Mesalamine Rectal and Hydrocortisone: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Mesalamine Rectal
Hydrocortisone
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of gastrointestinal adverse reactions, reduced salicylate exposure and an increased risk of salicylate toxicity when hydrocortisone is withdrawn
Interaction Deep Dive
Concomitant use of hydrocortisone and salicylates may increase the risk of gastrointestinal adverse reactions due to increase in the clearance of salicylates or may also increase the risk of salicylate toxicity when corticosteroid is withdrawn. Monitor patients receiving hydrocortisone and concomitant salicylates1.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
Common questions
Can I take Mesalamine Rectal and Hydrocortisone together?
An increased risk of gastrointestinal adverse reactions, reduced salicylate exposure and an increased risk of salicylate toxicity when hydrocortisone is withdrawn Always confirm with your pharmacist or prescriber before making any change.
How serious is the Mesalamine Rectal and Hydrocortisone interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Mesalamine Rectal or Hydrocortisone need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Product Information: KHINDIVI(R) oral solution, hydrocortisone oral solution. Eton Pharmaceuticals (per Manufacturer), Cranbury, NJ, 2025. DailyMed
- Graham G, Champion G, Day R, et al: Patterns of plasma concentrations and urinary excretion of salicylate in rheumatoid arthitis. Clin Pharmacol Ther 1977; 77:410-420.
- Edelman J, Potter JM, & Hackett LP: The effect of intra-articular steroids on plasma salicylate concentrations. Br J Clin Pharmacol 1986; 21:301-307. PubMed
Keep reading about Mesalamine Rectal
Keep reading about Hydrocortisone
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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