Anorectal Cream

Anorectal cream (lidocaine 5%) is a topical anesthetic cream. Each gram of anorectal cream contains lidocaine 50 mg, benzyl alcohol, carbomer 940, cholesterol, hydrogenated 

Mix for 20 minutes at 10 rpm (manual), temperature 50°C, homogenize at speed II for 4 minutes under 0.6 bar vacuum. Check for clarity if not clear, homogenize again. 

Scale (mg/g) Item Material Name Quantity/1000 Tablets (g) 

Prepare solution of items 1-3 at room temperature, heat to 70°C or cool to 6°C, and slowly add item 4 to the well-stirred solution until it is dissolved. 

Maintain the temperature until the air bubbles escape. A clear, colorless gel is obtained. 

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Pramoxine (Anusol Ointment, PrectoFoam NS, Others) [Topical Anesthetic] Uses Relief of pain itching from hemorrhoids, anorectal surg y topical for bums dermatosis Action Topical anesthetic Dose Apply freely to anal area q3h Caution [C, ] Disp Foam (Proctofoam-NS), cream, oint, lotion, gel, pads, spray SE Contact dermatitis, mucosal thinning w/ chronic use EMS None OD Unlikely... 

The possibility of absorption and systemic effects should be considered with more attention than with cutaneous use. Most risk of absorption theoretically exists for a lipophihc active substance in a hydrophilic base, but in fact hardly anything is known about this issue. An isosorbide dinitrate soft paraffin cream, for instance, may already cause headache due to systemic absorption although applied on a small anorectal surface. Absorption from a lidocaine soft paraffin cream is found when used for internal haemorrhoids and applied from a tube with a long nozzle (cannula) (see Sect. 24.4.19.12). The cream easily reaches the rectum and the lidocaine can then be absorbed. 

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