How does this medication work? What will it do for me?

Hydrocortisone rectal foam is used to treat diseases caused by inflammation of the colon and rectum such as ulcerative colitis of the sigmoid colon, proctosigmoiditis, granular proctitis, and ulcerative proctitis. It is usually used in combination with other medications. It works within the colon and rectum to decrease inflammation.

Improvement of the condition being treated usually occurs within 5 to 7 days. If you do not notice improvement within 2 to 3 weeks, or if the condition worsens, call your doctor.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

The aerosol rectal foam contains 10% hydrocortisone acetate. Nonmedicinal ingredients: propylene glycol, ethoxylated stearyl alcohol, polyoxyethylene-10 stearyl ether, cetyl alcohol, methylparaben, propylparaben, triethanolamine, water and inert propellants, isobutane, and propane.

How should I use this medication?

The usual adult dose of hydrocortisone rectal foam is 1 full applicator in the rectum once or twice daily for 2 or 3 weeks, and every second day thereafter. Follow the package insert for details on proper use. Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, use it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double a dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, do not puncture or incinerate the aerosol container, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to hydrocortisone or any ingredients of the medication
  • are pregnant, unless the expected benefits outweigh the risks
  • have acute psychosis
  • have conditions of the intestine that include obstruction, abscess, perforation, peritonitis, fresh intestinal anastomoses, extensive fistulas, and sinus tracts
  • have medical conditions that include peptic ulcer, acute glomerulonephritis, myasthenia gravis, osteoporosis, diverticulitis, thrombophlebitis, psychic disturbances, diabetes, hyperthyroidism, acute coronary disease, high blood pressure, or limited heart reserve, unless the expected benefits outweigh the risks
  • have tuberculosis, herpes simplex of the eye, varicella, vaccinia, or other fungal or viral infections

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • dizziness
  • dry, scaly skin
  • increased appetite
  • increased sweating
  • lightened skin colour
  • sensation of spinning
  • thin, fragile skin
  • thinning hair on scalp
  • unusual weight gain

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • burning and itching of skin
  • chills
  • depression
  • diarrhea
  • false sense of well-being
  • fever
  • infection
  • mood swings
  • painful, red or itchy, pus-containing blisters in hair follicles
  • personality changes
  • rectal bleeding, burning, dryness, itching, or pain not present before treatment
  • sensation of "pins and needles"
  • stabbing pain

Some side effects may occur only if the medication is used for long periods of time. Check with your doctor as soon as possible if any of the following side effects occur:

  • abdominal or stomach pain
  • acne
  • backache
  • coughing
  • coughing up of blood
  • decreased resistance to infection
  • dryness of mouth
  • eye pain
  • filling or rounding out of the face
  • gradual blurring or loss of vision
  • headache
  • hunchback
  • increased thirst
  • irregular heartbeat
  • loss of appetite
  • menstrual irregularities
  • mood or mental changes
  • muscle cramps or pain
  • muscle weakness
  • nausea or vomiting
  • non-elevated blue or purplish patch on the skin
  • osteoporosis or bone fractures
  • pain in joints
  • pain or discomfort in the area of a vein
  • rapid weight gain
  • reddish-purple lines on arms, face, legs, trunk, or groin
  • redness of eye
  • sensitivity of eye to light
  • shortness of breath
  • skin rash
  • slow healing of wounds
  • stunting of growth (in children)
  • swelling of feet or lower legs
  • tearing of eyes
  • trouble sleeping
  • unusual decrease in sexual desire or ability in men
  • unusual increase in hair growth (especially on the face)
  • unusual tiredness or weakness
  • unusual weight loss
  • weak pulse

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Cautions regarding the container: Contents are flammable and the aerosol container may explode if heated.

Do not insert any part of the aerosol container into the anus. Do not use in presence of open flame or spark - contents are under pressure. Do not place in hot water or near radiators, stoves, or other sources of heat. Do not puncture or incinerate container or store at temperatures over 50°C. Because the medication is not expelled from the body, hydrocortisone absorption into the bloodstream may be greater from the foam than from corticosteroid enema formulations. If there is no evidence of improvement within 2 or 3 weeks after starting therapy, or if the condition worsens, contact your doctor.

Diabetes: Hydrocortisone may cause an increase in blood sugar levels (may cause a loss of blood glucose control) and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication.

General precautions: Advise all doctors involved in your care that you have been using this medication.

Glaucoma: This medication may cause the symptoms of glaucoma (increased pressure in the eye) to become worse. If you have glaucoma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Report any changes in vision to your doctor as soon as possible while you are taking this medication.

Stopping medication: Do not stop using this medication abruptly without checking with your doctor first.

Ulcerative bowel disease: People with severe ulcerative bowel disease who use rectal hydrocortisone may be at increased risk of perforation of the bowel wall. If you have ulcerative bowel disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.

Breast-feeding: Mothers using hydrocortisone should not breast-feed.

What other drugs could interact with this medication?

There may be an interaction between hydrocortisone rectal foam and any of the following:

  • aldesleukin
  • hyaluronidase
  • ceritinib
  • deferasirox
  • other medications being applied to the area being treated

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.