Lidocaine Ointment for Hemorrhoids


Lidocaine Ointment for Hemorrhoids

Hemorrhoids are swollen blood vessels in the anal canal. They result from too much pressure in the rectal area.

Though not considered a serious problem, they can be very painful and cause a lot of embarrassment.

There are hemorrhoid creams and ointments available to alleviate the pain, itching, soreness, irritation, and dryness.

Lidocaine Ointment is topical anesthetic and anti-inflammatory combination. But, will it work for you? Let’s find out.

How Does It Work?

Lidocaine belongs to the class of medications known as local anesthetics. 

It works by stopping the nerves from transmitting painful signals to the brain. This helps in reducing the pain while passing bowels.

It also contains anti-inflammatory properties. The cream acts on the affected area to ease the inflammation and calm the irritation. 

Why Lidocaine Is Effective for Hemorrhoids

Lidocaine is a local anesthetic. It is sold in liquid, oral and semi-solid (suppository) form.

Lidocaine is used solely or in combination with other remedies in hemorrhoid ointments. Its main function is to numb the area where it is applied so as to provide a quick and effective pain relief.

Lidocaine ointment contains only a small amount of the active agent since it is easily absorbed through the skin and extensive absorption can lead to systemic side effects. However, it is safe in the low doses in which it is supplied in ointments.

Lidocaine produces its anesthetic effect by blocking the voltage gated sodium channels in the cell membranes of neurons. This action affects the polarization of the neurons and hinders the transmission of signals between neurons.

Therefore, lidocaine prevents pain signals from being transmitted to the brain by preventing their propagation as soon as they are triggered. This is the reason why lidocaine is effective as a local anesthetic which can be applied topically. It is also the reason lidocaine acts quickly to provide fast relief.

Lidocaine hemorrhoid ointment blocks all kinds of pain signals include the burning, itching, prickling pain associated with piles as well as any pain felt during bowel movement. It effectively numbs the skin for the duration of its action.

Since lidocaine is targeted at reducing the pain and not the swelling of hemorrhoids, it is often recommended to be used alongside other hemorrhoid remedies.

The effect of lidocaine is similar to that of Pramoxine (or Pramocaine), the other popular topical anesthetic commonly used in hemorrhoid ointments.

Is It Safe For Me?

You must not use Lidocaine ointment for hemorrhoids if you are allergic to local anesthetics such as: 

Etidocaine (Duranest); Mepivacaine (Carbocaine, Prolocaine); Bupivacaine (Marcaine); or Prilocaine (Citanest); or any other medications. 

Those who have tuberculosis or fungal infection of the skin, chickenpox, skin infection, or any kind of infection following smallpox vaccination, must consult a doctor before using this product. 

What Are The Side Effects?

Lidocaine Ointment may cause some side effects such as skin rashes, itching, difficulty breathing, swelling, hoarseness, fast pulse, nausea, vomiting, weakness, dizziness, confusion, and fainting. 

If you notice any of the above mentioned side effects, stop the medication and call your doctor immediately.

Are There Any Drug Interactions?

Some medical conditions may interact with this product. Tell your doctor or health care professional if any of the following apply to you: 

  • If you are pregnant or breast-feeding
  • If you are allergic to specific foods, substances and medicines
  • If you have a skin infection or other skin problems
  • If you have had a severe allergic reactions to anesthetics
  • If you are taking any kind of prescription or non-prescription medicine, dietary supplement or herbal preparation
  • If you have had any vaccinations recently or a positive tuberculin skin test
  • If you have liver, heart, or kidney problems, diabetes, diarrhea, stomach infection or other intestinal problems 

You must not take anti-arrhythmics (eg, flecainide, quinidine) with this medication because the risk of the side effects may be increased. 

Directions to Use:

Clean the affected area with mild soap & warm water or use a medicated wipe. Rinse thoroughly and pat dry.

Now take a small amount of medicine or as prescribed in the applicator and apply it to the anal area. 

You must use lidocaine ointment as directed by the doctor. Always remember to check the label on the medicine for precise dosing instructions. 

This hemorrhoid ointment is strictly for external use only.

You must keep the product out of children’s reach. If it gets into your eyes or nose, you must immediately rinse with cold water. 

If swallowed by mistake, call your health care provider or contact your poison control center immediately.

Lidocaine – Lidamantle, Xylocaine

USES: This medication is used on the skin to stop itching and pain from certain skin conditions (e.g.,scrapes, minor burns, eczema, insect bites) and to treat minor discomfort and itching caused by hemorrhoidsand certain other problems of the genital/anal area (e.g., anal fissures, itching around the vagina/rectum). Some forms of this medication are also used to decrease discomfort or pain during certain medical procedures/exams (e.g., sigmoidoscopy, cystoscopy). Lidocaine is a local anesthetic that works by causing temporary numbness/loss of feeling in the skin and mucous membranes.

