Engflag

Collicort

Quick links to important sections

Collicort

There is no image.

Treatment option:

Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Collicort

What is Collicort?

Collicort is a medicinal foam containing the active substance budesonide, a corticosteroid known for its local anti-inflammatory properties. It is specifically formulated for the management of certain inflammatory conditions affecting the lower part of the large intestine and the rectum.

Mechanism of Action

The active ingredient, budesonide, works by reducing the production of substances that trigger inflammation in the intestinal lining. Unlike systemic corticosteroids that circulate throughout the entire body, Collicort is designed to act locally at the site of inflammation. The foam formulation allows the medication to be distributed evenly across the affected mucosa in the rectum and the end of the colon.

Clinical Application

This medication is primarily utilized for the treatment of acute episodes of ulcerative colitis that are limited to the rectum and the sigmoid colon, a condition often referred to as proctosigmoiditis. By targeting the inflammation directly within these specific regions, the medication aims to induce remission and alleviate symptoms such as rectal bleeding and urgency.

Pharmacological Characteristics

One of the defining features of the budesonide found in Collicort is its high first-pass metabolism. After the medication performs its local action and is absorbed into the bloodstream, a significant portion is rapidly broken down by the liver. This characteristic is intended to limit the amount of active steroid reaching the rest of the body, thereby focusing the therapeutic effect on the intestinal wall.

What side effects are possible with Collicort?

Possible side effects and safety information

The official safety information for Collicort (Hydrocortisone) is organized by regulatory authorities to describe its potential systemic effects, reflecting its classification as a corticosteroid. The documented adverse reactions span multiple physiological systems.

Adverse Reaction Scope

The systemic safety profile includes official listings across metabolic, endocrine, psychiatric, musculoskeletal, and ocular systems. Many adverse reactions are typically classified with a frequency of Not known in regulatory documents, meaning the exact incidence rate cannot be estimated from available data, though some psychiatric disturbances are listed as Common.

System-Organ-Class Documented Effects (High-Level)
Endocrine Disorders HPA axis suppression, Cushingoid features.
Metabolism & Nutrition Fluid retention, hypokalaemia, glucose intolerance.
Musculoskeletal Osteoporosis, proximal myopathy, tendon rupture.
Eye Disorders Cataracts, glaucoma, Central Serous Chorioretinopathy.

Serious Safety Considerations

Official labels detail serious adverse reactions, including the risk of severe, sometimes fatal, infection and potential for gastrointestinal perforation or hemorrhage. Specific severe neurological events, such as spinal cord infarction, have been reported when corticosteroids are administered by certain routes.

Safety is often tied to duration of use. Major effects like Adrenal cortical atrophy and cataracts are explicitly associated with prolonged use. Furthermore, regulatory documents specify that Older Adults and Pediatric Patients require particular safety consideration due to higher susceptibility to consequences like osteoporosis and growth suppression, respectively. The medicine should not be used in the presence of systemic fungal infections.

Overdose and Emergency Response

Overdose and When to Seek Help

Overdose or prolonged exposure to doses exceeding physiological requirements of Hydrocortisone may result in documented clinical signs associated with its glucocorticoid activity. Acute overdose presentations primarily affect fluid and electrolyte balance, potentially leading to the elevation of blood pressure, salt and water retention, and potassium loss. Chronic high-dose use can cause manifestations resembling Cushing's syndrome.

Serious outcomes cited in regulatory labeling include thrombosis, convulsions, and the potentially fatal Pheochromocytoma crisis. Immediate medical attention is required in cases of acute deterioration, or if severe signs such as seizure, trouble breathing, or inability to be awakened are observed, as explicitly stated in government-supported guidance.

Regulatory documentation confirms that no specific antidote is known for Hydrocortisone overdose; management is symptomatic and supportive. Supportive measures may involve monitoring vital signs and conducting blood/urine tests and an ECG. Following cessation of high-dose therapy, close monitoring for adrenocortical insufficiency is required, especially in at-risk populations like children, who may be more susceptible to systemic toxicity from topical formulations.

