Pharmacology

1. ANORECTAL
PREPARATIONS
PRAMOXINE/ ZINC OXIDE

2.  Pramoxine and zinc oxide topical (for the skin) is a combination medicine
used to temporarily relieve pain, itching, burning, irritation, or soreness
caused by hemorrhoids.

3. MECHANISM OF ACTION
 Pramoxine: local anesthetic due to inhibition of conduction of nerve
impulses from sensory nerves, resulting from an alteration of the cell
membrane permeability.
 Zinc oxide: antiseptic and protectant properties.
 Absorption – minimal
 Onset: 3-5 min

4. DOSAGE & INDICTIONS
 PEDIATRICS
 DOSAGE FORMS & STRENGTHS
Pramoxine/mineral oil/ zinc oxide rectal
TOPICAL OINTMENT
1%/ 46.6%/ 12.5%
TOPICAL PAIN
For symptomatic relief of the discomfort associated with hemorrhoids, perianal
itching or irritation.
<12 years: safety and efficacy not established
≥12 years: apply externally to affected area up to 5 times daily PRN

5.  ADULTS
Topical ointment
1%/ 46.6%/ 12.5%
TOPICAL PAIN
For symptomatic relief of the discomfort associated with hemorrhoids, perianal itching, or
irritation.
Apply externally to affected area up to 5 times daily PRN

6. INTERACTIONS
 Beta carotene;
.mineral oil decreases levels of beta carotene by drug binding in GI tract.
Use caution/ monitor.
Vitamin D
.mineral oil will decrease the level or effect of vitamin D. Use caution/
monitor. Avoid concomitant use of mineral oil and vitamin D supplements to
avoid risks of decreased absorption of vitamin D. Applies to only oral
administration of these agents.

7. ADVERSE EFFECTS
 Redness
 Irritation
 Swelling( lips, face, tongue, throat)
 Pain
 Rectal bleeding
 Difficulty in breathing

8. WARNINGS
 Contraindications
Hypersensitivity
Cautions
For external use only
Do not use in the eyes
Do not use on blistered or broken skin
If conditions worsen, or if symptoms persist for >7days or clear up and
occur again within a few days, discontinue and reassess therapy.

9. PREGNANCY
 Pregnancy category: Undetermined, use with caution.
 Lactation: Unknown if excreted in breast milk, caution advised.
 Pregnant or breastfeeding patients should seek advice of health
professional before using OTP drugs.

10. hydrocortisone
 It suppresses the normal immune response and inflammation, i.e,
suppresses dermatological inflammation and immune

11. PHARMACOKINETICS.
 Minimal absorption but its prolonged use increases its systemic
absorption. It primarily remains at the site of absorption, metabolized in
the skin, and plasma half life of 1.5 to 2 hrs.
 Time and action depends on the condition being treated.

12. INDICATIONS
 Inflammation.
 Pruritis
 DOSAGE
 Aerosal form going for 1 to 2 times a day for two to three weeks then
adjusted.
 AVAILABILITY
 Rectal cream1% and rectal aerosol 10%.

13. CONTRAINDICATIONS
 Hypersensitivity, known tolerance to glucocorticoids and untreated viral
and bacterial infections.