Version May 2024
Anorectal disorders: Topical: Apply to the affected area ≤6 times daily (morning, evening, and after each bowel movement).
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
Anorectal disorders: Children ≥12 years and Adolescents: Topical: Refer to adult dosing.
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
Also see individual agents. No adverse reactions listed in the manufacturer's labeling.
OTC labeling: When used for self-medication, do not put into the rectum using fingers or any mechanical device or applicator.
Concerns related to adverse effects:
• Methemoglobinemia: Has been reported with local anesthetics; clinically significant methemoglobinemia requires immediate treatment along with discontinuation of the anesthetic and other oxidizing agents. Onset may be immediate or delayed (hours) after anesthetic exposure. Patients with G6PD deficiency, congenital or idiopathic methemoglobinemia, cardiac or pulmonary compromise, exposure to oxidizing agents or their metabolites, or infants <6 months of age are more susceptible and should be closely monitored for signs and symptoms of methemoglobinemia (eg, cyanosis, headache, rapid pulse, shortness of breath, lightheadedness, fatigue).
Other warnings/precautions:
• Self-medication (OTC use): When used for self-medication, discontinue use and notify health care provider if rectal bleeding occurs; an allergic reaction develops; or if condition worsens, does not improve within 7 days, the symptoms being treated do not subside, or if redness, irritation, swelling, pain, or other symptoms develop or increase.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Cream, External:
Preparation H: Glycerin 14.4% and lidocaine 5% (30 g [DSC]) [contains cetyl alcohol, disodium edta, methylparaben, propylene glycol, propylparaben]
Pad, External:
RectiCare: Glycerin 20% and lidocaine 5% (12 ea) [contains benzyl alcohol]
No
Pads (RectiCare External)
5-20% (per each): $1.06
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Topical: For external use only.
Cream: Prior to applying, cleanse affected area with cleansing wipe; dry with a tissue or a soft cloth.
Wipes: Prior to using, when possible, cleanse affected area with mild soap and warm water; rinse thoroughly. Gently apply wipe to affected area by patting; discard wipe.
Topical: For external use only in rectal area. Prior to applying cream, cleanse affected area with cleansing wipe; dry with a tissue or a soft cloth.
Anorectal disorders: Temporary relief of pain, soreness, burning, itching, and discomfort associated with hemorrhoids; temporarily relief of anorectal discomforts; temporarily protects irritated and inflamed perianal skin.
Refer to individual components.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Antiarrhythmic Agents (Class IB): Lidocaine (Topical) may enhance the adverse/toxic effect of Antiarrhythmic Agents (Class IB). Risk C: Monitor therapy
Cimetidine: May increase the serum concentration of Lidocaine (Topical). Risk C: Monitor therapy
Dapsone (Topical): May enhance the adverse/toxic effect of Methemoglobinemia Associated Agents. Risk C: Monitor therapy
Dichlorphenamide: Laxatives may enhance the hypokalemic effect of Dichlorphenamide. Risk C: Monitor therapy
Local Anesthetics: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased. Risk C: Monitor therapy
Methemoglobinemia Associated Agents: May enhance the adverse/toxic effect of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased. Risk C: Monitor therapy
Nitric Oxide: May enhance the adverse/toxic effect of Methemoglobinemia Associated Agents. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Risk C: Monitor therapy
Prilocaine: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Prilocaine. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Management: Monitor patients for signs of methemoglobinemia (e.g., hypoxia, cyanosis) when prilocaine is used in combination with other agents associated with development of methemoglobinemia. Avoid lidocaine/prilocaine in infants receiving such agents. Risk C: Monitor therapy
Sodium Nitrite: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Sodium Nitrite. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Risk C: Monitor therapy
Refer to individual monographs.
Refer to individual monographs.
Glycerin: Acts as a skin protectant or lubricant.
Lidocaine: Blocks both the initiation and conduction of nerve impulses by decreasing the neuronal membrane's permeability to sodium ions, which results in inhibition of depolarization with resultant blockade of conduction.
See individual agents.
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