Corticosteroids (Rectal)

Before Using This Medicine

In deciding to use a medicine, the risks of using it must be weighed against the good it will do. This is a decision you and your doctor will make. For rectal corticosteroids, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to any of the corticosteroids. Also tell your health care professional if you are allergic to any other substances, such as food, preservatives, or dyes.

Pregnancy - Betamethasone may change the number and ability of movement of sperm in men. Budesonide crosses the placenta. It is not known whether other rectal corticosteroids cross the placenta. Studies in animals have shown that budesonide, hydrocortisone, and hydrocortisone acetate cause birth defects. Rectal corticosteroids should not be used in large amounts or for a long time by women who are pregnant or who are planning to become pregnant.

Breast-feeding - It is not known whether rectal corticosteroids pass into breast milk. However, systemic (oral and injection) corticosteroids pass into breast milk and may cause problems with growth in nursing babies. It may be necessary for you to take a different medicine or to stop breast-feeding during treatment. Be sure you have discussed with your doctor the risks and benefits of using the medicine.

Children - Children and teenagers who must use this medicine should be checked often by their doctor. Rectal corticosteroids may be absorbed through the lining of the rectum and, rarely, may affect growth, especially if used in large amounts or for a long time. Before using this medicine in children, you should discuss its use with the child's doctor.

Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of rectal corticosteroids in the elderly with use in other age groups, these medicines are not expected to cause different side effects or problems in older people than they do in younger adults.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction may occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are using rectal corticosteroids, it is especially important that your health care professional know if you are taking any of the following:

• Immunizations (vaccinations) - While you are being treated with this medicine, and even after you stop using it, do not have any immunizations without your doctor's approval

• Skin test injections - Corticosteroids may cause false results in skin tests

Other medical problems - The presence of other medical problems may affect the use of rectal corticosteroids. Make sure you tell your doctor if you have any other medical problems, especially:

• Acute psychosis - This condition may be made worse

• Chickenpox (including recent exposure) or
• Measles (including recent exposure) - Risk of severe disease affecting other parts of the body

• Diabetes mellitus (sugar diabetes) - Corticosteroids may cause a loss of control of diabetes by increasing blood glucose (sugar)

• Glaucoma - Corticosteroids may cause the pressure within the eye to increase

• Heart disease or
• Hypertension (high blood pressure) or
• Kidney disease or
• Myasthenia gravis or
• Overactive thyroid or
• Swelling of blood vessels - Corticosteroids should be used with caution

• Herpes simplex of the eye - Corticosteroids may cause additional problems in the eye

• Ileocolostomy, postsurgical or
• Infection or
• Tuberculosis (active TB, nonactive TB, or past history of) - Corticosteroids may cause slower healing, worsen existing infections, or cause new infections

• Liver disease or
• Underactive thyroid - With these conditions, the body may not eliminate the corticosteroid at the usual rate; therefore, the medicine's effect may be increased

• Osteoporosis - Corticosteroids may worsen osteoporosis because they cause the body to lose more calcium

• Other stomach or intestine problems or
• Severe ulcerative colitis - Corticosteroids may cover up symptoms of a worsening stomach or intestinal condition; a patient would not know if his or her condition was getting worse and would not get medical help when needed

• Stomach ulcer - Corticosteroids may worsen this condition by causing an increase in the amount of acid in the stomach