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.