Diltiazem hydrochloride 2% cream

Diltiazem hydrochloride 2% cream is used to relieve pain and help healing around the anus (back passage).

It is commonly used to treat an anal fissure, which is a small tear in your anus that can cause sharp pain.

It can also be used after surgery to reduce muscle spasms around the anus (anal spasms), which can be painful and slow healing.

How the cream works

Diltiazem hydrochloride works by relaxing the muscle around the anus. This can help to:

reduce pressure and muscle spasm
improve blood flow
ease pain and support healing

Taking an unlicensed medicine

Diltiazem tablets and capsules are licensed in the UK to treat angina and high blood pressure.

Diltiazem cream is an unlicensed medicine that has been used for many years to treat anal fissure or post-operative anal spasms. It has been shown to work well to treat these conditions.

Read our information about unlicensed medicines. You can also call our pharmacy medicines helpline, phone 020 7188 8748, Monday to Friday, 9am to 5pm, or email [email protected]

Before you start treatment

Diltiazem cream is not suitable for some people.

To make sure it’s safe for you, tell your doctor or pharmacist if you:

are allergic to diltiazem or any other ingredients in the cream
are pregnant or breastfeeding
have any heart problems
are taking any medicines to reduce blood pressure
are taking other medicines containing diltiazem

As well as the active ingredient diltiazem hydrochloride, this cream also contains white soft paraffin, cetostearyl alcohol, polysorbate 40, propylene glycol, glycerol monostearate 40-50, medium chain triglycerides, liquid paraffin, sorbic acid, colloidal anhydrous silica, sodium hydroxide and purified water.

Diltiazem hydrochloride 2% cream is a white, opaque cream. It's supplied in a white aluminium tube.

How to apply the cream

Wash your hands before and after you use the cream.
Put about 2 to 2.5cm (1 inch) of the cream on your finger.
Gently apply the cream just inside and around your anus, as instructed by your doctor. You can use a finger covering such as cling film, disposable glove or finger cot when applying the cream. You can buy finger cots from a pharmacy or online.

Use the cream 2 times a day (morning and evening) or as directed by your doctor.

Try to make sure you have had a poo before using the cream. This is so that the cream can be in contact with the rectal tissue for as long as possible.

Important

This cream is for external use only. Do not take it by mouth.

Length of treatment

Your doctor will let you know how long you should use the cream for.

For anal fissure, it's usually about 2 weeks.

For anal spasms, this will usually be for 6 to 8 weeks.

If your symptoms have not improved after using the cream, contact your GP for a review, unless you have a follow-up hospital appointment already booked.

How to get a supply of the cream

If you are using the cream for anal spasms, this can only be prescribed by a hospital specialist and supplied at the outpatient pharmacy.

For anal fissures, this may be prescribed by the hospital, or by your GP if it has been recommended by the specialist team at the hospital.

The cream must be used within 4 weeks of opening. If your treatment lasts longer than 4 weeks, you will be given 2 tubes of cream.

Side effects

All medicines can cause side effects, although not everyone gets them.

The most common side effects (which happen in more than 1 in 100 people) are:

headaches, however these will usually be mild and can be treated with regular painkillers, such as paracetamol. If the headaches do not get better or are severe, please talk to your pharmacist or doctor.
feeling light-headed or dizzy, especially when getting up from sitting or lying down. If you begin to feel dizzy, sit or lie down until the feeling passes.
Itching or soreness around the anus, or rectal bleeding.

Speak to your healthcare team if:

you have these symptoms and they do not get better or they get worse
you have any other symptoms which you think might be due to this medicine

How to store diltiazem hydrochloride 2% cream

Do

store the cream in a dry place, below 25C, away from direct heat and light
keep all medicines out of the sight and reach of children

Don't

do not use the cream after 4 weeks of opening or after the expiry date on the tube. Return any unused cream to your local pharmacy who will dispose of it safely
do not share your medicine with anyone else, even if their symptoms appear similar to yours

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