Prednisolone enemas

Indication:
Reduce inflammation in acute attacks of Crohns and Ulcerative colitis.
Maintain remission of the above.

Formulation:
Predfoam (Foam enema 20mg – 14 applications)
Predsol retention enema (20mg in 100ml – single nozzle application)
Prednisolone soluble tablets 5mg
Dissolve the dose in 20 to 50ml of water and administer rectally.
(useful in pts with rectal stump – see below)

Dose:
Usually 10 to 20mg nocte or BD

Side effects:
Local irritation reported

Interactions:
None recorded

Notes:
Patients with a rectal stump will benefit from the use of the prednisolone soluble tablets rather than the high volume retention enema.
Care must be taken with the nozzles in children.
e.g. 1cm inserted for 1 to 2 years
2cm for 2 to 3 years

Mesalazine enemas (Asacol) can also be effective for left sided distal colitic problems.

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