Usage
This combination medication is primarily prescribed for the treatment of hemorrhoids (piles) and anal fissures. It is classified as an anorectal preparation. The components work together to provide anti-inflammatory, analgesic, vasoconstrictive, and skin protectant effects.
Alternate Names
While this combination is not widely recognized by a specific international nonproprietary name (INN), it is often marketed under brand names such as Osil Cream. Some formulations may also include aloe vera.
How It Works
Pharmacodynamics:
- Calcium Dobesilate: This acts as a vasoprotective agent, decreasing capillary permeability and fragility, improving microcirculation, and reducing inflammation and swelling.
- Hydrocortisone: A corticosteroid that exerts anti-inflammatory, antipruritic (anti-itch), and vasoconstrictive effects, reducing redness, swelling, and itching.
- Lidocaine/Lignocaine: A local anesthetic that blocks nerve signals, providing rapid pain relief.
- Allantoin: Promotes wound healing, softens and moisturizes the skin, and stimulates cell regeneration.
- Aloe Vera (in some formulations): Offers additional anti-inflammatory and soothing effects.
Pharmacokinetics:
The combined pharmacokinetic profile of this formulation isn’t extensively documented. However, individual component profiles are known:
- Calcium Dobesilate: Well-absorbed orally, metabolized, and excreted renally.
- Hydrocortisone: Absorbed readily through the skin, metabolized in the liver, and excreted by the kidneys.
- Lidocaine/Lignocaine: Absorbed quickly following topical application, metabolized in the liver, and excreted mainly by the kidneys.
- Allantoin: Metabolized to allantoic acid and excreted in the urine.
Dosage
Standard Dosage
Adults: Apply a thin layer to the affected area two to three times daily. For internal hemorrhoids, use the applicator provided.
Children: Use in children should be under the supervision of a physician.
Special Cases:
- Elderly Patients: Dosage adjustments may be necessary based on individual patient needs and renal/hepatic function.
- Patients with Renal Impairment: Exercise caution and consult a physician for dosage adjustments.
- Patients with Hepatic Dysfunction: Use with caution and consult a physician.
- Patients with Comorbid Conditions: Dosage adjustments may be needed based on specific comorbidities (e.g., diabetes, hypertension). Consult a physician.
Clinical Use Cases
This combination is typically not recommended for clinical scenarios such as intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations.
Side Effects
Common Side Effects:
- Burning sensation at the application site
- Irritation
- Itching
- Redness
Rare but Serious Side Effects:
- Allergic reactions (rash, hives)
- Worsening of inflammation
Long-Term Effects:
Prolonged use of topical corticosteroids can lead to skin atrophy.
Contraindications
- Hypersensitivity to any component of the medication.
- Viral or bacterial infections in the anorectal area.
Drug Interactions
Consult a physician regarding potential drug interactions, especially with anticoagulants, antiplatelets, or other topical medications.
Pregnancy and Breastfeeding
Consult a doctor before using this medication during pregnancy or while breastfeeding. Safety during these periods has not been definitively established.
Drug Profile Summary
- Mechanism of Action: Multifaceted—vasoprotective, anti-inflammatory, analgesic, wound healing.
- Side Effects: Commonly burning, itching, irritation, redness. Rarely allergic reactions.
- Contraindications: Hypersensitivity, anorectal infections.
- Drug Interactions: Consult a physician for specific interactions.
- Pregnancy & Breastfeeding: Consult a doctor before use.
- Dosage: Apply topically 2–3 times daily.
- Monitoring Parameters: Observe for skin reactions, improvement in symptoms, and any signs of adverse effects.
Popular Combinations
This combination itself is a popular formulation for anorectal issues.
Precautions
- Avoid contact with eyes, nose, and mouth.
- Wash hands thoroughly before and after application.
- Report persistent side effects to your physician.
- Avoid prolonged use unless directed by a physician.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Allantoin + Calcium Dobesilate + Hydrocortisone + Lidocaine/Lignocaine?
A: Apply a thin layer to the affected area 2-3 times daily, or as directed by a physician.
Q2: Can this cream be used during pregnancy?
A: Consult a physician before use during pregnancy, as safety has not been fully established.
Q3: How does calcium dobesilate contribute to treating hemorrhoids?
A: It improves blood flow and reduces inflammation by strengthening capillary walls and decreasing their permeability.
Q4: What is the role of lidocaine in this cream?
A: Lidocaine provides local anesthetic action, relieving pain and discomfort associated with hemorrhoids and fissures.
Q5: What should patients do if they experience burning or itching after application?
A: Patients should inform their physician if they experience persistent burning or itching. These can be common side effects, but should be monitored.
Q6: Are there any dietary restrictions while using this cream?
A: While not directly related to the cream’s action, a high-fiber diet and increased water intake can help prevent and alleviate hemorrhoid symptoms.
Q7: Can this cream be used for other skin conditions?
A: This cream is specifically formulated for anorectal use and is not recommended for other skin conditions without consulting a physician.
Q8: What are the potential long-term side effects of this medication?
A: Long-term use, especially due to the hydrocortisone component, can potentially lead to skin thinning (atrophy). Regular monitoring is advised for prolonged use.
Q9: How should this cream be stored?
A: Store the cream at room temperature, away from direct sunlight and excessive heat. Keep out of reach of children.
