Hemorrhoids Medications in the Palestinian Pharmacies Birzeit University

1. Haemorrhoids
Ala Abu Tair 1130962
Rinad bakri 1131358
Areej Abu Hanieh 1130234

2. Haemorrhoids
 Haemorrhoids are swollen veins which
protrude into the anal canal.
 Symptoms: itching, burning, pain, swelling
and discomfort in the perianal area and anal
canal.
 Haemorrhoids are often caused or
exacerbated by inadequate dietary fiber or
fluid intake.

3. Management of haemorrhoids
 Pharmacist should identify the exact nature of the
symptoms and if any products have been used
already.
 If the patient is constipated, the use of any
laxatives should be established.
 Treatment could be:
 Symptomatic treatment of haemorrhoids.
 Treatment of the underlying cause of constipation.

4. Process for Treatment
1. Determine whether the condition is
Haemorrhoids or not.
2. What stage it is.
3. Start the treatment.
4. If the treatment failed refer to the doctor.

5. The available medication for
Hemorrhoids in Palestinian
Pharmacies:

6. Hemoral H-C – Beit Jala :

7.  Dosage forms:
1. Ointment (28 mg) tube
2. Suppositories
Ingredients:
1. Hydrocortisone acetate 0.5%
2. Lidocaine HCL 1.5%
3. Zinc Oxide 5.0%
Use:
Ointment: for Adults and Children above 2 years , for 1-4
times daily for 7 days.
Suppositories: use for Adults: 1-2 times daily , for
internal and external hemmorhoids .

8. Directions for Use:
 ointment:
1. The cap should be removed and applicator attached
instead.
2. Using the finger, the applicator could be lubricated
from the outside with the ointment.
3. The entire applicator should be inserted gently into
the rectum.
4. The tube should get a good squeeze to introduce
enough ointment into the rectum.
5. The applicator should be pulled out of the rectum and
additional ointment could be applied on the anal
tissue.
6. After each use, the applicator should be detached
and washed with soap and water

9.  Contraindications :
for hypersensitivity, children under 2 years , if the
treatment site is infected , Category C for
pregnant women , and lactation .
 Side effect :
Rectal bleeding , pain, burning and itching .

10. Presto Gel

11.  Dosage form: Gel
 Use: Treatment of grade I , II hemorrhoids
 Active ingredients :
1. Aloe Barbadenis Extract: from aloe vera plants , its
function as a proctective around the fissures , the
hemorrhoids , thus prevent the toxins and acid from
being in contact with the fissure that will cause
irritation and pain , it act as anti-inflammatory too .
2. Geranium Thunbergii Extract and Pogostemon
Cablin Leaf Extract , those both act as preservatives
instead of using synthetic preservatives .

12.  Presto Gel does not contain any fragrance,
ingredients of animal origin, drugs or drug
components of any description, analgesics, harsh
chemicals, synthetic or chemical preservatives or
alcohol.
 The active substances in the gel are non-toxic,
non-irritating to the skin and non-hazardous.
 How to use it:
Imply it with an applicator BID and after each
defeacation.

13. Procto- Glyvencol

14. Procto- Glyvencol
 Active ingredient:
 Tribenoside 5g: (a synthetic compound belonging to
the group of glucofuranosides) used for the
inflammation and swelling.
 Lidocaine: as local anesthesia.
 The Properties:
Relieve pain , itching , skin tension , due to
inflammation of the anorectal area, so tribenoside act
as a decongestant which reduce the permeability of
vessels , and improve its tone ,and lidocaine as local
anesthetic.

15.  Instructions of use:
 During the first few days:
Apply 1g of the cream or insert 1 suppository twice a day.
 Then the frequency of application is reduced to once a
day.
 Duration of action: (7 -14)days.
 15 g cream tube is sufficient for approx. 10-15
applications.
 Contraindication:
Hypersensitivity to the active substances of Procto-
GlyvenoJ.

16.  Pregenancy and lactation :
As in the case of any form of drug therapy, Procto-
Glyvenol should be employed with caution during
pregnancy, especially in the first 3 months. It is not
known whether the active substances pass into the
breast milk. The benefits for the mother must be
weighed against the risks for the child.
 Side Effects :
Procto-Glyvenol is well tolerated. But it may produce
a slight burning sensation, pain, or increased
intestinal motility.

17. Procto- herbal

18. Procto- herbal
 Dosage form:
Ointment 30 ml.
 Ingredients:
Jojoba, garlic, mestica.
 Uses:
1. Hemorrhoid patient.
2. Anal fissure
3. Varicose vein problem
 Use instructions:
twice daily and after each defecation.

19. Alishech Nifedipine

20. Alishech Nifedipine
Dosage form:
Emulsion gel.
Ingredients:
- Nifedipine 0.4%
- Lidocaine 5%
- Biocomplex of Dead Sea minerals
Uses:
 Treating all fissures.
 Can treat prolapsed hemorrhoids (but not all of
them) e.g; thrombus hemorrhoids (a condition with
severe pain).

21. How it works:
Nifedipine: relaxes the smooth muscles of the anus and
reduces rectal pressure.
Lidocaine: as local anesthesia, & increases the efficiency
of Nifedipine.
These effects result in:
 Fissures healing quickly
 Hemorrhoids going inside
 Bleeding stops
 Pain decreases.
When used properly, the gel reduces pain in the first
days of treatment.

22.  Instructions for use:
1. During the first day pt should lubricate the outer
area of the anus with a small amount of gel applied
to the area of pain.
2. On the second day, apply the gel to the area of pain
and introduce the gel inside and outside the anus
using applicator without pushing it hard.
3. Repeat this process on all consecutive days.
4. In the first days patient should lubricate 4 times a
day (in the morning, afternoon, evening and at
night).
5. When the pain and the bleeding stop, patient should
lubricate twice a day.

23.  Duration of treatment:
7 to 28 days.
 Store:
at a room temperature
 Side effects:
Dizziness (rare)

24. General Recommendations
 When using these agents, Patients should:
 Eat foods that are rich in fibers
 Avoid eating spicy and fried dishes.
 Increase fluid intake.
 Laxative could be used too in case of
constipation.
 Washing the area 2-3 times a day.
 Warm baths

25. ‫شكرا‬
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