Compound haemorrhoidal preparations with corticosteroids

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Corticosteroids are often combined with local anaesthetics and soothing agents in preparations for haemorrhoids. They are suitable for occasional short-term use after exclusion of infections, such as herpes simplex; prolonged use can cause atrophy of the anal skin. See section 13.4 for general comments on topical corticos-teroids and section 1.7.1 for comment on local anaesthetics.

Children Haemorrhoids in children are rare. Treatment is usually symptomatic and the use of a locally applied cream is appropriate for short periods; however, local anaesthetics can cause stinging initially and this may aggravate the child's fear of defaecation.

Anugesic-HC® (Pfizer) A Cream, benzyl benzoate 1.2%, bismuth oxide 0.875%, hydrocortisone acetate 0.5%, Peru balsam 1.85%, pramocaine hydrochloride 1%, zinc oxide 12.35%. Net price 30 g (with rectal nozzle) = £3.71

Dose apply night and morning and after a bowel movement; do not use for longer than 7 days; CHILD not recommended

Suppositories, buff, benzyl benzoate 33mg, bismuth oxide 24 mg, bismuth subgallate 59 mg, hydrocortisone acetate 5 mg, Peru balsam 49 mg, pramocaine hydrochloride 27mg, zinc oxide 296mg, net price 12 = £2.69

Dose insert 1 suppository night and morning and after a bowel movement; do not use for longer than 7 days; CHILD not recommended

Anusol-HC® (McNeil) A Ointment, benzyl benzoate 1.25%, bismuth oxide 0.875%, bismuth subgallate 2.25%, hydrocortisone acetate 0.25%, Peru balsam 1.875%, zinc oxide 10.75%. Net price 30 g (with rectal nozzle) = £3.29

Dose apply night and morning and after a bowel movement; do not use for longer than 7 days; CHILD not recommended Note A proprietary brand (Anusol Plus HC® ointment) is on sale to the public

Suppositories, benzyl benzoate 33 mg, bismuth oxide 24 mg, bismuth subgallate 59 mg, hydrocortisone acetate 10 mg, Peru balsam 49 mg, zinc oxide 296 mg. Net price 12 = £2.31

Dose insert 1 suppository night and morning and after a bowel movement; do not use for longer than 7 days; CHILD not recommended

Note A proprietary brand (Anusol Plus HC® suppositories) is on sale to the public

Perinal® (Dermal) Spray application, hydrocortisone 0.2%, lidocaine hydrochloride 1%. Net price 30-mL pack = £6.11

Dose ADULT and CHILD over 14 years, spray once over the affected area up to 3 times daily; do not use for longer than 7 days without medical advice; CHILD under 14 years on medical advice only

Proctofoam HC® (Meda) A Foam in aerosol pack, hydrocortisone acetate 1%, pramocaine hydrochloride 1%. Net price 21.2-g pack (approx. 40 applications) with applicator = £5.06

Dose haemorrhoids and proctitis, 1 applicatorful (4-6 mg hydrocortisone acetate, 4-6 mg pramocaine hydrochloride) by rectum 2-3 times daily and after each bowel movement (max. 4 times daily); do not use for longer than 7 days; CHILD not recommended

Proctosedyl® (Sanofi-Aventis) A Ointment, cinchocaine (dibucaine) hydrochloride 0.5%, hydrocortisone 0.5%. Net price 30 g = £10.34 (with cannula)

Dose apply morning and night and after a bowel movement, externally or by rectum; do not use for longer than 7 days

Suppositories, cinchocaine (dibucaine) hydro-chloride 5 mg, hydrocortisone 5 mg. Net price 12 = £4.66

Dose insert 1 suppository night and morning and after a bowel movement; do not use for longer than 7 days

Scheriproct® (Bayer Schering) A Ointment, cinchocaine (dibucaine) hydrochloride 0.5%, prednisolone hexanoate 0.19%. Net price 30 g = £2.94

Dose apply twice daily for 5-7 days (3-4 times daily on 1st day if necessary), then once daily for a few days after symptoms have cleared

Suppositories, cinchocaine (dibucaine) hydro-chloride 1 mg, prednisolone hexanoate 1.3 mg. Net price 12 = £1.38

Dose insert 1 suppository daily after a bowel movement, for 5-7 days (in severe cases initially 2-3 times daily)

Ultraproct® (Meadow) A Ointment, cinchocaine (dibucaine) hydrochloride 0.5%, fluocortolone caproate 0.095%, fluocortolone pivalate 0.092%, net price 30 g (with rectal nozzle) = £4.57

Dose apply twice daily for 5-7 days (3-4 times daily on 1st day if necessary), then once daily for a few days after symptoms have cleared

Suppositories, cinchocaine (dibucaine) hydro-chloride 1 mg, fluocortolone caproate 630 micr-ograms, fluocortolone pivalate 610 micrograms, net price 12 = £2.15

Dose insert 1 suppository daily after a bowel movement, for 5-7 days (in severe cases initially 2-3 times daily) then 1 suppository every other day for 1 week

Uniroid-HC® (Chemidex) A Ointment, cinchocaine (dibucaine) hydrochloride 0.5%, hydrocortisone 0.5%. Net price 30 g (with applicator) = £4.23

Dose ADULT and CHILD over 12 years, apply twice daily and after a bowel movement, externally or by rectum; do not use for longer than 7 days; CHILD under 12 years on medical advice only

Suppositories, cinchocaine (dibucaine) hydro-chloride 5 mg, hydrocortisone 5 mg. Net price 12 = £1.91

Dose ADULT and CHILD over 12 years, insert 1 suppository twice daily and after a bowel movement; do not use for longer than 7 days

Xyloproct® (AstraZeneca) A Ointment (water-miscible), aluminium acetate 3.5%, hydrocortisone acetate 0.275%, lidocaine 5%, zinc oxide 18%, net price 20 g (with applicator) = £2.26

Dose apply several times daily; short-term use only

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