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Hydrocortisone 2.5%/Lidocaine 5%/Nitoglycerin 0.2% Rectal Ointment

The Hydrocortisone 2.5%/Lidocaine 5%/Nitroglycerin 0.2% Rectal Ointment is a specialized semi-solid formulation designed for rectal application. This ointment is compounded in a greasy or oily base to ensure ease of application and optimal delivery of the active ingredients directly to the affected area. Hydrocortisone, a corticosteroid, is included for its anti-inflammatory properties, making it effective in reducing swelling and discomfort associated with hemorrhoids and anal fissures. Lidocaine, a local anesthetic, provides immediate relief from pain and itching by numbing the affected area. Nitroglycerin, a vasodilator, helps to improve blood flow and can aid in the healing of anal fissures by reducing pressure in the region. This combination of ingredients makes the ointment particularly suitable for treating conditions such as hemorrhoids, anal fissures, and associated pain and inflammation.

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Topical Ointment
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Formula Information

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Our Hydrocortisone 2.5%/Lidocaine 5%/Nitroglycerin 0.2% Rectal Ointment is a specially compounded semi-solid formulation designed for rectal application. This ointment is dispensed in a tube for ease of use and is intended to provide symptomatic relief for a variety of anorectal disorders. The greasy or oily base of the ointment ensures that the active ingredients are delivered effectively to the affected area, promoting better absorption and localized treatment.

The hydrocortisone component of the ointment is a corticosteroid that helps reduce inflammation, itching, and discomfort. It works by suppressing the immune response in the skin, thereby decreasing inflammation and associated symptoms. This makes it particularly useful in treating inflammatory conditions of the anorectal area, such as hemorrhoids and anal fissures.

Lidocaine, a local anesthetic, is included in the formulation to provide immediate relief from pain and discomfort by numbing the affected area. This can be especially beneficial for patients experiencing acute pain during bowel movements or when suffering from conditions that cause chronic anorectal pain.

Nitroglycerin is a vasodilator that helps to relax the smooth muscles, including those in the anorectal region. In this formulation, nitroglycerin can aid in reducing the pressure in the anal sphincter, thereby improving blood flow and promoting healing of anal fissures. The inclusion of nitroglycerin also helps to alleviate pain associated with these fissures.

This compounded rectal ointment is indicated for the treatment of anorectal disorders such as hemorrhoids, anal fissures, and pruritus ani. By combining these three active ingredients, the ointment provides a multi-faceted approach to treatment, addressing inflammation, pain, and promoting healing. It is important for patients to follow the application instructions provided by their healthcare provider to ensure the best therapeutic outcomes.

For prescribers considering this formulation for their patients, it is essential to evaluate the patient's specific condition and symptoms to determine the appropriateness of this treatment. The unique combination of hydrocortisone, lidocaine, and nitroglycerin in this ointment offers a comprehensive treatment option that can be tailored to the patient's needs. As with any medication, monitoring for potential side effects and interactions with other medications is recommended.

If you have any questions about this formulation or its use in treating anorectal disorders, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is dedicated to providing in-depth information and support to both patients and healthcare providers to ensure the safe and effective use of our compounded medications.

Drug Interactions

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The Hydrocortisone 2.5%/Lidocaine 5%/Nitroglycerin 0.2% Rectal Ointment is a compounded medication designed for rectal application to treat conditions such as hemorrhoids, anal fissures, and other related anorectal disorders. Hydrocortisone is a corticosteroid that reduces inflammation, swelling, and discomfort. Lidocaine is a local anesthetic that provides temporary relief from pain and itching. Nitroglycerin is a vasodilator that helps to relax smooth muscles and can improve blood flow, aiding in the healing of anal fissures.

When using this compounded rectal ointment, it is important to consider potential drug interactions. Hydrocortisone, being a steroid, can interact with drugs that affect the cytochrome P450 enzyme system, potentially altering the metabolism of other medications. Patients should be cautious if they are taking other steroids, as this can increase the risk of systemic side effects such as adrenal suppression or Cushing's syndrome. Concurrent use of nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of gastrointestinal side effects.

