hydrocortisone rectal (Anusol HC, Cortifoam, Anucort-HC, Peranex HC, Proctol, Proctomyxin, Proctosedyl, Proctosedyl Ointment, Xyralid RC)
Classes: Corticosteroids, Gastrointestinal
Dosing and uses of Anusol HC, Cortifoam (hydrocortisone rectal)
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
