cinchocaine hydrochloride + hydrocortisone: clinical use

Prescribing considerations

• Confirm symptoms are consistent with haemorrhoids and reassess persistent or rapidly recurring symptoms.
• Avoid recurrent or prolonged exposure because of local sensitisation, skin damage and possible systemic corticosteroid absorption.
• Use in children younger than 12 only when directed by a doctor.
• Consider ophthalmic assessment if blurred vision or another visual disturbance develops.

Contraindications and cautions

• Hypersensitivity to hydrocortisone, cinchocaine or a formulation excipient.
• Tuberculosis affecting the treatment area.
• Anal candidiasis.
• Viral skin lesions such as herpes simplex, vaccinia or varicella.

Monitoring

• Monitor for local irritation, contact sensitisation, skin thinning or worsening infection.
• Where systemic exposure may be increased, monitor for adrenal suppression and other systemic corticosteroid effects.
• Monitor carefully if use with a CYP3A inhibitor is unavoidable.

Clinical pharmacology

Hydrocortisone has local glucocorticoid anti-inflammatory and antipruritic effects. Cinchocaine reversibly blocks sensory nerve conduction. Absorption of either component may increase through damaged tissue.

Formulation and product differences

• The ointment is primarily for external haemorrhoids but can be administered internally using the supplied nozzle.
• The ointment contains cetostearyl alcohol, which may cause contact dermatitis.
• Suppositories are intended for internal haemorrhoids and use a hard-fat base.