BNF for Children 2011-2012

BNFC 2011–2012 1.5.2 Corticosteroids 53Maintenance of remission of mild to moderateand severe ulcerative colitis. By mouthChild 2–12 years 5–7.5 mg/kg (max. 500 mg) 4times dailyChild 12–18 years 500 mg 4 times dailyTreatment of mild to moderate or severe ulcerativecolitis and maintenance of remission,active Crohn’s disease. By rectum as suppositoriesChild 5–8 years 500 mg twice dailyChild 8–12 years 500 mg in the morning and 1 gat nightChild 12–18 years 0.5–1 g twice dailyJuvenile idiopathic arthritis section 10.1.3Sulfasalazine (Non-proprietary) ATablets, sulfasalazine 500 mg, net price 112 = £6.74.Label: 14, counselling, blood disorder symptoms (seerecommendation above), contact lenses may bestainedTablets, e/c, sulfasalazine 500 mg. Net price 112-tabpack = £14.46. Label: 5, 14, 25, counselling, blooddisorder symptoms (see recommendation above),contact lenses may be stainedBrands include Sulazine EC cSuspension, sulfasalazine 250 mg/5 mL, net price500 mL = £29.50. Label: 14, counselling, blood disordersymptoms (see recommendation above), contactlenses may be stainedExcipients may include alcoholSalazopyrin c (Pharmacia) ATablets, yellow, scored, sulfasalazine 500 mg. Netprice 112-tab pack = £6.97. Label: 14, counselling,blood disorder symptoms (see recommendationabove), contact lenses may be stainedEN-Tabs c (= tablets e/c), yellow, f/c, sulfasalazine500 mg. Net price 112-tab pack = £8.43. Label: 5, 14,25, counselling, blood disorder symptoms (seerecommendation above), contact lenses may bestainedSuppositories, yellow, sulfasalazine 500 mg. Netprice 10 = £3.30. Label: 14, counselling, blood disordersymptoms (see recommendation above), contactlenses may be stained1.5.2 CorticosteroidsFor the role of corticosteroids in acute ulcerative colitisand Crohn’s disease, see Inflammatory Bowel Disease,p. 48.BUDESONIDECautions section 6.3.2; interactions: Appendix 1(corticosteroids)Contra-indications section 6.3.2Hepatic impairment section 6.3.2Pregnancy section 6.3.2Breast-feeding section 6.3.2Side-effects section 6.3.2Licensed use not licensed for use in childrenIndication and doseSee preparationsAdministration Capsules can be opened and thecontents mixed with apple or orange juiceBudenofalk c (Dr Falk) ACapsules, pink, enclosing e/c granules, budesonide3 mg, net price 100-cap pack = £75.05. Label: 5, 10,steroid card, 22, 25DoseMild to moderate Crohn’s disease affecting ileum orascending colon, chronic diarrhoea due to collagenouscolitis. By mouthChild 12–18 years 3 mg 3 times daily for up to 8 weeks;reduce dose for the last 2 weeks of treatment. See alsosection 6.3.2Entocort c (AstraZeneca) ACR Capsules, grey/pink, enclosing e/c, m/r granules,budesonide 3 mg, net price 100-cap pack = £99.00.Label: 5, 10, steroid card, 22, 25Note Dispense in original container (contains desiccant)DoseMild to moderate Crohn’s disease affecting the ileumor ascending colon. By mouthChild 12–18 years 9 mg once daily in the morningbefore breakfast for up to 8 weeks; reduce dose for thelast 2–4 weeks of treatment. See also section 6.3.2Enema, budesonide 2 mg/100 mL when dispersibletablet reconstituted in isotonic saline vehicle, netprice pack of 7 dispersible tablets and bottles ofvehicle = £33.00DoseUlcerative colitis involving rectal and recto-sigmoiddisease. By rectumChild 12–18 years 1 enema at bedtime for 4 weeksHYDROCORTISONECautions section 6.3.2; systemic absorption mayoccur; prolonged use should be avoidedContra-indications intestinal obstruction, bowel perforation,recent intestinal anastomoses, extensive fistulas;untreated infectionSide-effects section 6.3.2; also local irritationIndication and doseInflammatory bowel disease. By intravenous administrationSee p. 375. By rectumSee preparationsColifoam c (Meda) AFoam in aerosol pack, hydrocortisone acetate 10%,net price 14-application cannister with applicator =£9.28Excipients include cetyl alcohol, hydroxybenzoates (parabens), propyleneglycolDoseUlcerative colitis, proctitis, proctosigmoiditis. By rectumChild 2–18 years initially 1 metered application (125 mghydrocortisone acetate) inserted into the rectum once ortwice daily for 2–3 weeks, then once on alternate days1 Gastro-intestinal system