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Ulcerative Colitis
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Posted 1/19/2009 5:19 PM (GMT 0)

My doctor just prescribed cortifoam for me.  After only a few days it seems to be helping me, so I am hopeful of even more symptom relief as I use it for a longer time.

I am not able to follow the directions about filling the applicator with foam that are on the back of the box.

The directions say to hold down on the flanges for 1 - 2 seconds, then release and wait 5 - 10 seconds for the foam to expand in the applicator barrel.  The foam does not expand.  It is just the same amount as gets in the applicator by pressing down on the flanges.

Then, the directions say to repeat the process until the applicator reaches the fill line.  I keep pressing the flanges, waiting 10 seconds in between presses.  After about 5 presses, no more foam will come out of the aerosol can into the applicator. 

When I get to this point, the narrow part of the applicator is filled and there is barely any foam in the wider part of the applicator.  The foam is well below the fill line on the applicator.

Does anyone have any insight on this?  I think this is working so well for me, I can only imagine if I could get the full dose each time!

Thanks for reading.

Posted 1/19/2009 6:04 PM (GMT 0)
Cortifoam...rocks!

I have to make sure the can is well shaken and it takes about 10-14 pumps for the tube to fill...also make sure you keep the area under the plastic noozle that fits over the can clean as well as the opening where the foam comes out. Hope this helps

What is the doseage frequency your doc recommended?
Posted 1/19/2009 7:07 PM (GMT 0)
Shaking the can before attempting to fill the plastic container is crucial! That helps the foam to expand to the fill line, in my experience. Good luck with it! Cortifoam was a very helpful med when I needed it-- so I hope you'll get the same benefit from using it. / Old Hat (nearly 30 yrs with left-sided UC; original Colazal is my main med)
Posted 1/19/2009 7:11 PM (GMT 0)

I posted about a month ago with the same type questions!  I was thinking I was doing something wrong or that the little can was empty!  I agree with bbc about making sure it is well shaken before you start.  I  pull the plunger well back beyond the fill line.  I pump about 5 seconds, wait only about 3 seconds between, and that seemed to work better for us.  I did overfill the syringe a few times, so we only got about 13 doses out of the can instead of the 15 promised...

My 13 y.o. son (proctosigmoiditis) who has been bleeding since May or longer (with EVERY bm-2 times/day) has found this to be the only thing that has helped him...We saw a drastic difference in only a few days, and he hasn't had any blood in a month!  He was doing Cortifoam once every other day, and is now once every third day or so...We're hoping to slowly wean down, keeping him on the Colazal/VSL#3/Metamucil for maintenance...

Thanks to this site---it's a great help...

Posted 1/19/2009 7:24 PM (GMT 0)
Yup, always shake can well, little pumps and wait for the foam to stop expanding before you pump again so you don't go over the fill line.

:)
Posted 1/19/2009 7:41 PM (GMT 0)
:-)) Yeah, it takes me like 7-10 minutes to fill it, but I see it working on me, so I'll get used to it :-)
Posted 1/19/2009 9:52 PM (GMT 0)
Thank you for all of your replies.

bbc -right now I am using the cortiform 1/X day in the morning. I just started it on Thursday, and I've seen improvement in my symptoms each day. I am rinsing all parts of the applicator, aerosol foam can and cap after each use, per the directions on the box.

Old Hat and pb4 and JoMarie - yes, I'm shaking the can well before filling the applicator with foam. Is it necessary to reshake the can part way through filling the applicator? I'm still getting the feeling I am doing something wrong because the foam is not expanding in the applicator at all.

spluxa - 7 - 10 min to fill the applicator with foam? That puts a new perspective on in for me. I am not spending nearly that long. Maybe I need to be more patient to wait for the foam to expand or wait a little longer in between pumps.

Thanks, again, to all who replied. I am going to have to see what I can do about getting that applicator filled so I get my full dose of medicine.
Posted 1/19/2009 9:55 PM (GMT 0)
I fill the container in about 30 seconds. I shake the can 12 times, pull the plunger way back, and then push on the flanges for a few short bursts and wait.

My theory about the problem: there's build up underneath the flange piece. Assuming you have the same container with the white top, I'd pull it off the can to make sure that the foam isn't building up under there.

That has happened to me a few times -- when I saw that nothing was really coming out -- and it was because there was foam under the white top.

Every once in a while, I'd just switch the top with one from another box and it worked just fine.

By the way, there should be a warning that the force of filling the applicator can force the plunger to dislodge and fly up. It's only happened to me twice, but the first time it surprised the heck out of me!
Posted 1/19/2009 10:45 PM (GMT 0)
It's weird that it wouldn't expand at all unless you're squeezing tiny amounts at a time (too tiny), maybe check the expiry date on it? Maybe the tempature where you keep it isn't good (too warm or too cold)?

I always hold the applicator with my finger while filling it up so I've never had it pop off like what you describe.

:)
Posted 1/19/2009 10:51 PM (GMT 0)
Juliee, there is a warning but you've really gotta read the fine print.

Tmpl1957, how long does you doc want you to use it for etc etc
Posted 1/20/2009 11:46 AM (GMT 0)
Thanks again for the further replies.

julee70 - I am rinsing the white top for the can and the tip on the can with warm water after every use, per directions on the box. Water is easily running through the white top, so I do not think it is clogged with foam build up.

pb4 - expiration date is fine, 01/11, but maybe it is too cold in my bathroom where I am keeping the foam. I will try to move it to the powder room to see if that helps

bbc - I am not sure how long my dr plans for me to use the cortifoam. Not sure what you mean by etc, etc? What other meds am I taking, or when I was diagnosed? I am not sure what you are asking about.
Posted 1/20/2009 2:56 PM (GMT 0)

tmpl1957 said...
Thanks again for the further replies.

julee70 - I am rinsing the white top for the can and the tip on the can with warm water after every use, per directions on the box. Water is easily running through the white top, so I do not think it is clogged with foam build up.

pb4 - expiration date is fine, 01/11, but maybe it is too cold in my bathroom where I am keeping the foam. I will try to move it to the powder room to see if that helps

bbc - I am not sure how long my dr plans for me to use the cortifoam. Not sure what you mean by etc, etc? What other meds am I taking, or when I was diagnosed? I am not sure what you are asking about.

Normally they will say...use it 1x per day for 2 weeks and then start tapering to every other da then to 2xs per week etc etc

Did they say anything other than just use it once per day or do you have to see him/her in two weeks?

Posted 1/21/2009 1:18 AM (GMT 0)
bbc - no, my dr didn't mention anything about tapering the cortifoam. Tomorrow I have a small bowel function test (required by my ins co before my dr can order the test he really wants - the small bowel capsule endoscopy). Then I go back to see him for the results. I don't think this will all happen in two weeks, probably more like 3 - 4 weeks.

Today I brought the cortifoam back to the pharmacy and talked to the pharmacist for the second time about the problem I am having getting the applicator filled with foam. She is going to order me a replacement can, so hopefully that will work better than the one I have now.
Posted 1/21/2009 3:55 PM (GMT 0)
Filling the tube with less than 14 pumps is very rare for me especially after the first few uses. YOur docotor may ask you to taper the foam down to every other day after the first two weeks.
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