Anacaine HC Cream

Indications

Hydrocortisone and Lidocaine cream provides effective anti-inflammatory and anesthetic relief for conditions affecting the anal area. It is particularly beneficial for alleviating itching, pain, soreness, and discomfort associated with hemorrhoids, anal fissures, and pruritus ani.
Always use this medication as directed by a registered healthcare professional.

Pharmacology

Hydrocortisone is a corticosteroid known for its anti-inflammatory and immunosuppressive properties. Its mechanism involves reducing the migration of polymorphonuclear leukocytes and reversing increased capillary permeability, which helps diminish inflammation. Additionally, it may serve as a replacement therapy for adrenocortical insufficiency.

Lidocaine, an amide-type local anesthetic, works by stabilizing neuronal membranes and inhibiting sodium ion movements essential for nerve impulse conduction. In cardiac tissues, lidocaine decreases ventricular depolarization during diastole and lowers automaticity in the His-Purkinje system, thus shortening the duration of the action potential and the effective refractory period.

Dosage & Administration

Apply a thin layer of the cream around the anal opening twice daily using an applicator.
Always use this medication as directed by a registered healthcare professional.

Interaction

Caution is advised when using this cream alongside dental injection anesthetics, other local anesthetics, or amide-type related agents (e.g., antiarrhythmic drugs like mexiletine), as the toxic effects may be additive.

Patients on class III antiarrhythmic medications (e.g., amiodarone) should be monitored closely, and ECG monitoring may be warranted due to potential additive cardiac effects.

Drugs that inhibit lidocaine metabolism (such as cimetidine or beta-blockers) can lead to potentially toxic plasma levels, especially when lidocaine is administered repeatedly in high doses over an extended period. However, such interactions are generally insignificant during short-term treatment with recommended doses of lidocaine.

Contraindications

This cream is contraindicated for individuals with a known hypersensitivity to any of its components.

Side Effects

Potential side effects may include:

• Rectal bleeding
• Skin swelling
• Adrenal suppression
• Anaphylaxis
• Angioedema
• Cushing syndrome
• Hirsutism
• Acne
• Cutaneous and subcutaneous atrophy
• Dry, scaly skin
• Urticaria

Pregnancy & Lactation

Pregnancy Category C: Animal studies indicate adverse effects on the fetus, and there are no adequate, well-controlled human studies. Nevertheless, the potential benefits may justify the use of this medication in pregnant women despite the associated risks.

Lactation: It is unknown whether this medication is excreted in breast milk; therefore, caution is advised.

Precautions & Warnings

When treating extensive areas, systemic absorption may occur. The systemic absorption of topical steroids can lead to reversible suppression of the hypothalamic-pituitary-adrenal (HPA) axis, symptoms of Cushing’s syndrome, hyperglycemia, and glycosuria in some patients. If irritation, sensitivity, or signs of infection develop, discontinue use and seek appropriate medical treatment.

Therapeutic Class

Medications utilized in the ano-rectal region.