Rectal corticosteroids for induction therapy of ulcerative proctitis or distal colitis in adults
If the combination of a rectal and an oral 5-aminosalicylate is ineffective for induction therapy of ulcerative proctitis or distal colitis, add rectal corticosteroid therapy; use:
1budesonide 2 mg/applicator foam 1 applicatorful rectally, once daily budesonide budesonide budesonide
OR
1hydrocortisone acetate 10% foam 1 applicatorful rectally, once or twice daily hydrocortisone acetate hydrocortisone hydrocortisone
OR
1prednisolone 20 mg/100 mL enema rectally, once or twice daily prednisolone prednisolone prednisolone
OR (for isolated proctitis)
2prednisolone 5 mg suppository rectally, once or twice daily. prednisolone prednisolone prednisolone
For patients who cannot tolerate rectal mesalazine, rectal corticosteroids may be used as the only rectal preparation.
Continue rectal corticosteroid therapy until symptoms have resolved, then taper over several weeks. If symptoms recur, restart rectal therapy.