Most modern steroid enemas are foam based - as the likelihood of someone with colitis being able to retain a water based enema is quite low. These act topically applying the steroid directly to the colon - with only small amounts being absorbed into the bloodstream. This makes side effects less likely. The downside is that they can only reach the descending colon and rectum - so for those with extensive colitis oral steroids may be needed. A combination of Entocort and steroid enemas can provide topical treatment to the majority of the colon - again minimizing side effects. As the two main steroid enemas differ quite greatly I will cover them separately.
Once I treated children who suffered from acute allergic rhinitis with Prednisolone. I liked the effect of the drug, because it was able to quickly remove the swelling and allergic reaction. After that, I was prescribed Prednisolone for hives. Despite improvements in the condition, this medicine caused me to have some side effects in a form of sleep disturbances. But for me the main factor is effectiveness, if the medicine helps, then side effects can be tolerated. Especially, if they are so insignificant as a violation of sleep. I would not sleep anyway because of the illness.
Dosing should be individualized based on disease and patient response:
Initial dose: 5 to 60 mg orally per day; may be give once a day or in divided doses
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.
Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.