Prescription
Prescription RequiredCompoundedDiltiazem | Lidocaine Ointment
This compounded ointment combines diltiazem 2% and lidocaine 3% to ease pain and help healing in the anal area. Diltiazem relaxes the tight muscle around the anus, which can improve blood flow and reduce pressure on fissures or hemorrhoids. Lidocaine provides fast numbing relief so you feel less burning, itching, or pain while the area heals. Your healthcare provider may prescribe this ointment when over-the-counter treatments have not given enough relief.
Requires a valid prescription from your provider. Not sure if it's right for you? Ask a pharmacist.
These statements have not been evaluated by the Food and Drug Administration. Compounded products are not FDA-approved and are not intended to diagnose, treat, cure, or prevent any disease. Individual results may vary. This information is for educational purposes only and is not medical advice — always consult your healthcare provider before starting any new treatment.
Clinical information
Medication information for patients and providers.
Use as directed by your healthcare provider. Apply a small amount to the affected area 3 to 4 times a day, using the supplied finger cot or a clean glove. Wash hands before and after use. If you miss a dose, apply it when you remember unless it is almost time for your next dose. Do not double up.
Diltiazem is a calcium channel blocker. When placed on the skin around the anus, it relaxes the ring muscle (anal sphincter) and widens tiny blood vessels. This lowers pressure, improves blood flow, and lets tears or swollen veins heal faster. Lidocaine is a local anesthetic. It blocks pain signals in the nerves of the skin, giving numbness within 5–10 minutes that lasts about 1–2 hours. Together, the ointment reduces pain quickly and supports healing over days to weeks.
Do not use if you are allergic to diltiazem, lidocaine, other amide-type anesthetics, or any ingredients in this ointment (can cause severe rash or swelling). Do not use if you have a complete heart block, very low heart rate, or very low blood pressure unless your doctor tells you it is safe (small amounts can absorb into the body). Avoid if you have severe liver disease without medical supervision. Do not apply to open, actively bleeding, or infected wounds. Not for use inside the mouth, eyes, or vagina. Ask your doctor before use if you are pregnant, planning pregnancy, breastfeeding, or under 18 years old.
Because only a tiny amount enters the bloodstream, interactions are uncommon, but caution is still advised. Tell your healthcare provider if you take beta blockers (such as metoprolol), other calcium channel blockers (like verapamil), blood pressure medicines, digoxin, or anti-arrhythmia drugs, as added effects on heart rate or blood pressure could occur. Large amounts of lidocaine can interact with certain heart medicines (e.g., amiodarone) or antiseizure drugs. Avoid applying other topical numbing products or using hemorrhoid creams with phenylephrine at the same time unless advised. Limit alcohol—it can widen blood vessels and may increase dizziness.
Very common (more than 1 in 10): mild burning or stinging for a few minutes after application—usually fades quickly. Common (1–10 in 100): itching, redness, or swelling at the site; headache; light-headedness when standing. Uncommon (1–10 in 1,000): dizziness, low blood pressure, slow pulse, mild nausea. Rare but serious: severe allergic reaction with rash, hives, or swelling of face; irregular heartbeat; bluish skin or lips (sign of methemoglobinemia). Most local side effects improve within 15–30 minutes; systemic effects resolve after stopping the ointment. Seek medical help right away if you notice trouble breathing, chest pain, or severe dizziness.
Store at room temperature (68-77°F, 20-25°C). Keep the tube tightly closed and protect from moisture, heat, and direct sunlight. Do not freeze. Do not store in the bathroom. Keep out of reach of children and pets. Discard any unused ointment 90 days after first opening or by the expiration date, whichever comes first. Use a pharmacy take-back program for disposal when possible or mix leftover ointment with coffee grounds in a sealed plastic bag before throwing it in household trash.
Frequently asked questions.
Most people feel numbing from lidocaine within 5–10 minutes. Pain relief from muscle relaxation may take a few days of regular use. Full healing of a fissure can take several weeks.
It is best to apply after cleaning the area, usually after a bowel movement. If you need pain relief before going, you can apply a small amount, but you may need to reapply afterward for continued benefit.
Small amounts of the medicine are absorbed, but safety in pregnancy and breastfeeding has not been firmly established. Use only if your obstetric provider believes the benefit outweighs any risk.
A brief mild sting is normal. If burning lasts more than 10–15 minutes, wash the area with mild soap and water, stop using the ointment, and call your healthcare provider.
Check with your healthcare provider first. Using many products together can increase irritation or change how well the medicine works. If allowed, space applications at least 30 minutes apart.
Wash your hands, put on the provided finger cot or a disposable glove, apply a pea-sized amount to the fingertip, and gently spread a thin layer around the anus. Discard the finger cot and wash hands again.
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