Phenylephrine/Pramoxine/Glycerin/Petrolatum Rectal

Phenylephrine/pramoxine/glycerin/petrolatum rectal is a combination rectal ointment used for temporary relief of pain, soreness, and burning from hemorrhoids and to reduce pain and discomfort during bowel movements. Phenylephrine shrinks hemorrhoids, reduces inflammation, and pramoxine numbs the area for temporary pain relief. Glycerin acts as a stool softener and laxative, while petrolatum provides moisturizing and lubricating effects.

The four components of this drug work as follows:

• Phenylephrine is an alpha1 agonist that stimulates alpha1 receptors, causing the muscles around blood vessels to contract. This constricts blood vessels locally, reducing inflammation and shrinking hemorrhoids.
• Pramoxine is a local anesthetic that relieves pain and itching by inhibiting the conduction of pain signals in the application area.
• Glycerin is a sugar alcohol compound that acts as an osmotic laxative, drawing water into the colon and softening the stools for easier passage.
• Petrolatum is a purified lubricating substance that provides moisturizing and lubricating effects.

The combination ointment, also known as Preparation H, is available over the counter (OTC). Other Preparation H products include ointments, gels, and suppositories formulated in various combinations with phenylephrine and other substances.

Warnings

• Do not use phenylephrine/pramoxine/glycerin/petrolatum rectal if you are hypersensitive to any component of the formulation.
• Check with your physician before using if you have any of the following conditions: heart disease, high blood pressure (hypertension), diabetes, thyroid disease, or prostate gland enlargement and associated urinary problems.

Side Effects

Common side effects include mild pain or stinging if the hemorrhoid is bleeding and allergic reactions. Contact your doctor immediately if you experience serious symptoms or side effects such as fast or pounding heartbeats, severe headache, confusion, slurred speech, severe weakness, or serious eye symptoms.

Dosages

Rectal ointment: 0.25%/1%/14.4%/15%

For hemorrhoids, use as directed depending on age. Apply externally or in the lower portion of the anal canal up to 4 times a day, especially at night, in the morning, or after bowel movements that may exacerbate hemorrhoids.

Administration

• For application in the lower anal canal, remove cover from dispensing cap and attach it to the tube.
• For intrarectal use, remove cover from applicator, attach it to the ointment tube, and gently insert it into the rectum.

Overdose is unlikely but swallowing the product is likely to be harmful.

Drug Interactions

Inform your doctor of all medications you are currently taking to check for possible interactions. Avoid severe interactions with phenylephrine/pramoxine/glycerin/petrolatum rectal, including ergot derivatives, iobenguane radiopharmaceutical products, kratom, lisuride, and monoamine oxidase inhibitors. For more information on drug interactions, consult the RxList Drug Interaction Checker.

Always inform your doctor of all medications you use and their dosages and follow their recommendations.

Pregnancy and Breastfeeding

• Use phenylephrine/pramoxine/glycerin/petrolatum rectal during pregnancy only if necessary and the benefits outweigh potential risks to the fetus.
• It is unknown if the drug is present in breastmilk. Check with your healthcare provider before using if you are nursing.
• Consult your healthcare provider before using any OTC product, including this drug, if pregnant or breastfeeding.

Additional Information

• Use as directed.
• Preparation H is for external use only. Follow application directions and use the provided applicator.
• Do not exceed the recommended dosage without your physician’s instruction.
• Contact your physician if you develop an allergic reaction, experience bleeding, or if your condition does not improve within 7 days or worsens.

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Summary

Phenylephrine/pramoxine/glycerin/petrolatum rectal is a combination rectal ointment used for temporary relief of pain, soreness, and burning from hemorrhoids and to reduce pain and discomfort during bowel movements. It works by shrinking hemorrhoids, numbing the area, softening the stools, and providing moisturizing effects. Common side effects include mild pain or stinging if the hemorrhoid is bleeding and allergic reactions. Consult your doctor if pregnant or breastfeeding.