Therapeutic Uses of Collicort

Collicort (Hydrocortisone) is applied across several therapeutic domains to provide symptomatic relief by moderating undesirable inflammatory and immune responses or by addressing hormonal deficits. Its use is considered relevant in clinical settings marked by heightened distress and pronounced symptoms that interfere with daily stability.

The medication is commonly used to help address symptom clusters associated with various dermatoses (like eczema and psoriasis), systemic conditions involving significant discomfort (Rheumatoid Arthritis, Ulcerative Colitis), and Adrenocortical Deficiency. It is applied in contexts where additional symptomatic support is needed, for instance, during phases of increased distress or discomfort from inflammatory episodes. A supportive benefit is that it:

“...provides symptomatic relief that helps ease the overall symptom burden of distressing manifestations like intense itching and persistent swelling.”

In the domain of endocrinology, it may assist with supporting functional stability when symptoms of systemic imbalance are present.

Quick Fact: Relief for Inflammatory and Deficiency Symptoms

Domain Conditions Key Symptom Relief
Dermatologic Eczema, Psoriasis, Dermatitis Itching, Redness, Swelling
Systemic/GI Rheumatoid Arthritis, Ulcerative Colitis Painful Swelling, Internal Inflammation
Endocrine Adrenocortical Deficiency Symptoms of Systemic Imbalance

Eligibility and Restrictions for Use

Collicort (Hydrocortisone/Hydrocortisone Acetate) is used by adults for conditions where systemic or topical anti-inflammatory action is required, including treatment for Adrenocortical Deficiency. Eligibility is strictly defined by regulatory documents, focusing on absolute exclusions and populations requiring caution.

Contraindications

Systemic use is contraindicated in patients with a systemic fungal infection or a known hypersensitivity to any component of the formulation. It is also prohibited for patients receiving live or live-attenuated vaccines if the corticosteroid is being administered at immunosuppressive doses.

Age-Based Rules

For certain topical forms, use in children under 2 years of age is prohibited. Pediatric patients are noted to have a greater risk of systemic toxicity from topical use, and long-term systemic therapy may interfere with growth. Use in older adults is permitted but advised with caution due to potentially more serious consequences of side effects.

Eligibility-Related Restrictions

Caution is officially required for patients with renal insufficiency, hepatic impairment (cirrhosis), hypertension, congestive heart failure, or active/latent peptic ulcers. Systemic use during pregnancy is classified as Category C, meaning it is allowed only if the potential benefit outweighs the potential hazard to the fetus.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The official regulatory profile for Collicort (Hydrocortisone/Hydrocortisone Acetate) documents specific interaction patterns concerning its systemic clearance and effects on other medicines.

Pharmacokinetic and Metabolic Interactions

Co-administration with CYP3A4 inhibitors, such as Ketoconazole or Itraconazole, decreases hydrocortisone's metabolism, which is documented to lead to an increase in its serum concentration and enhanced effect. Conversely, hepatic enzyme inducers, including Phenytoin and Rifampicin, enhance the drug's clearance, which can reduce systemic exposure and potentially diminish the effect. The food product Grapefruit Juice is also documented as a CYP3A4 inhibitor that can increase blood levels.

Pharmacodynamic and Restriction-Based Interactions

Use is formally contraindicated when receiving immunosuppressive doses of Collicort alongside live or live, attenuated vaccines. This restriction is due to the potential for infection, and a similar restriction applies to the presence of active systemic fungal infections. The profile also details additive effects: co-administration with NSAIDs increases the risk of gastrointestinal irritation. Collicort is also documented to antagonize the desired effects of hypoglycaemic agents and increase the risk of hypokalaemia when used with certain diuretics.

Population-Specific Notes

The regulatory label notes that liver disease (e.g., cirrhosis) and hypothyroidism are conditions that can decrease the metabolism of hydrocortisone, resulting in an enhanced systemic effect.