HOW TO USE: To use the cream, lotion, spray, foam, or gel on the skin, clean and dry the affected area as directed. Apply a thin layer of medication to the affected area of skin, usually 2 to 3 times a day or as directed.If you are using the spray, shake the canister well before using. While holding the canister 3-5 inches (8-13 centimeters) from the affected area, spray until wet. If the affected area is on the face, spray the medication onto your hand and apply to the face. Do not spray near your eyes, nose, or mouth.If you are using the foam, shake the canister well before using. Spray the foam onto your hand and apply to the affected area.Do not use on large areas of the body, cover the area with waterproof bandages or plastic, or apply heat unless directed to do so by your doctor. These may increase the risk of serious side effects.Wash hands immediately after use unless you are treating an area on the hands. Avoid getting the product in eyes, nose, or ears. If the medication gets in these areas, rinse the area immediately with clean water.Dosage is based on your medical condition and response to therapy. Do not use more of this product, use it more often, or keep using it longer than prescribed by your doctor. If you are using a nonprescription product, follow all the directions on the product package, or use as directed by your doctor. If there is an infection or sore in the area to be treated, do not use this medication without consulting your doctor first.Inform your doctor if your condition does not improve or worsens.

SIDE EFFECTS: Temporary redness, stinging, and swelling may occur at the application site. If these effects persist or worsen, notify your doctor.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these rare but very serious side effects occur: slow/shallow breathing, slow/irregular heartbeat, seizures.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: new/worsening rash, new or worsening itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice any other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects.  You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using lidocaine, tell your doctor or pharmacist if you are allergic to it; or to other amide type anesthetics (e.g., bupivacaine, prilocaine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: broken skin/infection in the area where lidocaine is to be used, heart disease, liver disease.Caution is advised when using this drug in children because they may be more sensitive to the side effects of the drug.Duringpregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

OVERDOSE: This medicine may be harmful if inhaled or swallowed. If overdose, inhalation, or swallowing is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: drowsiness, irregular heartbeat, seizures.

MISSED DOSE: If you miss a dose, apply it as soon as you remember unless it is almost time for the next dose. In that case, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE: Store at room temperature away from light and moisture. Do not freeze. Keep all medications away from children and pets.Do not store the gel or the foam or spray canisters near high heat (more than 120 degrees F/49 degrees C), and do not store or use it near open flame. Because the foam or spray canisters are under pressure, do not puncture or burn the container.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Proof of systemic safety of a lidocaine ointment in the treatment of patients with anorectal pain.

OBJECTIVE:

The aim of the study was to demonstrate that repeated anorectal administration of a 5% lidocaine ointment (CAS 137-58-6; LidoPosterine Salbe, Posterisan akut Rektalsalbe) in the treatment of patients with acute anorectal pain does not result in systemically efficacious plasma concentrations of lidocaine.

PATIENTS AND METHODS:

In an open single-center study 24 male or female patients with anorectal pain due to hemorrhoids, anal fissures, fistulas or proctitis administered lidocaine ointment as a single anorectal dose (2.5 g ointment corresponding to 125 mg lidocaine) followed by repeated administration (2.5 g ointment t.i.d.) for 4 days. Safety evaluation was performed with respect to plasma concentrations of lidocaine, vital signs, electrocardiogram (ECG), physical findings and adverse events. Blood samples were drawn prior to the first single administration and at 13 time points over the first 24 h in order to create a pharmacokinetic profile. Blood samples were also drawn prior to administration of the last dose on day 5 and thereafter using the identical time points for blood sampling as on day 1. Vital signs and ECG were recorded immediately before and 1 and 4 h after the first and last administration, respectively. Adverse events and skin tolerability were also recorded at predefined times during the study period.

RESULTS:

After a single dose of 125 mg lidocaine the average extent of exposure in terms of the AUC(tau,sd) during a 6 h dosage interval amounted to 397.7 ng/ml x h (geometric mean). C(max,sd) reached a mean value of 131.8 ng/ml (geometric mean). Only a minor accumulation of the lidocaine plasma concentrations was observed after multiple dose application. The geometric mean of the AUC(tau,md) (503.8 ng/ml x h, tau = 6 h) and the geometric mean of C(max,md) (145.9 ng/ml) were slightly higher than the corresponding single dose values. The AUC accumulation ratio was calculated as 127% (90% CI: 108-148%) and the C(max) accumulation ratio reached 120% (90% CI: 101-139%). Plasma peak concentrations of lidocaine in all subjects remained with a sufficient safety margin below the minimal effective therapeutic plasma concentration (1.5 microg/ml) as well as by an order of magnitude below toxic concentrations (5 microg/ml). There were neither unexpected, serious nor severe adverse events. There were no clinically relevant findings with respect to vital signs and ECG.

CONCLUSIONS:

Repeated anorectal administration of a 5% lidocaine ointment proved to be safe with respect to systemic plasma concentrations of lidocaine and vital signs.

Reviewed by the QSota Medical Advisory Board