Products
Diltiazem ointments are not registered as finished drug products in many countries. However, they can be prepared as an extemporaneous prescription in a pharmacy. Typically, two-percent dosage forms are used (gel, cream, or ointment). There are various manufacturing instructions. For example, white petroleum jelly, Excipial oily ointment, DAC base cream, or a gel base containing hydroxyethylcellulose, water, and propylene glycol can be used as a base.
Structure and properties
Diltiazem (C22H26N2O4S, Mr = 414.52 g/mol) is a benzothiazepine derivative. It is present in drugs as diltiazem hydrochloride, a white, crystalline powder with a bitter taste that is readily soluble in water.
Effects
Diltiazem (ATC C08DB01) exerts local vasodilator, muscle relaxant, and wound-healing properties. The effects are due to inhibition of calcium influx into smooth muscle cells, resulting in relaxation. When used topically, diltiazem reduces sphincter tone of the internal sphincter, improving blood flow and thus promoting healing of the lesion.
Indications for use
For the treatment of anal fissure.
Dosage
According to the doctor’s instructions. The drug is usually applied locally two to three times a day. The duration of treatment is individually about two to three months.
Contraindications and interactions
See under diltiazem (systemic use).
Adverse effects
Systemic adverse effects cannot be ruled out even with topical use. The most common possible adverse effects when taken include slow heartbeat, conduction abnormalities, allergic reactions, rash, poor appetite, edema, flushing, dizziness, headache, fatigue, weakness, and nausea. These side effects are due in part to vasodilatation.
