1.7.1 Soothing haemorrhoidal preparations

ChoiceDrugDosage
Encourage self-care with OTC products as appropriate
1st choiceAnusol® cream, ointment or suppositories

Doses:
Anusol® cream or ointment: apply to the affected area at night, in the morning and after defaecation until the condition is controlled. For internal conditions, use rectal nozzle provided
Anusol® suppositories: insert one suppository at night, in the morning and after defaecation

2nd choiceXyloproct® ointment (contains lidocaine 5%)

Dose:
Apply several times daily when necessary; short-term use only

Prescribing Notes

  • Topical haemorrhoidal products are widely used despite lacking evidence.   There are some reported benefits to their use and the general opinion is that they may provide short-term symptomatic relief.
  • Local anaesthetic ointments can be absorbed through the rectal mucosa therefore excessive application should be avoided.
  • Preparations containing local anaesthetics should be used for short periods only (no longer than a few days) since they may cause sensitisation of the anal skin.
  • Patients with pruritus ani (itching around the anal canal)/excoriation should avoid applying creams and ointments where possible as this often causes additional irritation. They should be advised to reduce their caffeine intake, clean with water and avoid soaps/wipes/baby wipes and excessive rubbing with toilet paper. If this fails they can be prescribed Perinal® spray (hydrocortisone with lidocaine) on a when required basis.