Indications

Hydrocortisone plus Lidocaine cream is used for the anti-inflammatory and anesthetic relief of itching, pain, soreness, and discomfort due to hemorrhoids, anal fissures, pruritus ani, and similar conditions of the anal area.

Pharmacology

Hydrocortisone is a corticosteroid used for its anti-inflammatory and immunosuppressive effects. It’s anti[1]inflammatory action is due to the suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It may also be used as replacement therapy for adrenocortical insufficiency. Lidocaine is an amide-type local anesthesia. It stabilizes the neuronal membrane and inhibits Na ion movements, which are necessary for the conduction of impulses. In the heart, lidocaine reduces depolarisation of the ventricles during diastole and automaticity in the His-Purkinje system. The duration of action potential and effective refractory period are also reduced.

Dosage & Administration

Apply twice daily around the anal opening in a thin layer using an applicator.

Interaction

This cream should be used with caution together with dental injection anesthesia, other local anesthetics or agents structurally related to local anesthetics of amide-type eg, antiarrhythmic drugs (eg, mexiletine), as the toxic effects of these drugs are additive. Patients treated with class III antiarrhythmic drugs (eg, amiodarone) should be closely observed and ECG monitoring should be considered, as the cardiac effects of lidocaine and class III antiarrhythmic drugs can be addictive. Drugs that inhibit the metabolism of lidocaine (eg, cimetidine or ?-blockers) may cause potentially toxic plasma concentrations when the lidocaine is given in repeated high doses over a long time period. Such interactions are of no clinical importance following short[1]term treatment with lidocaine at recommended doses.

Contraindications

Patients with a history of hypersensitivity to any of its ingredients.

Side Effects

Side effects like Rectal bleeding, Swelling of the skin, Adrenal suppression, Anaphylaxis, Angioedema, Cushing syndrome, Hirsutism, Acne, Cutaneous and subcutaneous atrophy, Dry scaly skin, and Urticaria.

Pregnancy & Lactation

Pregnancy Category: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant the use of the drug in pregnant women despite potential risks

Lactation: Unknown if distributed in breast milk; exercise caution

Precautions & Warnings

If extensive areas are treated, the possibility of systemic absorption exists. Systemic absorption of topical steroids has produced reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, manifestations of Cushing’s syndrome, hyperglycemia, and glycosuria in some patients. If irritation or sensitivity occurs or infection appears, discontinue use and institute appropriate therapy.

Therapeutic Class

Drugs used in the Ano-rectal region.

Generic

Hydrocortisone + Lidocaine

Pharmaceutical Name

Incepta Pharmaceuticals Ltd.