total dosage in hydrocort enemas

There are 100 mg of hydrocortisone in the enemas. An average dosage of prednisone, at least to start, is 40 mg. Doesn't that make the total dosage in the enemas a bit high, especially depending on a person's size and weight? I know that the steroid bypasses the liver when delivered rectally, yet I experience some systemic side effects (insomnia, some swelling in my legs) while on them.

My husband is a nurse who brought this up to me and I didn't have a good answer. Any thoughts?

Thanks so much, DBwithUC! Very helpful. I guess my logic that trying the cort enema before taking oral pred is not all that off base.

I have pancolitis and am also taking 4800 mg of Asacol a day. Trying to avoid oral pred if I can. Did really well on the first day with hydrocort enema; second day gurgles and cramping and little bits of mucous and blood made another appearance.

The thing is, according to bootstrap's scale of severity, my flare is mild. Total trips to the bathroom per day are five max, usually all by late morning. And yet my GI said that if I need another round of pred (that would be the second in two years) the next course of action would be 6MP, for which I have the "intermediate" range of tolerance according to the Prometheus? Promethean? blood test. Really? That seems so extreme considering the overall severity of my flare. The problem is the 5-ASAs aren't getting me out of it. I've only been flaring for about three weeks and have not seen any real improvment. Not getting worse, just not getting better.

I am not a believer in any kind of cause/effect with diet. I've had the disease for 22 years and never had such a hard time getting out of flares as I have in the last two years. It all seems so random to me.

I was wondering too thanks for posting.

the mg of Cort is on the label. if the manufacturer is not providing an estimate of systemic absorption, assume it is lower than the absorption by enemas - because they don't go as high. Maybe estimate 30%? - after that is it just math.

Old Hat thank u , and u would say how much for the cortenema

The 40% absorption rate for Cortenema sounds right. When one is on them nightly for more than 6 weeks some steroid side effects might start kicking in, such as increased appetite, scalp hair loss, energy rush. They are not intended for longterm use because eventually they would affect the bones and other major organs, too. / Old Hat (31 yrs with left-sided UC; presently in remission taking brandname Colazal)

Hey all,

I am tapering off the hydrocort enemas. I think I went two nights in a row without taking one (instead of every other night) and now I have the shakes, a headache, anxiety, etc. Just put in a call to my GI but thought if anyone could advise ASAP...should I put one in now (it's 10:00 am my time)? I am freaking out that I'm going to have a heart attack or something.

Thanks.

Thanks, DBwith UC. I was only on them for ten days before starting the taper.

I spoke with my doc's nurse and am expecting a call back as to how to proceed. I appreciate your talking me off the cliff!

I tapered off those Cort enemas very slowly . People thought I was crazy. I couldn't sleep, felt like I was on pred. Very sensitive also to the stuff!

I'm far from any sort of expert here, i can just say that  the same thing happened to me in the beginning of August.

So i went back on Cortenema for 2 weeks, plus twice a day Canasa.

Just started to taper every other night this week, and so far so good.

But it was suggested to me here to use half cortenema, half rowasa until using all rowasa as part of a slow taper. I started that last night and hope to continue until all ROwasa!

Maybe you can start that? Just a suggestion as you are trying to avoid oral steroids?