$22.40

ANUCORT-HC

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.

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

• 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