Side Effects of Cortenema (hydrocortisone enema)

Cortenema (hydrocortisone enema) is a corticosteroid used rectally for the treatment of ulcerative proctitis, inflamed hemorrhoids, and anal itching, burning, and inflammation caused by several conditions that affect the anal area.

Common side effects of Cortenema include

• local pain,
• burning,
• rectal bleeding,
• allergic reaction,
• reduced wound healing,
• spinning sensation (vertigo), and
• headache.

Serious side effects of Cortenema include

• high blood pressure,
• fluid retention,
• heart failure,
• sodium retention,
• low potassium,
• peptic ulcer,
• increased risk of diabetes,
• adrenal insufficiency, and
• growth suppression in children.

The risk of drug interactions from Cortenema is low because it is administered rectally. 

Cortenema has not been adequately evaluated during pregnancy. 

Hydrocortisone taken orally can appear in breast milk, and can have adverse effects on the baby. It is unknown if Cortenema administered rectally is absorbed in sufficient amounts to appear in breast milk. Consult your doctor before breastfeeding.

Side effects of hydrocortisone enema include:

• Local pain
• Burning
• Rectal bleeding

Other side effects include:

• Allergic reaction
• Reduced wound healing
• Vertigo
• Headache

Possible serious side effects include:

• High blood pressure
• Fluid retention
• Heart failure
• Sodium retention
• Low potassium
• Peptic ulcer
• Increased risk of diabetes
• Adrenal insufficiency
• Growth suppression in children

Local pain or burning, and rectal bleeding attributed to Cortenema have been reported rarely. Apparent exacerbations or sensitivity reactions also occur rarely. The following adverse reactions should be kept in mind whenever corticosteroids are given by rectal administration.

Fluid and Electrolyte Disturbances

• Sodium retention;
• fluid retention;
• congestive heart failure in susceptible patients;
• potassium loss;
• hypokalemic alkalosis;
• hypertension.

Musculoskeletal

• Muscle weakness;
•  steroid myopathy;
• loss of muscle mass;
• osteoporosis;
• vertebral compression fractures;
• asceptic necrosis of femoral and humeral heads;
• pathologic fracture of long bones.

Gastrointestinal

• Peptic ulcer with possible perforation and hemorrhage;
• pancreatitis;
• abdominal distention;
• ulcerative esophagitis.

Dermatologic

• Impaired wound healing;
• thin fragile skin;
• petechiae and ecchymoses;
• facial erythema;
• increased sweating;
• may suppress reactions to skin tests.

Neurological

• Convulsions;
• increased intracranial pressure with papilledema (pseudo-tumor cerebri) usually after treatment;
• vertigo;
• headache.

Endocrine

• Menstrual irregularities;
• development of Cushingoid state;
• suppression of growth in pediatric patients;
• secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness, decreased carbohydrate tolerance;
• manifestations of latent diabetes requirements for insulin or oral hypoglycemic agents in diabetics.

Ophthalmic

• Posterior subcapsular cataracts;
• increased intraocular pressure;
• glaucoma;
• exophthalmos.

Metabolic

• Negative nitrogen balance due to protein catabolism.

No information provided.