Euphorbia Prostrata Extract + Lidocaine

Usage

Euphorbia Prostrata Extract + Lidocaine cream is prescribed for the topical management of painful anal fissures and fistulas associated with hemorrhoids (piles). Hemorrhoids are swollen veins in the rectum and anus, while anal fissures are small tears in the lining of the anus. This medication combines the hemostatic and anti-inflammatory properties of Euphorbia Prostrata extract with the local anesthetic action of Lidocaine.

• Pharmacological Classification: This drug is classified as a topical anesthetic and anti-hemorrhoidal agent.

• Mechanism of Action: Euphorbia Prostrata extract helps shrink blood vessels, control bleeding, and reduce inflammation. Lidocaine provides local pain relief by blocking nerve signals.

Alternate Names

While no specific alternate generic names exist, the combination is often referred to as Euphorbia Prostrata + Lidocaine or Euphorbia Prostrata and Lidocaine Cream. Some brand names under which this combination is marketed include Sitcom LD and others.

How It Works

• Pharmacodynamics: Euphorbia Prostrata extract contains flavonoids, phenolic compounds, and tannins which possess anti-inflammatory, analgesic, antioxidant, hemostatic, antithrombotic, wound-healing, and vasoprotective properties. Lidocaine acts by stabilizing the neuronal membrane, inhibiting the ionic fluxes required for the initiation and conduction of nerve impulses. This leads to a decrease in the sensation of pain and itching.

• Pharmacokinetics: Primarily applied topically, the absorption of Euphorbia Prostrata extract and Lidocaine through the rectal mucosa is limited, minimizing systemic exposure. However, some degree of systemic absorption is reported. Specific details on the metabolism and elimination of Euphorbia Prostrata Extract are limited. Lidocaine is metabolized primarily in the liver and excreted by the kidneys.

Dosage

Standard Dosage

Adults:

A small amount of cream should be applied to the affected anal area after each bowel movement, typically for up to 14 days. An applicator may be provided with the cream for administration.

Children:

The safety and efficacy of this medication in children have not been established, and its use is generally avoided in pediatric patients.

Special Cases:

• Elderly Patients: Use with caution.
• Patients with Renal Impairment: Avoid use due to potential complications related to Lidocaine metabolism.
• Patients with Hepatic Dysfunction: Use with caution due to Lidocaine metabolism primarily occurring in the liver.
• Patients with Comorbid Conditions: Use with caution in patients with bleeding disorders. Those on anticoagulants or antiplatelet agents should be closely monitored.

Clinical Use Cases

The primary clinical use case is the topical management of painful anal fissures and fistulas associated with hemorrhoids. Dosage is typically as described above, applied after each bowel movement for a period generally not exceeding two weeks. The use of this combination in settings such as intubation, surgical procedures, mechanical ventilation, or the ICU has not been established.

Dosage Adjustments

Dose adjustments are not generally recommended, as the medication is applied topically. However, caution is warranted in patients with hepatic or renal dysfunction and those using anticoagulants.

Side Effects

Common Side Effects

Burning or stinging sensation at the application site and redness are common side effects.

Rare but Serious Side Effects

Allergic reactions are possible, though rare. Symptoms may include rash, itching, shortness of breath, or swelling of the face, lips, tongue, or throat. Methemoglobinemia has been reported with Lidocaine use, particularly in susceptible individuals.

Long-Term Effects

Long-term effects are not well documented. Chronic complications from prolonged use are unlikely due to limited systemic absorption. However, continuous use beyond the recommended duration is discouraged.

Adverse Drug Reactions (ADR)

Severe allergic reactions require immediate medical attention. Methemoglobinemia necessitates prompt intervention.

Contraindications

• Hypersensitivity to Euphorbia Prostrata, Lidocaine, or any component of the formulation.
• Bleeding disorders.
• Pregnancy and lactation.
• Severe hepatic or renal impairment.
• Children.

Drug Interactions

• Limited data on drug interactions for topical application are available.
• Potential interactions with anticoagulants exist, so caution is advisable.
• Inform your doctor about all concomitant medications, including OTC drugs and supplements.

Pregnancy and Breastfeeding

The safety of this drug during pregnancy and breastfeeding has not been established. Its use is contraindicated in these populations.

Drug Profile Summary

• Mechanism of Action: Euphorbia Prostrata extract provides hemostatic, anti-inflammatory, and wound-healing effects. Lidocaine offers local anesthetic action.
• Side Effects: Burning, stinging, redness at the application site, rare allergic reactions.
• Contraindications: Hypersensitivity, bleeding disorders, pregnancy, lactation.
• Drug Interactions: Potential interactions with anticoagulants.
• Pregnancy & Breastfeeding: Contraindicated.
• Dosage: Topical application after bowel movements for up to 14 days.
• Monitoring Parameters: Observe for local skin reactions and signs of allergic reactions.

Popular Combinations

This combination is usually prescribed as a fixed-dose combination product. The oral form of Euphorbia Prostrata extract is sometimes combined with Calcium Dobesilate for treating hemorrhoids.

Precautions

• Screen for allergies and contraindications before initiating treatment.
• Advise pregnant and breastfeeding women to avoid the drug.
• Exercise caution in children and the elderly.
• Instruct patients on proper application and hygiene practices.
• Limit alcohol consumption, as interaction data are limited.

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage for Euphorbia Prostrata Extract + Lidocaine?

A: Apply a small quantity of cream to the affected area after each bowel movement, generally for up to 14 days.

Q2: Can I use this cream if I am pregnant or breastfeeding?

A: No, this cream is contraindicated during pregnancy and lactation due to safety concerns.

Q3: What are the common side effects of this medication?

A: Common side effects are generally mild and limited to the application site, including burning, stinging, and redness.

Q4: Are there any drug interactions I should be aware of?

A: While data are limited, caution is advised when using this medication with anticoagulant or antiplatelet drugs.

Q5: What should I do if my symptoms worsen or don’t improve after two weeks?

A: Consult a doctor if your symptoms persist or worsen despite treatment.

Q6: Can this cream be used in children?

A: No, its use is generally avoided in children as safety and efficacy haven’t been established in this age group.

Q7: Can I use this cream if I have liver or kidney problems?

A: Use with caution in patients with hepatic impairment and avoid it in patients with severe renal issues.

Q8: What should I do if I accidentally get the cream in my eyes?

A: Immediately rinse the eyes thoroughly with water for at least 15 minutes and seek medical advice.

Q9: Can I swallow the cream?

A: No, this cream is strictly for external rectal application only. Do not ingest.