choice of PPI for administration via enteral feeding tubes and alternative PPIs can be found in the GORD pathway.
- Jorveza is the recommended budesonide formulation for eosinophilic oesophagitis as it is designed for oesophageal delivery. Alternative steroid formulations are no longer recommended for this indication. The 0.5mg Jorveza dose is as effective as the 1mg dose and therefore is the preferred dose to be used.
History Notes
30/08/2023
East Region Formulary content agreed - ERFC 09/08/2023.