Mechanism of Action

Direct Modulation of Genomic Signaling

Collicort ( Hydrocortisone) functions as an agonist of the Glucocorticoid Receptor (GR) inside the cell, where the activated complex represses major pro-inflammatory transcription factors like NF-kappa B. This mechanism modifies the early molecular steps by reducing the gene expression responsible for producing inflammatory proteins, thereby initiating a dampening of the cellular inflammatory response.

Cascading Suppression of Inflammatory Mediators

The molecular action leads to the decreased synthesis of key chemical messengers, including pro-inflammatory cytokines ( IL-1, TNF-alpha) and eicosanoids ( prostaglandins). This widespread chemical suppression limits the impact of excessive mediator activity and contributes to the drug’s immunosuppressive action by suppressing the inflammatory signal cascade at multiple points.

⏱️ Control of Vascular Leakage and Sustained Action

The mechanism stabilizes the walls of small blood vessels ( endothelium), which physiologically limits the leakage of fluid and cells into the surrounding tissue space. Furthermore, the inclusion of Hydrocortisone Acetate acts as a local reservoir to prolong the mechanistic effect at the target site, which induces a more regulated state within the targeted peripheral pathways.

Dosage and Administration Information

Collicort, which contains Hydrocortisone, is administered via multiple routes. These methods define the required administration route, dose range, and frequency.

Oral preparations, such as tablets in strengths of 5 mg to 20 mg, are frequently taken in divided doses daily to align with the body’s natural release pattern. For these oral forms, the medication is taken with food or milk to help minimize potential gastric irritation. Standard adult dosing for replacement therapy typically falls within the 20 mg to 30 mg daily range.

For acute, severe conditions, the injectable form (Hydrocortisone sodium succinate) is administered intravenously (IV) or intramuscularly (IM). This powdered formulation requires reconstitution with an appropriate sterile diluent before administration. Initial IV doses range from 100 mg to 500 mg and may be repeated every two, four, or six hours based on the required clinical schedule.

Topical preparations are applied as a thin film, typically two to four times daily. The duration of systemic use is monitored: following any prolonged systemic course, the dose is gradually reduced (tapered) before complete discontinuation. Pediatric dosing is often determined by body surface area (BSA), emphasizing precise calculation for administration.

Recent Clinical Evidence

Research evidence / Overview of Studies for Collicort

Evidence for Use in Inflammatory Skin Conditions (Dermatologic)

Research exploring Collicort for inflammatory skin conditions, such as eczema, primarily relies on short-term Randomized Controlled Trials (RCTs) and supporting systematic reviews. These studies examined populations of both adults and children whose conditions were characterized by fluctuating or episodic manifestations. The main outcomes measured were related to physical discomfort, focusing on the evolution of inflammation signs and the measurement of persistent itching during the study period.

For moderate to severe presentations, the overall certainty level of the short-term evidence has been classified as high. However, long-term effects are not fully established, as follow-up durations were limited. Data for less severe forms of the conditions also remains insufficient.

Evidence for Use in Systemic and Gastrointestinal Inflammation

Research examining Collicort for systemic inflammatory states, such as Ulcerative Colitis, often involves Randomized Controlled Trials and network meta-analyses. Research explored outcomes reflecting functional imbalance, such as assessments for clinical remission or internal healing during the observed time intervals. Studies primarily monitored responses over defined induction periods, which typically range from four to twelve weeks. The certainty level of this evidence related to the induction phase is generally categorized as moderate.

Evidence for Use in Hormone Replacement Therapy (Adrenocortical Deficiency)

Collicort was studied for Adrenocortical Deficiency (hormone replacement) based on decades of clinical experience and supported by current Clinical Practice Guidelines. This evidence base is rated as high, reflecting its established role in conditions involving temporary physiological imbalance. Studies describe patterns where the medicine was observed in patients used for the purpose of hormone replacement. Data for certain groups, specifically involving new formulations, are still emerging.

