Hydrocortisone - rectal

Hydrocortisone is used together with other medicines to treat ulcerative colitis (inflammation of the large intestines).

This medicine may also be used to treat haemorrhoids (swollen veins in the anus).

Use Hydrocortisone exactly as directed by your doctor or according to the instructions on the label. Do not use more or less than instructed by your doctor.

This medicine is available as a rectal suppository, suspension enema and foam.

Hydrocortisone suppository, enema or foam may only be used by inserting it into the rectum. Do not take it by mouth or use it in any other way. Try to go to the toilet before using this medicine.

If you are using the rectal suppository, follow these steps:

1. Wash your hands thoroughly.
2. Remove the suppository from the foil wrapper.
3. If you are right-handed, lie on your left side and pull your right knee up to your chest.
4. Gently insert the suppository with the pointed end first into your rectum. Gently push the suppository as far as it would go.
5. Remain lying in this position for several minutes to allow the suppository to melt. If you feel that the suppository is slipping out, press your buttocks together. The suppository must remain in the rectum so that the medicine can be absorbed.
6. Wash your hands.

If you are using the rectal suspension enema, follow these steps:

1. Use this medicine only at bedtime, just before you sleep.
2. Shake the bottle well before using.
3. Take out the protective cap from the nozzle.
4. Hold the bottle at the neck otherwise the medicine may leak out.
5. Lie down on your left side with your left leg stretched out while the right leg bent forward.
6. Insert the nozzle gently into your rectum.
7. Tilt the bottle slightly so that the nozzle is aimed towards your back.
8. Squeeze the bottle slowly to release the medicine into your rectum.
9. After completely emptying the bottle, withdraw the nozzle from your rectum.
10. Remain in the same position for at least 30 minutes to allow the medicine to be distributed through your bowel.
11. Do not get up from the bed. Remain in a lying down position if possible to retain the medicine in your body while you are sleeping all night.

If you are using the rectal foam, follow these steps:

1. Shake the container well for 5-10 seconds before using. Do not remove the cap during use.
2. Hold it upright and place the applicator tip gently onto the nose of the container cap.
3. Pull the plunger past the fill line on the applicator barrel.
4. Firmly press down on the cap flanges, hold for 1-2 seconds, and release to fill the applicator barrel with the medicine. Pause for a few seconds to allow the foam to expand on the applicator tip, then repeat until the foam reaches the fill line.
5. Remove the applicator from the container cap.
6. Hold the applicator by the barrel. Ensure that the thumb and middle finger are securely placed on the barrel wings and the index finger over the plunger.
7. Gently insert the applicator into the rectum and push the plunger to release the foam.
8. Withdraw the applicator.
9. After each use, clean the applicator parts with warm water. Do not insert any part of the foam container directly into the rectum.

Hydrocortisone suppository, enema or foam may cause staining of direct contact surfaces such as fabrics, if possible, take appropriate precautionary measures when using this medicine.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition.

Hydrocortisone must be used regularly for it to be effective. Continue using this medicine even when you feel better. Do not stop using it unless instructed by the doctor.

Use the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to use your medicine, let your doctor and pharmacist know.

Alert your doctor if you have the following conditions:

• fungal infection affecting the entire body
• had a surgical procedure in the colon
• inflammation of the lining in the abdomen
• bowel problems e.g. blocked or ruptured bowel, abnormal connections in the colon

as Hydrocortisone may not be suitable for you.

Alert your doctor if you have been recently vaccinated.

You must avoid any vaccinations without consulting with your doctor.

Inform your doctor if you have the following conditions:

• high blood pressure
• heart disease e.g. heart failure, recent heart attack
• diabetes
• stomach problems e.g. stomach ulcer
• myasthenia gravis (muscle weakness disorder)
• osteoporosis (thinning and weakening of bones)
• eye disease e.g. glaucoma (increased pressure in the eye), cataract (clouding of the lens of the eye)
• thyroid disease
• liver disease
• kidney disease

Let your doctor know if you are pregnant or breastfeeding.

Avoid exposure to anyone who is infected with chickenpox or measles. If you are exposed to these infections, contact your doctor immediately.

If you are going to have a certain laboratory test (e.g. skin test) or operation, including minor surgery or dental work, your doctor or dentist that you are using this medicine.

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly. Regular monitoring for signs of changes in your adrenal glands may be needed.

Hydrocortisone may cause any of the following side effects: rectal irritation, pain, burning sensation, or bleeding on the application site.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• rashes, breathlessness, swelling of the face, eyes or mouth
• rounding of the face, acne, weight gain, slow healing, stretch marks on the skin
• blurring of your vision or other visual disturbances
• unusual changes in mood or behaviour (being too depressed, agitated, or having compulsive and impulsive behaviour)
• unusual tiredness, increased thirst and hunger, frequent urination

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Avoid live vaccinations during treatment with Hydrocortisone. Alert your doctor if you have been recently vaccinated or if you are planning to get vaccinated.

Inform your doctor and pharmacist if you are taking or using any of these medicines:

• medicines to treat fungal infection e.g. ketoconazole, amphotericin B
• medicines for epilepsy (fits or seizures) e.g. carbamazepine, phenytoin, phenobarbital
• medicine to treat TB (infection known as tuberculosis) e.g. rifampicin, rifabutin
• certain antibiotics e.g. erythromycin, clarithromycin
• NSAIDs (medicine for pain and inflammation) e.g. aspirin, diclofenac, ibuprofen

This list does not include all medicines that may interact with Hydrocortisone.

Always notify your doctor and pharmacist if you are taking or using any other medicines, including herbal tonics such as traditional Chinese medicine, supplements and medicines that you buy without a prescription.

Avoid alcohol.

Store in a cool, dry place away from the reach of children.

Protect from heat. Do not freeze.

Medicines must not be used past the expiry date.