Corticosteroid Hormone
| Drug | Dosage | Remarks |
|---|---|---|
| Hydrocortisone |
100-500 mg slow IV injection or infusion 6-8 hourly or 25 mg rectally 12 hourly |
Adverse Reactions
|
Hemorrhoidal Preparations (Oral)*
| Drug | Dosage | Remarks |
|---|---|---|
| Bioflavonoids | ||
| Aescin (Amorphous aescin) |
Initial dose: 40 mg PO 8 hourly or 180 mg PO 8 hourly Maintenance dose: 20 mg PO 8 hourly or 90 mg PO 8 hourly |
Adverse Reactions
|
| Diosmin | Acute hemorrhoidal attack: 1,800 mg/day PO x 3 days followed by 600 mg/day PO |
Adverse Reactions
|
| Diosmin/Hesperidin (Micronized purified flavonoid fraction) |
Diosmin 450 mg/Hesperidin 50 mg Diosmin 900 mg/Hesperidin 100 mg Acute hemorrhoidal attack: 1,000 mg PO 8 hourly x 4 days, then 1,000 mg PO 12 hourly x 3 days, then 1,000 mg PO 24 hourly thereafter Chronic hemorrhoids: 1,000 mg PO 24 hourly |
|
| Hidrosmin | 200 mg PO 8 hourly | |
| Oxerutins (Hydroxyethylrutoside) |
Initial dose: 300-600 mg PO 8 hourly x 7-14 days or 200 mg PO 8 hourly x 7 days Maintenance dose: 300 mg PO 24 hourly or 200 mg PO 12 hourly |
|
| Rutoside (Rutin) | 500 mg PO 12 hourly | |
| Troxerutin (Trihydroxyethylrutoside) |
600-1,200 mg PO 24 hourly Maintenance dose: 300 mg PO 12 hourly |
|
| Other Sclerosing Agent | ||
| Calcium dobesilate | 500-1,000 mg PO 24 hourly |
Adverse Reactions
|
| *Various combination products are available. Please see the latest MIMS for specific formulations and prescribing information. | ||
Hemorrhoidal Preparations (Topical)*
| Drug | Indications |
|---|---|
| Aescin (Aesculin) | Capillary stabilizing agent |
| Aloe barbadensis | Relieves pain and itching |
| Aluminium subacetate | Local antiseptic effect |
| Benzalkonium Cl | Antiseptic |
| Benzocaine (Ethyl aminobenzoate) | Local anesthetic: Temporarily relieves pain and itching Allergic reactions may occur |
| Betamethasone | Corticosteroid: Reduces inflammation and swelling |
| Bismuth salts (Bismuth oxide, Bismuth resorcinol compound, Bismuth subgallate, Bismuth subnitrate) | Protectant |
| Bufexamac | Topical anti-inflammatory effect |
| Calendula officinalis extract | Anti-inflammatory and wound healing agent |
| Centella asiatica extract | Wound healing agent |
| Cetrimide | Topical antiseptic effect |
| Cinchocaine (Dibucaine) | Local anesthetic: Temporarily relieves pain and itching Allergic reactions may occur |
| Cocoa | Emollient: Acts as a physical barrier which lubricates the tissues |
| Diphenhydramine | Topical antihistamine, may cause sedation |
| Fluocortolone | Corticosteroid: Reduces inflammation and swelling |
| Framycetin | Antimicrobial agent |
| Glyceryl trinitrate | Pain relief and to aid wound healing after hemorrhoidectomy |
| Hamamelis virginiana | Moisturizes and hydrates dry itchy skin, reduces irritation and swelling |
| Hexetidine | Bactericidal and fungicidal antiseptic |
| Hidrosmin | Capillary stabilizing agent |
| Hydrocortisone | Corticosteroid: Reduces inflammation and swelling |
| Hypericum perforatum | Anti-inflammatory and analgesic agent |
| Lanolin | Skin protectant |
| Lidocaine (Lignocaine) | Local anesthetic: Temporarily relieves pain and itching Allergic reactions may occur |
| Matricaria chamomilla | Anti-inflammatory and antioxidant agent |
| Mucopolysaccharide polysulfate | Reduces swelling |
| Neomycin | Antimicrobial agent |
| Pentosan polysulfate | May be used for its anti-inflammatory and thromboembolic effects |
| Peru balsam (Peruvian balsam) | Mild antiseptic effect |
| Phenylephrine | Vasoconstrictor: Reduces swelling and congestion |
| Prednisolone | Corticosteroid: Reduces inflammation and swelling |
| Resorcinol | Keratolytic: May help to expose underlying tissue to therapeutic agent |
| Ruscogenin | Constricts veins; improves venous tone |
| Ruscus aculeatus | Improves blood circulation and reduces venous congestion |
| Rutoside (Rutin) | Capillary stabilizing agent |
| Shark liver oil | Emollient: Acts as a physical barrier which lubricates the tissues |
| Titanium dioxide | Acts as a protectant |
| Triamcinolone | Corticosteroid: Reduces inflammation and swelling |
| Tribenoside | Reduces capillary permeability |
| Trimebutine | Antispasmodic |
| Zinc oxide (ZnO) | Emollient: Acts as a skin protectant |
| *These agents are found in various topical hemorrhoidal combination preparations throughout different countries. They are available as creams, ointments, gels and suppositories. Please see the latest MIMS for specific formulations and prescribing information. | |
Sclerosing Agents
| Drug | Available Strength | Dosage | Remarks |
|---|---|---|---|
| Lauromacrogol 400 (Polidocanol) | 1%, 3% solution |
Individualize dose based on manufacturer’s recommendations 0.5-1.5 mL/dilated knot submucosal injection Max dose: 2.5-3 mL/session or 0.5 mL/session for 11 o’clock hemorrhoid in men |
Adverse Reactions
|
| Phenol | 5% oily Phenol |
2-3 mL injection into the submucosal layer at the base of the hemorrhoid or 2-5 mL injection into the submucosal space of the hemorrhoid or into the apex of the hemorrhoid |
|
| 250 mg/5 mL |
3-5 mL submucosal injection at each site For small hemorrhoids, may give 3 injections of 3 mL each |
Disclaimer
All dosage recommendations are for non-pregnant and non-breastfeeding women, and non-elderly adults with normal renal and hepatic function unless otherwise stated.
Not all products are available or approved for above use in all countries.
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs.
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information.
Not all products are available or approved for above use in all countries.
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs.
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information.