hydrocortisone rectal (Anusol HC, Cortifoam, Anucort-HC, Peranex HC, Proctol, Proctomyxin, Proctosedyl, Proctosedyl Ointment, Xyralid RC)

Dosing and uses of Anusol HC, Cortifoam (hydrocortisone rectal)

• Adult
• Pediatric

 

Adult dosage forms and strengths

cream

• 1%
• 0.5%
• 1%
• 2%
• 2.5%

enema

• 100mg/60mL

foam

• 10% (15g)

suppository

• 25mg
• 30mg

 

Ulcerative Proctitis

Application to distal rectum in patients who cannot retain steroid enemas

Foam

• 1 applicatorful PR once daily or q12hr for 2-3 weeks, then every other day if necessary; use lowest dosage that maintains clinical response; discontinue if no proctologic improvement is noted after 2-3 weeks
• 1 applicatorful = 900 mg; contains 90 mg hydrocortisone acetate (= 80 mg hydrocortisone)

Suspension

• 1 enema at bedtime for 21 days or until remission is achieved; 2-3 months of therapy may be required; taper to discontinue long-term therapy; improvement in mucosal integrity may be preceded by clinical improvement

 

Pediatric dosage forms and strengths

Safety and efficacy not established

 

Anusol HC, Cortifoam (hydrocortisone rectal) adverse (side) effects

Frequency not defined

Burning

Dryness

Folliculitis

Hypopigmentation

Itching

Pain

Rectal bleeding

Secondary infection

 

Warnings

Contraindications

Documented hypersensitivity

Systemic fungal infections

Ileostomy during immediate or early postoperative period

Obstruction, abscess, perforation, peritonitis, fresh intestinal anastomoses, extensive fistulas

 

Cautions

Always follow directions for use on product carton

Do not insert any part of aerosol container directly into anus

Sigmoidoscopy is recommended for judging treatment course, rather than symptomatic improvement

 

Pregnancy and lactation

Pregnancy category: C

Lactation: Use with caution

 

Pregnancy categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

 

Pharmacology of Anusol HC, Cortifoam (hydrocortisone rectal)

Mechanism of action

Decreases inflammation by suppressing migration of polymorphonuclear leukocytes (PMNs) and reversing increased capillary permeability

 

Absorption

Absorption limited

Onset: 5-7 days