Prednisolone rectal foam, enema and suppositories

About rectal prednisolone preparations

In inflammatory bowel conditions such as Crohn's disease and ulcerative colitis, patches of inflammation develop in the lining of parts of your gastrointestinal tract. Both of these conditions can cause inflammation of the lower parts of your bowel and the rectum. Inflammation in the rectum is called proctitis. Symptoms of a flare-up of inflammation in the rectum are fresh bleeding and a feeling of wanting to go to the toilet frequently. It may be helpful during flare-ups such as these for you to be treated with a corticosteroid given rectally. This means giving the medication into your back passage, as an enema or suppository.

Prednisolone is a corticosteroid medicine, it is also referred to as a steroid medicine. It relieves the symptoms of a flare-up by reducing inflammation. There are three types of prednisolone formulation available for rectal use: suppositories, a liquid enema in a disposable pack with an application nozzle, and a foam which is administered using an applicator attached to an aerosol cannister.

Before using rectal prednisolone

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 prednisolone it is important that your doctor knows:

• If you have any kind of infection, or if you have ever had tuberculosis (TB).

• If you (or anyone you are in close contact with) have recently had chickenpox, measles or shingles.

• If you have ever had a blood clot in an artery or vein.

• If you are pregnant or breastfeeding. This is because your doctor will want to monitor the progress of you and your baby closely.

• If you have any of the following: high blood pressure, weakened bones (osteoporosis), epilepsy, an underactive thyroid gland, or a stomach ulcer.

• If you have had a heart attack, or if you have any other heart problems.

• If you or anyone in your family have diabetes mellitus, or increased eye pressure (glaucoma).

• If you have recently had, or are about to have, any vaccinations.

• If you have a condition causing muscle weakness, called myasthenia gravis.

• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

• If you have had an allergic reaction to a medicine, or if you have developed muscle pain after taking a steroid medicine.

How to use rectal prednisolone

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about prednisolone and will provide you with a full list of the side-effects which you may experience from using it. It will also give you a step-by-step guide on how to use the preparation you have been supplied with.

• Follow the directions you have been given by your doctor about how much to use and when to use it. It is usual to be prescribed either one or two doses a day depending upon which preparation you have been supplied with. Your dose will be printed on the label of the pack to remind you about what the doctor said to you.

• It is usual for a course of treatment to last 2-4 weeks, but your doctor will tell you what is right for you. The aim is to treat the flare-up but to keep the total amount of steroid treatment as low as possible.

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.

• Prednisolone can suppress your immune system, so it is important if you become ill that you make an appointment to see your doctor straightaway. If you come into contact with anyone who has measles, shingles or chickenpox (or anyone who suspects they might have them), you should contact your doctor for advice as soon as possible.

• If you are having an operation or dental treatment, tell the person carrying out the treatment that you are using a rectal steroid preparation. It is also important that, if you are due to have any vaccinations, you make sure that the person treating you knows that you are using prednisolone. Some vaccines are not suitable for you while you are being treated with prednisolone.

• If you buy any medicines, check with your pharmacist that they are suitable for you to take with prednisolone.

Can rectal prednisolone cause problems?

Prednisolone can be absorbed into the body from rectal formulations, so these preparations can cause similar unwanted side-effects to oral steroids. However, because less of the medicine is absorbed when given rectally than when taken by mouth, the risk of side-effects is much lower.

Children are susceptible to side-effects from corticosteroids. The main concern is for children who need frequent courses, as it can have an effect on their growth and this may need to be monitored.

How to store prednisolone

• 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