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Nefecon Oral Candidiasis — ESENeph MCQ

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EasyGlomerulonephritisNefecon Oral CandidiasisESENeph

A 55-year-old man with IgA nephropathy on Nefecon (targeted-release budesonide 16 mg daily) for 4 months develops oral candidiasis. What is the mechanism and management?

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Correct answer: ANefecon releases budesonide in the ileum but some systemic absorption occurs, causing local oropharyngeal effects; manage with oral antifungal (Nystatin/Fluconazole) and continue Nefecon

Nefecon (targeted-release budesonide) is designed to release budesonide in the ileum to target Peyer's patches. However, some systemic absorption occurs (approximately 10% bioavailability). Oral candidiasis is a recognised side effect of any inhaled or enterically delivered corticosteroid. Management involves topical or oral antifungal treatment (Nystatin mouthwash or Fluconazole). Nefecon should generally be continued as the benefits outweigh this manageable side effect. Rinsing the mouth after taking the capsule may help prevent recurrence.

Reference: NefIgArd Trial Safety Data; Nefecon (Kinpeygo) SPC