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Medications for Managing Eosinophilic EsophagitisBy Hallie LevineMedically Reviewed by Brunilda Nazario, MD on April 11, 2025Eosinophilic esophagitis (EoE) is a rare inflammatory disease of the esophagus, the tube that connects your mouth to your stomach. If you have EoE, a type of white blood cell known as an eosinophil builds up in your esophagus, causing injury and inflammation. This may make it hard for you to eat and swallow. EoE can make it hard for kids to get proper nutrition and lead to poor growth. It can also cause chronic pain.While there’s no cure for eosinophilic esophagitis (EoE), there are several medications doctors prescribe to control symptoms, ease inflammation, and prevent further damage. These often work best if they’re used along with dietary changes to avoid foods that may worsen the condition.Here’s a look at what’s available, as well as a peek into what treatments may emerge in the future.Proton pump inhibitors (PPIs). These are often the first medications doctors use to treat EoE. Their main use is to keep stomach acid out of the esophagus in people who have acid reflux, but they can also reduce inflammation. This may be because the disease is similar to reflux – or often comes along with it. To start, you’ll take a full dose of a PPI once a day for 8 weeks. If your symptoms aren’t better after about a month, you take a full dose twice a day. When 2 months are up, your doctor will check again to see if your symptoms have improved.The doctor may do a follow-up test called an upper endoscopy to check the number of eosinophils and the level of inflammation. They’ll use a camera on the end of a long tube to take a look at the inside of your esophagus.Or they may just ask you about your symptoms to decide if the PPIs have worked. Most of the time, if you feel like you’ve improved, your doctor will continue the PPI at the lowest dose possible to control your symptoms.Corticosteroids. These meds help control the inflammation that may worsen the condition. Most patients respond well to this treatment. There are two main types of steroids your doctor may use:Oral budesonide(Eohilia). While doctors have long prescribed swallowed corticosteroids off-label for EoE, in 2024 the FDA approved the first oral corticosteroid treatment, budesonide (Eohilia). It’s a liquid you take by mouth twice a day, and is approved for children 11 and up as well as adults. In studies, most people who took this drug had less inflammation and less trouble swallowing after 12 weeks.Fluticasone. You’ll spray this medication into your mouth from an inhaler, then swallow it. You can’t breathe in while you get a dose, and you can’t eat or drink for 30 minutes afterward. People usually take about four to eight sprays over the course of the day. You should feel better within a few days to week. Your doctor will check you again after about 12 weeks on this treatment. If you feel better, you’ll get another upper endoscopy to make sure it’s working.If you don’t respond to either corticosteroid, your doctor may try other steroid options such as ciclesonide or mometasone furoate. Small studies show both treatments may help.While all of these drugs work, you need to take them every day to see benefits. Once you stop, your symptoms will come back. Your doctor may put you on a lower dose for maintenance.Dupilumab (Dupixent). This new drug is a type of medication called a monoclonal antibody, or biologic. It acts on the inflammation that causes eosinophils to grow in your esophagus. You take it once a week as a shot. In studies, about 60% percent of people with EoE who took it responded to treatment. It led to a significant reduction in common EoE symptoms like trouble swallowing. It’s the first drug approved just for EoE, and adults and children over 12 who weigh at least 88 pounds can take it.Show SourcesPhoto Credit: jcphoto / Getty ImagesSOURCES:UpToDate: “Treatment of Eosinophilic Esophagitis.”News Release, FDA.FDA: Tertiary Pharmacology/Toxicology Review, Fasenra (benralizumab).American Academy of Allergy, Asthma & Immunology: “Eosinophilic Esophagitis: Symptoms, Diagnosis & Treatment.”American Partnership for Eosinophilic Disorders: “Eosinophilic Esophagitis.”Mayo Clinic: "Upper endoscopy."Gastroenterology Clinics of North America: "Steroids in Pediatric Eosinophilic Esophagitis."National Jewish Health: "Treatment of EoE with Oral Viscous Budesonide."Frontiers in Physiology: “Interleukin-5 in the Pathophysiology of Severe Asthma.”American Academy of Pediatrics: “FDA approves first oral therapy for EoE.”FDA: “EOHILIA (budesonide oral suspension).”BMJ Paedeatrics Open: “Swallowed topical steroid therapy for eosinophilic oesophagitis in children: practical, evidence-based guidance by the BSPGHAN Eosinophilic Oesophagitis Working Group.” Explore MoreLoad More See More on Digestive Disorders From WebMD Go Now PoliciesAboutFor Advertisers © 2005 - 2025 WebMD LLC, an company. All rights reserved. WebMD does not provide medical advice, diagnosis or treatment. , There are many medications for eosinophilic esophagitis. Proton pump inhibitors, steroids, or a new drug, Dupixent, can all help you find relief., Drugs used to treat Eosinophilic Esophagitis The medications listed below are related to or used in the treatment of this condition. Select drug class All drug classes Inhaled corticosteroids (6) Glucocorticoids (2) Interleukin inhibitors (2).
The Food and Drug Administration (FDA) recently approved dupilumab (Dupixent) for treatment of adults and children 12 years and older with eosinophilic esophagitis. Dupilumab is a type of medicine known as a monoclonal antibody., The US Food and Drug Administration (FDA) approved the first oral therapy for EoE in 2024. Eohilia (budesonide oral suspension) is approved for patients 11 years and older. No mixing is required for this medication, which improves standardization of the dose. Additional options (off-label) are. Budesonide (swallowed slurry), 9. In patients with EoE, AGA/JTF recommends using anti–IL-5 therapy for EoE only in the context of a clinical trial. 10. In patients with EoE, AGA/JTF recommends using anti-IL-13 or anti-IL-4 receptor α therapy for EoE only in the context of a clinical trial. 11. In patients with EoE, AGA/JTF suggests against the use of anti-IgE therapy for , , , .