Proctosedyl

Patients who have bowel problems often develop tears or fissures in their anus (rear end) when people strain trying to pass out stool. These hemorrhoids are not only painful, but also cause a lot of discomfort. Proctosedyl is available in both ointment and suppository form and is generally recommended by doctors for treatment of inflammation and swelling or relieving of itches for patients suffering from these problems. It can also be used for patients who have under gone recent rectal surgery and who maybe going through similar problems.

It comes in two packing or forms:

• A BP 5mg/g ointment or suppository with Cinchocaine hydrochloride as the main component.
• A BP 5mg/g ointment or suppository with Hydrocortisone as the main component.

Presentation

The Appearance of the Proctosedyl ointment can be best described as being yellowish white in color. The ointment is greasy in nature and is almost translucent with no odor present. The suppositories on the other hand, are smooth to touch and are off white in color and come packed inside blister strips. One gram of ointment or a single suppository is said to be incorporated with two active ingredients; Either 5 mg of BP hydrocortisone or 5 mg of BP Cinchocaine hydrochloride.

Uses/Course of action

The two active ingredients contained in Proctosedyl bring their own individual properties to the mix. Cinchocaine is known for its local anesthetic properties and is a common analgesic with added spasmolytic properties, whereas Hydrocortisone reduces inflammation and is an antipruritic agent. The emollient foam vehicle of the ointment contains these two key ingredients. The potent anesthetic effects of Cinchocaine are quite long lasting and causes temporary relief from spasms or any pain the patient might be suffering from. Corticosteroids with topical applications are responsible for bringing about vasoconstrictive actions. Hydrocortisone is one such Glucocorticoid and is a common anti-inflammatory agent used in topical creams and ointments. Inflammation usually results due to the presence of certain agents which cause the blood vessels in the affected area to widen giving it a swollen appearance which often causes itching and pain. The vasoconstrictive action acts against this inflammation and causes the blood vessels to constrict and also reduces the production of such substances.

Indications/Symptoms

Proctosedyl may be used for the following conditions:

• Anal tears and fissures due to bowel movement
• Hemorrhoids; both external and internal
• Eczema of the anal area and rear end
• Anal pruritus
• Rectal and Anal surgeries which may lead to the development of hemorrhoids; both pre and post-operative treatments for such surgeries
• Proctitis which is non infective in nature

Dosage and Administration

For both suppositories and ointment

During the first week of treatment:

• Three times a day after passing stool in the morning. Noon and evening

During the second week of treatment

• Two times a day i.e. after passing the morning and evening stool.

During the third week of treatment

• Once a day; after passing the morning stool

You should consult your doctor for dosage and follow his instructions carefully. Do not however exceed the three week period of treatment.

Instructions for Application

• Suppositories need to be inserted inside the rectum. Use a single suppository at a time.
• The ointments come in 3 basic tube packings:
  • 15 g and 30 g tubes: Squeeze out a small quantity, enough to suffice the covering of the affected area only. Use your finger to apply gently to the area which needs treatment. Use a cannula if deeper penetration is required. Attach it to the mouth of the tube and insert it in the rectum. Use the lower end to pull out during the withdrawal process.
  • One time use tubes containing 2g: Take care while using these for sensitive areas with high inflammation. Take off the tab and insert the cannula inside the rectum. Squeeze out the entire contents of the tube and use the lower end of the tube to pull out during the withdrawal process. Discard after use.

Contraindications

Allergic reactions may occur if the patient is allergic to any of the ingredients contained in the medicine (Cinchocaine and hydrocortisone). It is highly recommended to discontinue the usage of Proctosedyl if any sexually transmitted diseases or infection may be present in the anal area to be treated e.g. herpes because Proctosedyl is known to mask the symptoms of these infections. If there is an indication of some fungal infection to be present, then an antifungal treatment should be carried alongside. For those suffering from tuberculosis this treatment may worsen their condition.

Precautions

Discontinue treatment if allergic symptoms develop. These may include skin rash, itching, swollen tongue or mouth, shortness of breath etc. Systemic absorption is recommended for topical application of Proctosedyl as it gives better results, abraded skin needs an increased period of systemic absorption but care must be taken that you do not exceed the time for treatment. The doctor must be consulted and told about any medical conditions the patient might suffer from (such as bleeding from the rectum etc.) Infections and allergies should be treated specifically.

Concern for Pregnant Women

Although fetal abnormalities and defects have been found in pregnant animals treated with corticosteroids, no relevant results have been found for pregnant women. It may be a concern though, so precautions must be taken naturally and over dosage should be avoided. No large quantities should be applied for long periods of time

Side Effects

All medical applications have their side effects though for Proctosedyl these are not so pronounced. A burning sensation in the anal region has been reported by some after application. It is usually short lived and subsides soon. Allergic reactions for those who are sensitive to the ingredients.

Interactions

None known up to date

Over Dosage

Those fearing over dosage may consult their physicians immediately or report to the nearest hospital. They might be in need of medical attention without their knowing.

Storage

• The suppositories need to be stored below 25˚ C, keep it refrigerated during hot weather.
• The ointments should be kept away from light and temperatures should not be exceeding 30 ˚C.

References

https://www.aptalispharma.com/proctosedyl

https://chealth.canoe.ca/drug_info_details.asp?brand_name_id=946