Lidocaine, as a local anesthetic, can interact with antiarrhythmic drugs such as amiodarone or beta-blockers, potentially causing additive cardiac effects. Caution is advised when using other local anesthetics or medications that affect cardiac conduction. Patients with liver disease should use lidocaine with caution, as it is metabolized in the liver and may lead to increased plasma concentrations.

Nitroglycerin may interact with other vasodilators, antihypertensives, or erectile dysfunction medications such as phosphodiesterase inhibitors (e.g., sildenafil, tadalafil), leading to hypotension or cardiovascular instability. Alcohol may also enhance the hypotensive effects of nitroglycerin. Patients using any medications that affect blood pressure should consult with a healthcare provider before using this ointment.

It is also important to note that the absorption of the active ingredients through the rectal mucosa can be variable, and systemic absorption may lead to interactions not typically expected with topical use. Patients should inform their healthcare providers of all medications they are taking, including over-the-counter drugs and herbal supplements, to assess for potential interactions. If you have any questions or concerns about using this formulation or its potential interactions with other medications, please reach out to us at Bayview Pharmacy for further guidance and information.

How Does it Work

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The Hydrocortisone 2.5%/Lidocaine 5%/Nitroglycerin 0.2% Rectal Ointment is a specially compounded formulation designed to provide relief and treatment for specific anorectal conditions. This ointment is a semi-solid preparation that is applied topically to the affected area, and it is dispensed in a tube for ease of application. The base of the ointment is greasy or oily, which not only helps in the delivery of the active ingredients to the site of action but also provides a protective barrier on the skin.

Hydrocortisone is a corticosteroid that works by reducing inflammation, itching, and swelling. When applied to the affected area, hydrocortisone penetrates the skin cells to inhibit the release of inflammatory substances that cause the symptoms of irritation. This makes it particularly effective in treating inflammatory conditions of the skin and mucous membranes.

Lidocaine is a local anesthetic that provides temporary relief from pain by blocking the nerve signals in the body. When included in this rectal ointment, lidocaine numbs the local area, providing relief from pain, itching, and discomfort that can accompany hemorrhoids, anal fissures, and other anorectal disorders.

Nitroglycerin is a vasodilator that works by relaxing the smooth muscles and dilating the blood vessels. In the context of this ointment, nitroglycerin is used in a very low concentration to help increase blood flow to the anorectal area, which can promote healing of anal fissures by reducing the pressure in the internal anal sphincter and improving blood supply to the area.

The combination of these three active ingredients in the rectal ointment provides a multi-faceted approach to treating anorectal conditions. Hydrocortisone addresses the inflammation, lidocaine provides pain relief, and nitroglycerin aids in healing. This makes the formulation particularly useful for patients experiencing a combination of symptoms such as pain, inflammation, and difficulty in healing. It is important for patients and prescribers to note that this ointment is intended for external use only and should be applied as directed by a healthcare professional.

As compounding pharmacists at Bayview Pharmacy, we understand that each patient's needs are unique, and we are dedicated to providing personalized care. If you have any questions about this formulation or how it can be tailored to suit individual needs, please reach out to us for more information and guidance.

Other Uses

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The Hydrocortisone 2.5%/Lidocaine 5%/Nitroglycerin 0.2% Rectal Ointment is primarily indicated for treating anal fissures, hemorrhoids, and other anal-rectal conditions where a combination of anti-inflammatory, analgesic, and vasodilatory effects can provide therapeutic relief. Hydrocortisone acts as a corticosteroid, reducing inflammation and swelling; Lidocaine serves as a local anaesthetic, providing relief from pain and discomfort; and Nitroglycerin is a vasodilator, helping to improve blood flow and facilitate healing in the affected area. However, this versatile compound may have other uses beyond those related specifically to the anorectal region.

