Colocort Rectal Suspension Retention Enema 7's
Colocort Rectal Suspension Enema provides the potent anti-inflammatory effect of hydrocortisone. Because this drug is absorbed from the colon, it acts both topically and systemically. Although rectal hydrocortisone, used as recommended for hydrocortisone rectal suspension, has a low incidence of reported adverse reactions, prolonged use presumably may cause systemic reactions associated with oral dosage forms. Colocort®, Hydrocortisone Rectal Suspension, USP, (Retention) 100 mg/60 mL, is supplied as disposable single-dose bottles with lubricated rectal applicator tips, in boxes of seven x 60 mL (NDC 0574-2020-07) and boxes of one x 60 mL (NDC 0574-2020-01).
How to use the retention enema:
Best results are achieved if the bowel is emptied immediately before the enema is given.
1 Preparing the Medication for Administration
- Shake the bottle well to make sure that the suspension is homogeneous.
- Remove the protective sheath from the applicator tip. Hold the bottle at the neck so as not to cause any of the medication to be discharged.
2 Assuming the Correct Body Position
- Best results are obtained by lying on the left side with the left leg extended and the right leg flexed forward for balance.
- An alternative to lying on the left side is the “knee-chest” position as shown here.
3 Administering the Retention Enema
- Gently insert the lubricated applicator tip into the rectum, pointed slightly toward the navel (umbilicus).
- Grasp the bottle firmly, then tilt slightly so that the nozzle is aimed toward the back, and squeeze slowly to instill the medication. Steady hand pressure will discharge most of the solution. After administering, withdraw and discard the used unit.
- Remain in position for at least 30 minutes to allow thorough distribution of the medication internally. Retain the enema all night, if possible.
Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature]
The use of Colocort® Hydrocortisone Rectal Suspension, USP is predicated upon the concomitant use of modern supportive measures such as rational dietary control, sedatives, antidiarrheal agents, antibacterial therapy, blood replacement if necessary, etc.
The usual course of therapy is one Colocort® nightly for 21 days, or until the patient comes into remission both clinically and proctologically. Clinical symptoms usually subside promptly within 3 to 5 days. Improvement in the appearance of the mucosa, as seen by sigmoidoscopic examination, may lag somewhat behind clinical improvement. Difficult cases may require as long as 2 or 3 months of Colocort® treatment. Where the course of therapy extends beyond 21 days, Colocort® should be discontinued gradually by reducing administration to every other night for 2 or 3 weeks.
If clinical or proctologic improvement fails to occur within 2 or 3 weeks after starting Colocort®, discontinue its use.
Symptomatic improvement, evidenced by decreased diarrhea and bleeding; weight gain; improved appetite; lessened fever; and decrease in leukocytosis, may be misleading and should not be used as the sole criterion in judging efficacy. Sigmoidoscopic examination and X-ray visualization are essential for adequate monitoring of ulcerative colitis. Biopsy is useful for differential diagnosis.
Patient instructions for administering Colocort® are printed on this carton. It is recommended that the patient lie on their left side during administration and for 30 minutes thereafter, so that the fluid will distribute throughout the left colon. Every effort should be made to retain the enema for at least an hour and preferably, all night. This may be facilitated by prior sedation and/or antidiarrheal medication, especially early in therapy when the urge to evacuate is great.
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