hydrocortisone rectal

Hydrocortisone is a synthetic formulation of cortisol, the natural steroid hormone produced in the cortex region of the adrenal glands, hence known as a corticosteroid. Hydrocortisone rectal is used in the treatment of ulcerative colitis, an inflammatory bowel disease, especially in the forms that affect the left and lower portions of the colon.

Hydrocortisone rectal is absorbed in the colon and works both topically and systemically. Hydrocortisone rectal reduces colon inflammation by:

• Preventing the migration and aggregation of polymorphonuclear leukocytes (PMN), types of white cells such as neutrophils, eosinophils and basophils that release inflammatory substances.
• Reducing capillary permeability to prevent leakage of inflammatory cells and proteins (cytokines) into the inflammation site.

Hydrocortisone rectal is used as an adjunct therapy in the treatment of adult patients with the following types of ulcerative colitis:

• Ulcerative proctitis (inflammation of the rectum)
• Ulcerative proctosigmoiditis (inflammation of the rectum and sigmoid colon)
• Left-sided ulcerative colitis (inflammation of the descending colon)

Do not use hydrocortisone rectal:

• If you have documented hypersensitivity to hydrocortisone or other components in the formulation
• If you have systemic fungal infections; hydrocortisone may exacerbate symptoms
• Immediately after or early postoperative period after an ileostomy
• In case of any obstruction, abscess, perforation, peritonitis, fresh intestinal anastomoses or extensive fistulas

In severe colitis it is hazardous to delay surgery while waiting for a response to hydrocortisone rectal treatment

Common side effects of hydrocortisone rectal include:

• Burning
• Dryness
• Follicle inflammation (folliculitis)
• Reduced pigmentation (hypopigmentation)
• Itching
• Pain
• Rectal bleeding
• Secondary infection

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Cream

• 1%
• 0.5%
• 1%
• 2%
• 2.5%

Suspension for enema

• 100mg/60mL

Foam

• 10% (15g)

Suppository

• 25mg
• 30mg

Adult

Enema suspension

• 1 enema at bedtime for 21 days or until remission is achieved; 2-3 months of therapy may be required; taper to discontinue long-term therapy; improvement in mucosal integrity may be preceded by clinical improvement

Foam/Cream/Suppository

• Application to distal rectum in patients who cannot retain steroid enemas
• 1 applicatorful applied rectally once daily or every 12 hour for 2-3 weeks, then every other day if necessary; use lowest dosage that maintains clinical response; discontinue if no proctologic improvement is noted after 2-3 weeks
• 1 applicatorful = 900 mg; contains 90 mg hydrocortisone acetate (= 80 mg hydrocortisone)

Pediatric

• Safety and efficacy not established

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

Some drugs that may interact with hydrocortisone rectal include:

• aldesleukin

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• There are no adequate and well-controlled studies for hydrocortisone use in women of child-bearing potential, pregnant or breastfeeding women.
• Hydrocortisone rectal may be used in pregnant women if potential benefits outweigh potential risks to the mother and fetus.
• It is not known if hydrocortisone rectal passes into breast milk, and it must be used with caution in nursing mothers.

• Always follow directions for use on product carton
• Do not insert any part of aerosol container directly into the anus