Budesonide (rectal)

About rectal budesonide

Budesonide given into the rectum can be used to help treat ulcerative colitis.

Ulcerative colitis occurs when the large intestine (bowel) becomes inflamed and ulcers are formed. Symptoms include diarrhoea often containing blood and stomach pain. The condition has times when the symptoms are worse, known as flare-ups. In between these flare-ups a patient may have few or no symptoms.

Budesonide reduces inflammation and therefore helps to relieve the symptoms of ulcerative colitis. It is given into the rectum (back passage) so that it is in the part of the bowel which needs treatment.

Before using rectal budesonide

Before using rectal budesonide make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have ever had tuberculosis (TB).
• If you are suffering from any kind of infection particularly chickenpox, shingles or measles, or if you have recently been in contact with anyone who has them.
• If you have hypertension (high blood pressure).
• If you have thyroid problems.
• If you have epilepsy (fits).
• If you or any of your close family have heart problems.
• If you have liver or kidney problems.
• If you or any of your close family have diabetes mellitus, cataracts or glaucoma (increased pressure in the eye).
• If you have osteoporosis (brittle bones) or if you are a woman who has gone through the menopause.
• If you or any of your close family have ever had mental health problems such as depression or manic-depressive illness.
• If you or any of your close family have had problems (particularly mental health problems) caused by taking a steroid.
• If you suffer from myasthenia gravis (a muscle weakening disease).
• If you have a peptic (stomach) ulcer or any gastrointestinal disorder other than the one being treated.
• If you have recently had a vaccination or are about to have one.
• If you have recently had a heart attack or a clot in a blood vessel.
• If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
• If you have ever had an allergic reaction to this or any other medicine.

How to use rectal budesonide

• Before beginning treatment, read the manufacturer's printed information leaflet.
• Use your medication exactly as directed by your doctor.
• If possible, empty your bowels before using rectal budesonide. Wash your hands after use.

1. Attach an applicator to the spray can and then shake the can well.
2. Turn the spray upside down.
3. Insert the applicator into your back passage as far as possible.
4. Push down the pump dome once and release it very slowly.
5. Wait for 10-15 seconds before withdrawing the applicator.
6. Remove the applicator and dispose of it in the plastic bag provided.

1. Unscrew the nozzle section and protective cap from one of the plastic bottles containing liquid.
2. Drop one of the tablets from the foil strip into the bottle.
3. Put the nozzle and protective cap back on to the bottle and shake the bottle for 15 seconds.
4. Lie down, then take off the protective cap and gently insert the nozzle into your back passage as far as is comfortable.
5. Squeeze the bottle to empty the liquid, then remove the nozzle from your back passage and dispose of the bottle into a plastic bag.
6. Roll on to your stomach and remain like this for at least five minutes to allow the liquid to be held in place for as long as possible.

Getting the most from your treatment

• If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment that you are having budesonide.
• Keep your regular doctor's appointment so your progress can be monitored.
• If you buy any medicines, check with a pharmacist that they are safe to take with your other medicines.

Can rectal budesonide cause problems?

Along with their useful effects all medicines can cause unwanted side-effects. These usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store rectal budesonide

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Budenofalk® Rectal Foam, Dr. Falk Pharma UK Ltd, electronic Medicines Compendium. Dated August 2009, accessed October 2009.
• Manufacturer's PIL, Entocort® Enema, AstraZeneca UK Limited, electronic Medicines Compendium. Dated April 2009, accessed October 2009.
• British National Formulary; 58th Edition (September 2009) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF).