Proper Use of This Medicine

It is important that your doctor check your progress at regular visits .

For patients using the enema form of this medicine:

• This medicine usually comes with patient directions. Read and follow them carefully before using this medicine.

For patients using the foam form of this medicine:

• This medicine is used with a special applicator. Do not insert any part of the aerosol container into the rectum.

For patients using the suppository form of this medicine:

• If the suppository is too soft to insert, chill it in the refrigerator for 30 minutes or run cold water over it before removing the wrapper.
• To insert the suppository: First remove the wrapper and moisten the suppository with cold water. Lie down on your side and use your finger to push the suppository well up into the rectum.

Do not use rectal corticosteroids in larger amounts, more often, or for a longer time than your doctor ordered . To do so may increase the chance of absorption through the lining of the rectum and the chance of side effects.

Dosing—The dose of rectal corticosteroids may be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of corticosteroids. If your dose is different, do not change it unless your doctor tells you to do so.

For betamethasone
• For enema dosage form:
  • For ulcerative colitis:
    • Adults—The usual dose is 5 milligrams (mg) (1 unit), used as directed, every night for two to four weeks.
    • Children—Dose must be determined by your doctor.

For budesonide
• For enema dosage form:
  • For ulcerative colitis:
    • Adults—The usual dose is 2 milligrams (mg) (1 unit), used as directed, every night for four to eight weeks.
    • Children—Use and dose must be determined by your doctor.

For hydrocortisone
• For enema dosage form:
  • For ulcerative colitis:
    • Adults—The usual dose is 100 milligrams (mg) (1 unit), used as directed, every night for two or three weeks or until condition improves as determined by your doctor.
    • Children—Dose must be determined by your doctor.

For hydrocortisone acetate
• For foam dosage form:
  • For ulcerative colitis:
    • Adults—At first, 1 applicatorful, used as directed, one or two times a day for two or three weeks. Then, the dose may be decreased to 1 applicatorful every other day.
    • Children—Dose must be determined by your doctor.
• For suppository dosage form:
  • For ulcerative colitis:
    • Adults—The usual dose is 25 or 30 milligrams (mg) two times a day, in the morning and at night, for two weeks. In more severe cases, the dose may be 25 or 30 mg three times a day or 50 or 60 mg two times a day.
    • Children—Dose must be determined by your doctor.
  • For inflammation of the rectum caused by radiation therapy:
    • Adults—The usual dose is 25 or 30 mg two times a day, in the morning and at night, for six to eight weeks.
    • Children—Dose must be determined by your doctor.
  • For other rectal problems:
    • Adults—The usual dose is 20 to 30 mg a day for three days, or 40 to 80 mg a day as needed.
    • Children—Dose must be determined by your doctor.

For tixocortol
• For enema dosage form:
  • For ulcerative colitis:
    • Adults—The usual dose is 250 milligrams (mg) (1 unit), used as directed, at bedtime for twenty-one days in a row.
    • Children—Use and dose must be determined by your doctor.

Missed dose—If you miss a dose of this medicine, use it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store suppositories in the bathroom medicine cabinet because the heat or moisture may cause the medicine to break down.
• Keep the medicine from freezing.
• Do not puncture, break, or burn the rectal foam aerosol container, even when it is empty.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.