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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. Most patients respond well to this treatment., For example, one patient/family may place high value on not restricting their diet as much as possible whereas another may wish to avoid medications. Dietary Therapy For many children, EoE is a non-IgE-mediated allergic disease, thus removal of relevant food allergens can cause remission of the disease..
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 , Expanded Access is a potential pathway for a patient with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available., Common Medications for Eosinophilic Esophagitis (EoE) Subject: This sheet gives a brief summary of the types of medications used to treat Eosinophilic Esophagitis (EoE). It explains how they re given and the benefits of each. Please talk about specific medications with your child s doctor. Keywords: Medications, Eosinophilic Esophagitis Created , , , .