About hydrocortisone rectal foam

In ulcerative colitis (UC) and similar conditions, patches of inflammation develop in your large intestine. If these patches are confined to the lower parts of your bowel (the lower colon and rectum), it may be helpful during flare-ups for you to be treated with a preparation applied directly into your back passage. Hydrocortisone is a steroid medicine which is available as a rectal foam and which can be applied in this way. It reduces inflammation, which helps ease your symptoms.

A course of treatment with hydrocortisone will last a few weeks - it will be stopped once your flare-up has settled.

Before using hydrocortisone

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start using hydrocortisone it is important that your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you think there may be any blockage in your bowel, or if there is any irritation around your back passage.
• If you have any kind of infection, or if you have ever had tuberculosis (TB).
• If you have any of the following: high blood pressure, sugar diabetes, glaucoma (increased eye pressure), osteoporosis (weakened bones), cataracts, an underactive thyroid, or epilepsy.
• If you have had a heart attack or have any other heart problems.
• If you have liver or kidney problems.
• If you have ever had a blood clot in an artery or vein.
• If you have had a stomach ulcer.
• If you have ever had mental health problems, such as depression or psychosis.
• If you have myasthenia gravis (this is a condition causing muscle weakness).
• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
• If you have ever had an allergic reaction to a medicine, or if you have ever developed muscle pain after taking a steroid medicine.

How to use hydrocortisone rectal foam

• Before you start this treatment, it is important that you read the manufacturer's printed information leaflet from inside the pack. The leaflet will give you more information about hydrocortisone and a full list of side-effects which you may experience from using it. It will also give you a step-by-step guide on how to use it.
• Your doctor or pharmacist will tell you how often you should use hydrocortisone. It is usual to use it once or twice a day for 2-3 weeks, and then for the dose to be reduced to once on alternate days for a short while. This information will be on the label of the pack to remind you.

How to use Colifoam®

1. Shake the canister well before each use.
2. Withdraw the plunger slowly until it stops at the catch line.
3. Hold the applicator with the nozzle downwards, and then insert the top of the canister of foam into the nozzle.
4. Press the canister top gently so that foam fills about a quarter of the applicator. Only a short press is needed to do this. Wait a few seconds for the foam to expand and then press the canister top again. Continue to fill the applicator a little at a time until the foam reaches the fill line.
5. Stand with one leg raised on a chair (or lie down on your side if you prefer) and gently insert the applicator into your back passage. Push the plunger to empty the applicator.
6. Wash the applicator after each use.

Getting the most from your treatment

• Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
• Continue to use the foam for as long as your doctor has told you to. A course of treatment is likely to last a few weeks.
• If you forget a dose, do not worry, just have the next dose when it is due.
• Hydrocortisone may suppress your immune system, so it is important if you become ill that you make an appointment to see your doctor straightaway. Also, if you come into contact with anyone who has measles, shingles or chickenpox (or anyone who suspects they might have them), you should see your doctor as soon as possible.
• Some vaccines may not be suitable for you while you are being treated with hydrocortisone. If you need any immunisations, make sure you mention that you are having a steroid.
• If you are having an operation or any medical treatment, tell the person carrying out the treatment that you are using hydrocortisone.
• If you buy any medicines, check with a pharmacist that they are safe to take with your other medicines.

Can rectal hydrocortisone cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

For more information about the side-effects which are possible when hydrocortisone is used over a long period of time, see the separate condition leaflet called Oral Steroids.

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

How to store hydrocortisone

• 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