What is Diltiazem ointment and how is it used?

When dealing with sensitive conditions like anal fissures, finding the right treatment can be a source of significant relief. While many standard treatments exist, compounded Diltiazem and Nifedipine ointments offer a specialized approach for those who haven’t found success with over-the-counter options. This article explores how these medications work, how to use them, and why they are a staple in specialized compounding.

In this fact sheet, we’ll explore:

• What are Diltiazem and Nifedipine ointments?
• How do these ointments work for anal fissures?
• How to apply the ointment correctly
• Potential side effects and considerations
• The role of compounding in your treatment

What are Diltiazem and Nifedipine ointments?

Diltiazem and Nifedipine belong to a class of medications known as calcium channel blockers. While they are traditionally used in tablet form to treat cardiovascular issues like high blood pressure, compounding pharmacies can reformulate them into topical ointments.

These ointments are specifically used to treat chronic anal fissures, small tears in the lining of the anal canal. When standard pharmacist-only medicines or over-the-counter products are not sufficient, a doctor may prescribe a compounded diltiazem ointment to help facilitate healing.

How do these ointments work for anal fissures?

An anal fissure can cause significant distress, pain, and discomfort. Because of the location and the constant tension of the surrounding muscles, these tears are often very slow to heal.

When applied topically, Diltiazem or Nifedipine works by:

• Relaxing smooth muscle: It reduces the pressure in the anal canal by relaxing the internal sphincter muscle.
• Improving blood flow: By reducing muscle tension, blood flow to the area is increased.
• Promoting healing: Better circulation directly supports the body’s ability to repair the damaged tissue and reduces pain.

How to apply the ointment correctly

Since this is a prescription-only medication, your doctor will provide specific instructions tailored to your needs. However, the typical application process involves:

• Frequency: Most patients are advised to apply the ointment three times a day.
• Amount: Use a pea-sized amount (roughly a quarter of a five-cent piece).
• Application: Using a clean finger or a glove, apply the ointment gently to the affected area as directed.

Potential side effects and considerations

While these medications are generally well-tolerated because they are applied topically, some side effects can occur:

• Local irritation: Some patients may experience soreness or itching at the site of application.
• Headaches: Due to the muscle-relaxing effects of the active ingredients, mild headaches can occasionally occur.
• Dizziness: In rare cases, some individuals might feel lightheaded or dizzy.

If you experience severe irritation or persistent side effects, it is important to consult your healthcare provider.

The role of compounding in your treatment

One of the greatest benefits of a compounding pharmacy is the ability to fill the gaps where mass-produced pharmaceutical products may not meet a patient’s specific needs. At National Custom Compounding, we can customize your formulation to include other ingredients, such as local anesthetics, to help numb the area and provide immediate pain relief alongside the healing properties of the calcium channel blocker.

If you are suffering from discomfort and standard treatments haven’t worked, have a chat with your GP or specialist about a compounded solution.

References:

• https://www.healthdirect.gov.au/anal-fissure
• https://www1.racgp.org.au/ajgp/2024/january-february/anal-fissures

Transcript

Hi there! A bit of a sensitive topic today, but we’re going to be talking about Diltiazem ointment and we can also put Nifedipine into that same category as well. So Diltiazem a medicine that belongs to a group called calcium channel blockers, um, generally used in a tablet for cardiovascular um issues. It’s a prescription only medicine. So talk to your doctor first. And what we’re talking about today is not that we’re actually talking about a compounding pharmacy using diltiazem in an ointment. So the beauty of compounding is that we can take an ingredient that’s used in a tablet, for example, but we can put it into a base that’s different. The ointment, um, and it can actually have a really beneficial effect in a different area of the body. So the ointment diltiazem ointment is used generally rectally. Um, things like chronic anal fissures are where it typically exerts benefit. And it’s used in situations where over-the-counter or pharmacist only medicines might not be sufficient. So those products could be proctosedyl, for example, or rectogesic. And when you get something like an anal fissure, it’s a very small tear in the lining of the anal canal, so it can put people into a lot of distress, a lot of pain, a lot of discomfort. And because of the location of it, it’s really, really slow to heal. So when you use a diltiazem ointment, generally from a compounding pharmacy, um, what it does is it relaxes the smooth muscle in this area and that helps to improve the blood flow, which in turn helps the healing and also reduce the pressure of that area. So it can really benefit people that are very uncomfortable and in a bit of distress. Normally the doctors will. This is definitely a prescription only medicine. Doctors will specify how often to use it. Typically we see it’s about three times a day and someone would normally measure about a pea sized amount, so about a quarter of a five cent piece onto clean fingers or gloves and then apply it rectally. Um, and obviously there’s some side effects that might occur from these types of medicines. Um, things like irritations or soreness on application of the ointment is one of them. Um, sometimes headaches due to the muscle relaxation effect and the active ingredient can occur um, but rarely things like lightheadedness or dizziness. So it’s one of those really good examples of where a compounding pharmacy can fill a void that big Pharma may not have been able to make a product for. Um, it’s one of those things that we can add other ingredients, such as, um, anesthetics to help numb the area too. So if it’s something that you are suffering from, have a chat to your GP or your specialist. They can talk to our compounding pharmacists, and we can make a formulation that’s well suited to yourself. So if you’ve got any questions like always reach out and we’ll speak to you soon. Thank you.