What is Still Uncertain About Collicort Research

The broader evidence landscape highlights several key limitations. Data for certain groups remain insufficient, particularly for long-term outcomes. Furthermore, for some systemic uses, comparative evidence is lacking to fully contextualize the findings against all available therapeutic options. Research provides context but not individual predictions, and evidence highlights what is known—and what is still uncertain—about patterns observed in the studies.

Key Studies & References

  1. Topical corticosteroids - Systematic review of treatments for atopic eczema - NCBI Bookshelf

Frequently Asked Questions (FAQ)

Common questions about Collicort (FAQ)

Q: How long can a person safely use Collicort?

A: Official documents state that major adverse effects like adrenal cortical atrophy and cataracts are explicitly associated with prolonged use.

Because of these risks, therapy duration and dosage tapering is typically determined by a healthcare provider. The official guidance emphasizes the importance of clinical monitoring during extended treatment.

Q: Can Collicort cause changes in mood or behavior?

A: Regulatory data lists psychiatric disturbances as common adverse reactions associated with the active ingredient.

These disturbances can include changes in mood, personality, depression, and irritability.

Q: Why is it important to know about potential drug interactions with Collicort?

A: It is important because drug interactions may alter the concentration of the medicine in the body.

According to regulatory documents, this change in concentration can either reduce the drug's effectiveness or increase the risk of adverse reactions.

Q: Why might a doctor stop a person from taking Collicort?

A: Discontinuation or adjustment of the medicine may be considered in the presence of an absolute contraindication (such as a systemic fungal infection) or the onset of serious adverse effects.

Official labels require that treatment decisions be made on an ongoing basis.

Q: Does Collicort interact with common flu or cold medicines?

A: Regulatory documents list interactions with NSAIDs (non-steroidal anti-inflammatory drugs), which are components of some cold and flu medicines.

Co-administration specifies a potential risk of gastrointestinal irritation.

Q: Why are people often told to avoid grapefruit juice with certain medicines, including Collicort?

A: Official documents note that grapefruit juice can inhibit an enzyme (CYP3A4) that helps break down the active ingredient.

This inhibition can increase the drug's concentration in the bloodstream, which may lead to enhanced effects and side effects.

Q: Is Collicort used for other conditions besides what it's mainly for?

A: Regulatory labels list a broad range of indications for which the medicine may be used.

These generally include various allergic, inflammatory, endocrine, and rheumatologic conditions beyond its main uses.

Q: How quickly should I expect Collicort to start working?

A: The onset of action for oral forms is typically reported in clinical pharmacology texts as being 1.2 to 2.0 hours.

However, the time to the full therapeutic effect is variable and depends on the specific condition being treated.

Q: What if I miss a day of taking Collicort?

A: Patient guidance suggests that if a dose is missed, it may be taken as soon as remembered.

However, if it is almost time for the next scheduled dose, the missed dose should be skipped to maintain the proper schedule.

Q: Does Collicort cause weight gain or changes in appetite?

A: Regulatory documents list increased appetite and fluid retention among the documented adverse reactions.

Additionally, abnormal fat deposits in certain areas of the body are noted as a potential side effect.

Q: Does Collicort have a risk of dependence or withdrawal effects?

A: Official labels detail the risk of adrenal cortical atrophy after prolonged use.

Official regulatory guidance indicates that treatment involves gradual dose reduction, or tapering, to avoid signs of acute adrenal insufficiency (withdrawal).

Q: Is Collicort safe to use during pregnancy or while breastfeeding?

A: The active ingredient is classified as Pregnancy Category C.

Patient information highlights that the potential benefits must be considered alongside the risks when using the medication while pregnant or breastfeeding, based on information regarding its transfer to the nursing infant.

Q: What happens if Collicort is taken with alcohol?

A: Some official patient sources suggest avoiding alcohol because it may worsen certain effects of the drug.

Alcohol can potentially increase central nervous system side effects such as feeling dizzy, tired, or weak.

