Before using haemorrhoidal preparations with corticosteroid

Before using haemorrhoidal preparations with corticosteroid make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have an infection in the affected area.
• If you have a viral infection (such as herpes, shingles, or chickenpox).
• If this preparation is for a child under 12 years of age.
• If you have ever had an allergic reaction to this or any other medicine.

How to use haemorrhoidal preparations with corticosteroid

• Before beginning treatment, read the manufacturer's printed information leaflet.
• Use this preparation exactly as directed by your doctor.

1. If the suppository is too soft, it may be chilled in the refrigerator or under cold running water before unwrapping. Remove the wrapping and moisten the suppository with water. Lie on your left side (if you are right-handed) and draw your knees up towards your chest, with the right leg drawn up more than the left.
2. Using your index finger or middle finger (whichever you find easier) gently push the suppository into the rectum (back passage) as far as possible, pointed end first.
3. Lower your legs to a comfortable position to help you to hold the suppository in place.
4. Always wash you hands after use.

1. Wash and dry the affected area before applying the preparation.
2. Apply a small amount to the affected area at night, again in the morning, and after each bowel movement unless you have been directed otherwise.
3. Some preparations may be used internally. If you have been instructed to do so, use the applicator provided. After each use, wash the nozzle in hot soapy water and rinse it afterwards in cold water.
4. Always wash you hands after use.

1. Prime the pump before using it by pressing down on the top of the pump once or twice.
2. Use the spray on and around your back passage, parting your buttocks if necessary. It can be used up to three times a day if needed.
3. Always wash you hands after use.

1. Shake the cannister before use.
2. Pull back the plunger until it stops at the catch line.
3. Hold the applicator with the tip downwards and insert the canister top into the applicator tip.
4. Briefly squeeze the cannister top and allow the foam going into the applicator to expand. Repeat this step until the foam fills the applicator up to the fill line.
5. Stand with one leg raised on a chair, or lie down on your side. Insert the applicator gently into the back passage and push down the plunger.
6. Always wash you hands after use.

If you have been told to use the foam outside the back passage, shake the cannister before use, squeeze a small amount of foam on to two fingers and apply to the affected area.

Getting the most from your treatment

• Use this preparation for short periods only (no longer than 7 days).
• Eat a well balanced diet containing plenty of fibre and drink 6-8 glasses of water each day to help prevent hard painful stools and straining.
• Talk to your doctor if your symptoms do not improve or worsen, or if bleeding occurs.

Can haemorrhoidal preparations with corticosteroid cause problems?

Along with their useful effects all medicines can cause unwanted side-effects, which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store haemorrhoidal preparations with corticosteroid

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Anugesic® HC Cream, Pfizer Limited, electronic Medicines Compendium. Dated May 2008, accessed November 2009.
• Manufacturer's PIL, Perinal® Cutaneous Spray, Dermal Laboratories Limited, electronic Medicines Compendium. Dated September 2007, accessed November 2009.
• Manufacturer's PIL, Proctofoam® HC, Meda Pharmaceuticals, electronic Medicines Compendium. Dated August 2009, accessed November 2009.
• Manufacturer's PIL, Proctosedyl® Ointment, Sanofi-aventis, electronic Medicines Compendium. Dated July 2008, accessed November 2009.
• Manufacturer's PIL, Scheriproct® Suppositories, Meda Pharmaceuticals, electronic Medicines Compendium. Dated July 2009, accessed November 2009.
• British National Formulary; 58th Edition (September 2009) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF).