Diltiazem Ointment

This ointment contains diltiazem, a medicine that relaxes smooth muscle and helps widen nearby blood vessels. When applied to the anal area, it can lower the tightness and spasm of the anal muscle, which may reduce pain and improve blood flow to the fissure. Better blood flow can support healing over time. Some people feel less pain within a few days, but healing often takes several weeks of regular use. If symptoms are not improving after a few weeks, contact your healthcare provider.

Do not use if you are allergic to diltiazem or any ingredient in this ointment (signs can include rash, hives, itching, swelling, or trouble breathing). Do not use on severely broken skin, active infection, or open wounds in the area unless your prescriber tells you to, because it may worsen irritation or delay proper treatment. Tell your healthcare provider before use if you have very low blood pressure, certain heart rhythm problems (such as sick sinus syndrome or heart block) unless you have a pacemaker, or heart failure, because diltiazem can affect heart rate and blood pressure even when used topically. If you are pregnant, planning pregnancy, or breastfeeding, use only if your prescriber decides the benefits outweigh the risks, since safety information for rectal/topical use is limited. Do not use in children unless specifically prescribed by a pediatric specialist.

Even though this medicine is applied locally, small amounts may be absorbed and could add to the effects of other medicines. Moderate interaction: blood pressure or heart medicines (such as beta-blockers like metoprolol, atenolol; and other calcium channel blockers like verapamil, amlodipine) may increase the chance of slow heartbeat, dizziness, or low blood pressure—contact your prescriber if you feel faint or your heart rate feels unusually slow. Moderate interaction: medicines that strongly affect liver enzymes (such as clarithromycin, erythromycin, ketoconazole, itraconazole, ritonavir, and grapefruit products) may increase diltiazem levels and side effects—ask your pharmacist before using these. Caution: alcohol can worsen dizziness or lightheadedness in some people. Tell your healthcare provider about all prescription and over-the-counter medicines, vitamins, and herbal supplements you use.

Common (may affect 1 to 10 people out of 100): itching, burning, stinging, or mild irritation where applied; mild headache. Uncommon (may affect 1 to 10 people out of 1,000): dizziness, flushing, nausea, or feeling lightheaded, especially if more medicine is used than directed. Rare but serious: allergic reaction (hives, rash, swelling of face/lips/tongue, trouble breathing), fainting, very slow heartbeat, or severe weakness—get emergency help right away. Local irritation often improves within a few days; if it is severe, lasts more than 1 week, or you notice bleeding, pus, fever, or worsening pain, contact your healthcare provider.

Store at room temperature (68-77F, 20-25C) unless your prescription label says otherwise. Keep tightly closed and protect from heat, moisture, and direct light. Do not store in the bathroom. Keep out of reach of children and pets. Do not share this medication with anyone. Dispose of unused or expired ointment through a pharmacy take-back program when available; if not available, place it in a sealed bag (mixed with an undesirable material like used coffee grounds) and throw it in the household trash, and remove personal information from the label.