Clinical Information
Use as directed by your healthcare provider. Most patients insert one suppository rectally at bedtime and leave it in place overnight. If you miss a dose, insert it as soon as you remember unless it is almost time for your next scheduled dose. Do not use two suppositories at the same time.
Hydrocortisone is a mild steroid that lowers inflammation, which reduces swelling, redness, and itching in the rectal area. Lidocaine is a local anesthetic that blocks pain signals in the nerves, giving quick numbness within minutes that lasts a few hours. Nifedipine relaxes tiny blood vessels and smooth muscle around the anus, improving blood flow and easing spasms; this helps damaged tissue heal and reduces pressure. Many people feel less pain and itching after the first few nights, but full relief of swelling or fissures may take 1–2 weeks of nightly use.
Do not use if you are allergic to hydrocortisone, lidocaine, nifedipine, other local anesthetics ("caine" drugs), or any ingredient in the base. Do not use if you have a rectal or anal infection caused by bacteria, fungus, or virus (such as herpes) unless your provider says it is safe. Do not use if you are pregnant or breastfeeding unless your prescriber decides the benefits outweigh the risks. Not for use in children under 18 years of age. Avoid use if you have severe low blood pressure or are already taking high doses of oral nifedipine or similar heart medicines without medical supervision.
Because the medicine is applied locally, body absorption is low, but some interactions can still happen. Tell your healthcare provider if you take blood pressure medicines such as nifedipine tablets, diltiazem, verapamil, beta-blockers (e.g., metoprolol), or alpha-blockers (e.g., tamsulosin); combining can drop blood pressure further. Avoid using other rectal products that contain steroids, anesthetics, nitroglycerin, or vasodilators at the same time unless instructed. Herbal supplements like ginkgo or high-dose garlic may increase bleeding risk if your hemorrhoids are bleeding. Limit alcohol, as it can add to dizziness or light-headedness.
Very common (more than 1 in 10): mild burning or stinging for a few minutes after insertion, temporary numbness in rectal area. Common (1–10 in 100): itching, mild headache, dizziness, or feeling faint when standing up quickly; usually improves in a few days. Uncommon (1–10 in 1,000): rectal bleeding, rash, acne around anus, or yeast infection. Rare but serious: severe allergic reaction with swelling of lips, face, or throat; sudden severe dizziness or fainting due to low blood pressure; slow heart rate. Most local side effects lessen after the first week or stop when the medication is discontinued.
Store in the refrigerator at 36–46°F (2–8°C) to keep the suppositories firm. Keep in original blister or foil wrap until use to protect from light and moisture. Do not freeze or expose to temperatures above 77°F (25°C) for long periods, as the base may melt. Keep out of reach of children and pets. Return unused or expired suppositories to a pharmacy take-back program or mix them with kitty litter in a sealed bag before discarding in household trash.
Frequently Asked Questions
Q:How do I insert the rectal rocket without making a mess?
A:Wash your hands, remove the foil, and slightly moisten the tip with cool water or a water-based lubricant. Lie on your side, gently insert the narrow end into the anus until the wider outside flange rests against the skin. The flange keeps part of the rocket outside so it can treat external tissue.
Q:Will it hurt to have part of the suppository outside overnight?
A:Most people feel only mild pressure that goes away in a few minutes. The lidocaine numbs the area, so sleeping is usually comfortable. If you feel pain that does not fade, contact your healthcare provider.
Q:When should I expect relief from hemorrhoid pain and swelling?
A:The lidocaine starts to numb pain within minutes of insertion. Swelling and itching often improve after a few nights, but deeper healing can take 1–2 weeks. Keep using nightly as prescribed, even if you start to feel better sooner.
Q:Can I use over-the-counter hemorrhoid creams during the day?
A:Ask your provider first. Using extra products that contain steroids or anesthetics may raise the chance of side effects. Plain petroleum jelly or unscented wipes are usually safe for comfort between doses.
Q:What if the suppository melts before I can use it?
A:If it softens, return it to the refrigerator for about 30 minutes to firm up. Do not refreeze. If the shape is badly deformed or leaking, discard it and use a new one.
Q:Is it safe to drink alcohol while using this medication?
A:Small amounts are usually fine, but heavy drinking can increase dizziness or low blood pressure. Limit alcohol and rise slowly from sitting or lying positions to avoid light-headedness.
Q:Can pregnant or breastfeeding women use this suppository?
A:Talk to your healthcare provider. There is limited safety information on rectal nifedipine in pregnancy or while nursing. Your provider will weigh the benefits against possible risks and may suggest other options.
Q:How should I clean up the next morning?
A:Gently remove any remaining base by wiping with warm water and a soft cloth or unscented wipe. Wash your hands well. If you notice unusual bleeding or irritation, call your provider.
Related Products
Ketamine | Ketoprofen | Gabapentin | Clonidine | Lidocaine Cream
This compounded cream combines five active drugs that work together to help ease nerve and muscle pain when applied to the skin. It is made for patients who have chronic pain that has not improved with single-drug treatments. Because the medicine stays mostly in the skin and tissues where it is applied, it may lower the chance of whole-body side effects seen with oral pain pills.
Nifedipine | Lidocaine | Hydrocortisone Cream
This compounded rectal cream combines nifedipine, lidocaine, and hydrocortisone to ease pain, itch, and swelling caused by anal fissures or hemorrhoids. Nifedipine relaxes the tight muscles around the anus to improve blood flow and speed healing. Lidocaine numbs the area for quick pain relief. Hydrocortisone lessens redness, swelling, and itching.
Ketoprofen | Gabapentin | Baclofen | Lidocaine Cream
A compounded topical cream that combines an anti-inflammatory drug (ketoprofen), two nerve and muscle pain modulators (gabapentin and baclofen), and a local anesthetic (lidocaine) to help relieve localized muscle, joint, and nerve pain without the need for high-dose oral medicines.
Nitroglycerin Ointment
Nitroglycerin 0.2% ointment is a compounded medicine used on the skin around the anus to ease pain from anal fissures and sometimes hemorrhoids. It relaxes the muscle ring inside the anus and boosts blood flow, helping small tears heal faster and making bowel movements less painful. This prescription product is made by Olympia Pharmacy under a healthcare provider’s order.