Q: Can Collicort interact with herbal supplements?

A: Regulatory sources warn about interactions with herbal products that affect liver enzymes (CYP3A4), such as St. John's Wort.

These herbal supplements can alter the drug's blood levels.

Q: Why do some people experience trouble sleeping when taking Collicort?

A: Regulatory documents list insomnia (difficulty sleeping) and neuropsychiatric effects as potential adverse reactions associated with use.

This is a common pattern for medicines in this class.

Q: Does Collicort affect your ability to drive or operate machinery?

A: Patient guidance suggests that caution should be exercised regarding operating machinery.

Driving or operating machinery may be avoided if side effects such as dizziness, fatigue, or changes in vision are experienced.

Q: What should I do if I think I'm experiencing a severe side effect?

A: Patient instructions indicate that one should seek emergency medical attention or contact a healthcare provider immediately upon experiencing severe reactions.

This is the official guidance provided in patient information leaflets.

Q: Is it normal to feel a bit tired or dizzy after starting Collicort?

A: Regulatory documents list dizziness, headache, and general fatigue/malaise (a general feeling of discomfort) among the documented side effects.

These effects may be experienced, particularly when starting the medication.

Q: How long does Collicort stay in your system?

A: Official pharmacokinetics data states the elimination half-life of the active ingredient is short, typically 1.2 to 2.0 hours.

However, the observed duration of the drug's action in the body is longer, usually around 8 to 12 hours.

Q: Is Collicort a controlled substance?

A: Official government classifications confirm that the active ingredient, Hydrocortisone, is not listed as a controlled substance under the relevant regulatory acts.

Q: Does Collicort work the same way for everyone?

A: Research evidence notes that studies provide context about patterns but not individual predictions.

The response to the medicine can vary based on a person's specific condition, individual metabolism, and other factors.

Q: Can I stop taking Collicort suddenly if I feel better?

A: Regulatory documents explicitly warn against abrupt discontinuation after prolonged systemic use.

Stopping suddenly may risk serious health issues; regulatory documents require a gradual dose reduction (tapering) to manage this risk.

Q: Are there any laboratory tests required before starting Collicort?

A: Regulatory documents recommend monitoring of certain health markers, such as blood pressure and blood glucose, during therapy.

This monitoring often may suggest the need for baseline measurements before starting the medicine.

Q: Is Collicort used to prevent something or to treat an existing issue?

A: The medicine's indications are primarily for treating symptoms of inflammation or replacing a missing hormone (Adrenocortical Deficiency).

These are generally therapeutic uses, aimed at addressing an existing imbalance or issue.

Q: How do people report new side effects for Collicort?

A: Official government agencies (like the FDA or EMA) provide specific portals and instructions for the public and healthcare providers.

These systems allow users to formally report suspected adverse reactions that may occur during use.

Q: Does Collicort interact with birth control pills?

A: Regulatory labels specifically address interactions with oral contraceptives.

These interactions note that birth control pills can decrease the clearance of the drug, potentially increasing its concentration and systemic effect.

How should Collicort be stored and disposed of?

Storage and Disposal Conditions for Collicort (Hydrocortisone)

Collicort must be stored under specific, officially mandated conditions to ensure the stability of the hydrocortisone active ingredient.

Required Storage and Protection

The medication must be stored at a Controlled Room Temperature (CRT), typically defined as 20 C to 25 C. It is an explicit regulatory requirement to protect the product from freezing and store it away from excessive heat. The container must be kept tightly closed to exclude moisture and contaminants, and the medicine must always be stored out of the reach of children.

Disposal Instructions

Unused or expired Collicort must be disposed of according to local regulatory requirements. If a drug take-back program is unavailable, certain government guidelines recommend mixing the product with an undesirable substance, such as coffee grounds, placing it in a sealed container, and discarding it in the household trash. Fabrics exposed to the product may present a serious fire hazard.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

Equivalent of Collicort found in:

A-Z Index: