";s:4:"text";s:4515:" 4. Patient does not provide medical advice, diagnosis or treatment.Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. Rifamycins accelerate metabolism of corticosteroids (reduced effect); erythromycin inhibits metabolism of methylprednisolone and possibly other corticosteroids. Although Prednisolone Rectal Solution is applied locally, it should be borne in mind that there is likely to be substantial systemic absorption, especially when the bowel is inflamed.The volume of the enema is considered to be the optimum to ensure maximum coverage of the affected area, however, undesirable effects may be minimised by using for the minimum period.
The efficacy of coumarin anticoagulants may be enhanced by concurrent corticosteroid therapy and close monitoring of the INR or prothrombin time is required to avoid spontaneous bleeding.Carbamazepine, phenobarbital, phenytoin and primidone accelerate metabolism of corticosteroids (reduced effect).Increased risk of hypokalaemia with amphotericin (avoid concomitant use unless corticosteroids are required to control reactions); ketoconazole inhibits metabolism of methylprednisolone and possibly other corticosteroids.Decreased effect of anticholinesterases in myasthenia gravis.Ritonavir possibly increases plasma concentration of prednisolone.Increased toxicity if hypokalaemia occurs with corticosteroids.Increased risk of haematological toxicity with methotrexate.Antagonism of diuretic effect; acetazolamide, loop diuretics, and thiazides increased risk of hypokalaemia.Aminoglutethimide accelerates metabolism of corticosteroids (reduced effect).Effects of corticosteroids may be reduced for 3-4 days after mifepristone.Alteration in the plasma protein binding and metabolism of prednisolone caused by oestrogens, with or without progesterone, can result in exposure of women to increased levels of unbound prednisolone for prolonged periods of time.The growth promoting effect of somatropin may be inhibited.Increased risk of hypokalaemia if high doses of corticosteroids given with high doses of bambuterol, fenoterol, formoterol, ritodrine, salbutamol, salmeterol, and terbutaline.Live vaccines should not be given to individuals with impaired immune response as a result of treatment with large doses of corticosteroids.Co-treatment with CYP3A inhibitors, including cobicistat-containing products, is expected to increase the risk of systemic side-effects.
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Topical administration of corticosteroids to pregnant animals can cause abnormalities of foetal development including cleft palate and intrauterine growth retardation. The nozzle should then be removed from the rectum. Also, hypoadrenalism may occur in the neonate. The product complies with the specification for Prednisolone Enema BP. The main concern is for children who need frequent courses, as it can have an effect on their growth and this may need to be monitored.Never use more than the prescribed dose. If your dose is different, do not change it unless your doctor tells you to do so.
Although Prednisolone Rectal Solution is applied locally, it should be borne in mind that there is likely to be substantial systemic absorption, especially when the bowel is inflamed. Clinical particulars. Thrombo-embolism.A 'withdrawal syndrome' may also occur including fever.Increased intra-cranial pressure with papilloedema in children (pseudotumour cerebri), usually after treatment withdrawal.Reporting suspected adverse reactions after authorisation of the medicinal product is important. Attach the nozzle and lubricate with petroleum jelly.
The volume of the enema is considered to be the optimum to ensure maximum coverage of the affected area.
Treatment may be continued in patients showing progressive improvement, but it should not be persisted with if the response has been inadequate.