Due to its anti-inflammatory and analgesic properties, some practitioners might consider using this ointment off-label for other dermatological conditions where inflammation and pain are present, such as certain eczemas or dermatitis, provided there is no contraindication for the use of steroids or anesthetics on the affected skin. Moreover, the nitroglycerin component may aid in situations where increased blood flow could be beneficial to the healing of certain skin ulcers or ischemic tissues, although its addition is fundamentally for its effect within the anal mucosa. It should be noted that this off-label use should only be pursued upon consultation with and under the supervision of a healthcare provider.

It is important for both patients and prescribers to understand the pharmacologic actions of each component in the ointment. While Hydrocortisone and Lidocaine can be found in various topical preparations for different indications, the inclusion of Nitroglycerin is somewhat unique and often intended for specific vascular issues surrounding anal fissures and hemorrhoids. Patients with hypersensitivities or contraindications to any of the individual components should not use this ointment. Care should also be taken in prolonged use due to the potential systemic absorption of steroids and lidocaine and their associated side effects.

The rectal ointment should be applied as directed by a healthcare professional, and patients should be advised on the correct method of application, particularly when used for conditions outside of the anorectal area. It is also essential to highlight that the safety and efficacy of this ointment for other uses have not been established by formal studies. Therefore, the empirical use for other conditions would be at the discretion of the prescriber and should be based on their clinical judgement and experience with similar formulations.

Patients or prescribers with questions or in need of further guidance on the possible uses and administration of Hydrocortisone 2.5%/Lidocaine 5%/Nitroglycerin 0.2% Rectal Ointment are encouraged to reach out to us at Bayview Pharmacy. Our knowledgeable team of compounding pharmacists is committed to providing detailed information and personalized advice to ensure safe and effective use of this medication for all appropriate indications.

Frequently Asked Questions

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What is Hydrocortisone 2.5%/Lidocaine 5%/Nitroglycerin 0.2% Rectal Ointment used for?

This compounded ointment is primarily used for treating discomfort associated with hemorrhoids and anal fissures. Hydrocortisone reduces inflammation and itching, Lidocaine provides local pain relief, and Nitroglycerin helps by increasing blood flow to the area and relieving muscle spasm.

How should I apply this rectal ointment?

Apply a small amount of the ointment to the affected area as directed by your healthcare provider. Usually, it is applied externally to the anus or the skin surrounding the rectum. Make sure the area is clean and dry before application.

What are the potential side effects of using this compounded ointment?

Common side effects can include mild burning or irritation at the application site. If you experience severe pain, bleeding, or allergic reactions such as rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing, seek medical attention immediately.

Can this ointment be used for conditions other than hemorrhoids or anal fissures?

While it is formulated for hemorrhoids and anal fissures, always consult your healthcare provider before using it for any other conditions, as it may not be appropriate for other uses.

How often can I apply the compounded ointment?

The frequency of application will depend on your specific condition and your healthcare provider's instructions. It's important to follow their guidance precisely and not to overuse or underuse the ointment.

Should I apply the ointment internally or just externally?

This compounded formulation is designed for external application. Do not insert it into the rectum or any other body cavity unless specifically instructed by your healthcare provider.

Is this ointment suitable for children?

The use in children should be under the close supervision of a healthcare provider. Dosage and application might differ, and pediatric patients are more susceptible to systemic side effects.

Can I use this ointment if I am pregnant or breastfeeding?

Please consult your healthcare provider before using this ointment if you are pregnant or breastfeeding. Certain ingredients may be absorbed systemically and could potentially affect your baby.

Can this ointment be used in conjunction with other medications?

Inform your healthcare provider about all other medications you are using, as there may be potential interactions. In particular, be cautious of other topical products used in the same area to avoid excessive medication absorption.

How should I store the compounded ointment?

Store the ointment at room temperature away from light and moisture. Keep it out of reach of children and pets, and do not freeze it. After opening, make sure the tube is sealed tightly after each use.

What should I do if I miss a dose of the ointment?

If you miss a dose, apply it as soon as you remember. However, if it is near the time for your next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

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Formulas and/or material listed are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment. Every patient is unique, and formulas should be adjusted to meet their individual needs.

No compounded medications are reviewed by the FDA for safety or efficacy.