phenol: clinical use

Prescribing considerations

• Confirm that the target is an internal haemorrhoid suitable for injection sclerotherapy.
• Use precise submucosal injection; avoid intravascular injection, intrathecal administration and placement near the anal verge.
• Avoid treatment over large areas because clinically significant systemic absorption may occur.
• Check specifically for phenol, nut and almond-oil hypersensitivity.
• The product is not recommended during pregnancy or breastfeeding.

Contraindications and cautions

• Hypersensitivity to phenol, nuts—particularly almond—or another product component.
• Neonates and children.

Monitoring

• Observe for severe procedural pain, which may indicate incorrect placement, and for immediate hypersensitivity or dizziness.
• After treatment, assess persistent severe pain, fever, discharge, ulceration or tissue damage for infection or abscess.
• Investigate new dysuria, urinary incontinence, pelvic pain or erectile dysfunction for local complications.

Clinical pharmacology

Phenol acts locally as an analgesic sclerosant, producing submucosal fibrosis that fixes the mucosa to underlying muscle. Absorbed phenol is mainly conjugated and its metabolites are excreted in urine.

Formulation and product differences

• The selected product is a sterile oily injection containing almond oil.
• It is supplied in glass ampoules or rubber-capped glass vials; not all pack presentations may be marketed.
• It is for submucosal use only and must not be administered intrathecally.

Injection

Route: Parenteral

Strengths: 5% w/v