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Diltiazem Ointment for Anal Fissures

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I have mentioned from time to time I would discuss how compounding is helping by a particular formulation or compound. Also, I will briefly discuss Pavilion Compounding’s method of formulating this ointment. Today, for no apparent reason, I will look at a treatment option for anal fissures. What is an anal fissure? According to the American Society of Colon and Rectal Surgeons and I quote; “An anal fissure is a small tear or cut in the skin that lines the anus. Fissures typically cause pain and often bleed. Fissures are quite common, but are often confused with other causes of pain and bleeding, such as hemorrhoids.”

Ok, so now that we have the definition, what do we do to help with this problem?

Usually the colo-rectal Md’s will use diltiazem ointment as a treatment option to relax the sphincter muscle and allow the healing process to begin. Other options are various strengths of nitroglycerin or nifedipine ointment, but both of these have more side effects, mostly headaches. As if the fissure was not already causing a headache. When compounding the 2% Diltiazem ointment, it is important to run the ointment thru an ointment mill to reduce the particle size and lessen the grittiness of the final product. This procedure, also allows a larger amount of the drug to be absorbed into the rectal tissue. Nothing worse than a gritty rectal ointment….so, ask your compounding pharmacist, one, if they are using the pure diltiazem powder, USP, which makes for a finer product, and two, if they are taking the extra step to run the ointment thru the mill. Additionally, Pavilion Compounding Pharmacy, can add lidocaine or bupivacaine, a longer lasting anesthetic, along with aloe vera to provide both pain relief and healing properties to the formula.

Using those two methods, will ensure you are getting a superior compounded product. Smooth, well absorbed, and elegant. Additionally, I have found adding about 10% Pracasil Plus®, a unique base with silicon and Pracaxi adds to the healing process.

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