Indications: induction and maintenance of remission in ulcerative colitis; and Crohn's disease.

Cautions: Use with caution in hyperthyroidism, cirrhosis, hypertension, osteoporosis, congestive heart failure, diabetes, peptic ulcer, and myasthenia gravis, renal impairment, corneal perforation, epilepsy, hypothyroidism, hypertension, pregnancy, breast feeding, frequent monitoring required if history of tuberculosis.

Contra-indications: glaucoma, hypersensitivity, systemic fungal infections, certain viral infections such as varicella and herpes genitalis infections.

Side effect: Gastric and duodenal ulceration, with possible perforation and hemorrhage may occasionally occur, Cushing-like syndrome, menstrual irregularities, hirsutism, Acute adrenal insufficiency may occur with abrupt withdrawal after long term therapy.

Drug Interactions: barbiturates, phenytoin, salicylates, vaccines, rifampicin, cholestyramine and colestipol decreased corticosteroids effect. Corticosteroids may decrease the effect of oral hypoglycemic agents, anticoagulants, aspirin, oral contraceptives.

Dose: by mouth, initial dose 10-20 mg daily, in single or divided doses, until remission occurs, followed by reducing doses. Rectally, initially, 20 mg enema daily at bedtime for 2-4 weeks then reduced to one enema on alternate days. The enema should be retained for at least 1 hour.