To : Rebecca W. Ward Re : Rectal Hydrocortisone As for the question of using hydrocortisone enemas for treating ulcerative colitis in breastfeeding mothers... Rectal hydrocortisone is poorly absorbed, only approximately 2% is systemically absorbed (Mollmann, 1991), although this can be highly variable. The usual adult dose is 100 mg rectally once or twice daily. This can continue in some patients for up to 30-60 days. If used long enough, you can get symptoms of steroidism, but this would take some time and is infrequent. It is generally considered topical therapy for the colon, and can be used in pediatric patients when indicated. Mollmann H, et.al: Pharmacokinetics and rectal bioavailability of hydrocortisone acetate. J Pharm Sci 80:835-836, 1991. Regards Tom Hale PH.D.