Colifoam enema

Also called hydrocortisone acetate foam enema

A Colifoam enema is used to treat ulcerative colitis. Find out how to use it safely and the possible side effects.

Type of medicine

Also called

  • It belongs to a group of medicines called corticosteroids
  • Foam enema
  • Colifoam®
  • Hydrocortisone acetate enema

What is Colifoam enema?

A Colifoam enema is done to treat inflammation of the lower bowel in conditions such as ulcerative colitis and proctitis. 

Colifoam contains hydrocortisone which is a steroid medicine. It works by calming the body's immune system and reducing inflammation. It can help to reduce symptoms such as pain and diarrhoea (runny poo).

It is useful during flare-ups, where there is a sudden worsening of your symptoms.


  • In Aotearoa New Zealand Colifoam is available as an enema.
  • The usual dose is 1 enema inserted into the rectum 1 or 2 times a day, for 2–3 weeks.
  • Your doctor will then reduce your dose to once daily or alternate days, before stopping.
  • Always use your Colifoam enema exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to use, how often to use it, and any special instructions.
  • Use regularly and finish the treatment course: Keep using Colifoam enema. It usually takes 5–7 days to notice an improvement in your symptoms.
  • Missed dose: If you forget your dose, just take the next dose at the right time. Do not use double the dose.

When to use your dose

  • Try using Colifoam at the same times each day.
  • It is best to have a bowel motion before using Colifoam rather than after. If you have a bowel motion soon after using Colifoam, you may lose all the benefit of the medication.
  • Avoid using Colifoam just before having a bath, shower or going swimming.

How to use Colifoam enema

The enema is inserted into the rectum (back passage) and delivers the hydrocortisone as a foam directly into the lower bowel (lower colon and rectum).

Preparing the enema

  • Shake the container vigorously for 60 seconds before use, to create the foam.
  • Hold container upright and insert into opening of the tip of the applicator.
  • Be sure the applicator plunger is drawn all the way out. The container must be held upright to obtain proper flow of the medication.
  • To fill, press down gently on the container cap. When the foam reaches the fill line of the applicator, it is ready for use.

Using the enema

  • Remove the applicator from the aerosol container. The aerosol container should never be inserted directly into the rectum.
  • Allow some foam to remain on the applicator tip. Hold the applicator by the barrel and gently insert the tip into the rectum. With applicator in place, push the plunger to expel the foam, then withdraw the applicator.
  • Clean the applicator parts by pulling apart and washing thoroughly with warm water.

More detailed instructions are available in the consumer medication information. 

Precautions before starting Colifoam

  • Do you have diabetes?
  • Are you taking any other medicines or over-the-counter and complementary medicines, eg, vitamins, minerals, herbal or naturopathic medicines?

If you have answered yes to any of these questions, it’s important that you tell your doctor or pharmacist before you take Colifoam. Sometimes a medicine isn’t suitable for a person with certain conditions, or can only be used with extra care. 

Precautions while taking Colifoam

Treatment is usually for 2–3 weeks. If you are using Colifoam for longer than this, speak to your doctor to make sure you still need to use it. You may experience more side effects. Read more about taking steroids long-term.

What are the side effects of hydrocortisone acetate (foam enema)?

Like all medicines, Colifoam can cause side effects, although not everyone gets them. Most side effects are related to the dose you are taking and how long you are using Colifoam for. 

Side effects

What should I do?

  • Irritation, burning and redness around the rectum
  • These are quite common when you first start using Colifoam, and usually goes away with time.
  • Tell your doctor if they bother you.
  • Changes in mood or behaviour
  • Feeling depressed
  • Mood swings, irritability, anxiety, bad dreams
  • Swollen face
  • Tell your doctor immediately or ring Healthline 0800 611 116.
  • Changes in vision including blurred vision
  • Tell your doctor.
For more information on side effects, see the Medsafe consumer information leaflet Colifoam.

Did you know that you can report a medicine side effect to the Centre for Adverse Reactions Monitoring (CARM)? Report a side effect to a product

Learn more

Colifoam Medsafe Consumer Information Sheet, NZ


  1. Hydrocortisone acetate NZ Formulary

Clinical resources

Colifoam rectal foam Medsafe, NZ
Colifoam (hydrocortisone acetate rectal foam): Supply issue Pharmac Dec 2021

Credits: Sandra Ponen, Pharmacist. Reviewed By: Maya Patel, MPharm PGDipClinPharm, Auckland Last reviewed: 21 Jan 2022