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What Are the Uses of Diltiazem Cream?

By Maggie J. Hall
Updated Mar 03, 2024
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Doctors prescribe diltiazem cream as a topical preparation for the treatment of anal fissures and for patients who have undergone hemorrhoid surgery. Other uses of diltiazem, sometimes marketed as nifedipine, include taking the medication in oral tablet form for the treatment of angina, hypertension, atrial fibrillation, and ventricular tachycardia. Patients experience fewer side effects from diltiazem cream than from other forms of the medication.

Anal fissures occur when the external anal surface cracks or tears. The tissue trauma generally occurs with constipation straining and passing hard stools. The irritation associated with diarrhea can also give rise to the condition, however. Individuals with fissures experience bleeding, itching, and moderate to severe pain. Before the introduction of diltiazem cream, physicians often prescribed topical glyceryl trinitrate, also known as nitroglycerin.

Diltiazem belongs to a group of medications known as calcium channel blockers. The formulation acts by inhibiting calcium ions from entering membranes. This causes muscular and vascular tissues to relax, dilating blood vessels and preventing muscular spasms. The reduction of painful spasms and increased blood flow to the area can then allow fissures to heal. Physicians in England developed the treatment, which gained acceptance in Australia and finally in the United States.

Using a glove or cellophane finger cot, patients typically apply a pea-sized amount of the 2% diltiazem cream to the external anal area twice daily for up to 12 weeks. Physicians may prescribe larger amounts of up to one inch (2.5 cm) when having patients apply the cream or ointment both externally and internally. The topical diltiazem dosage is less than one-tenth the amount commonly prescribed in oral form. Physicians recommend that patients wash their hands thoroughly following application, to prevent further skin absorption and additive effects.

More than one course of treatment may be required before healing occurs. Peri-anal itching or burning is the most common adverse reaction associated with diltiazem cream and may occur in up to 10% of the patients being treated. Other common side effects of diltiazem cream are headaches and dizziness. The dizziness occurs mainly when changing positions abruptly.

Patients should inform physicians of all current medications to prevent possible diltiazem drug interactions with other cardiac or hypertensive medications. Physicians generally recommend that patients suffering from chronic constipation increase daily amounts dietary fiber and water. Other treatments for anal fissure include botulinum injections or surgical repair.

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Discussion Comments
By anon954730 — On Jun 03, 2014

I just started using diltiazem cream and and was such a help, with no side effects as itching or burning. Hopefully it will help to avoid further actions like botox or surgery for my fissure.

By anon947293 — On Apr 24, 2014

I have been using diltiazem cream for about a week, and sometimes I feel as if there is a knot near my rectal opening, or a tightening of the anal sphincter while using the cream. I have also noticed a medium grade of itching in my lower area of my buttocks after applying this cream. By the way, my pharmacist was not very talkative about using this cream in front of his colleagues, and my doctor said apply it to your anal verge. What exactly is a verge? --Karimdsl

By literally45 — On Jan 11, 2014

@ddljohn-- Itching is a very common side effect of diltiazem cream. But if the itching is severe and constant, and if you also develop a rash, you might be allergic. You need to tell your doctor immediately in that case.

I'm allergic to diltiazem. When I first started using it, I had itching but my doctor had warned me about it so I didn't get worried. But within days, the itching got worse and I also developed a rash. When I told my doctor about it, he asked me to stop using the cream. He prescribed me a different cream for anal fissures and I had no problems with that cream.

So if the itching is mild, then don't worry. But if it's severe, call your doctor.

By burcidi — On Jan 11, 2014

Diltiazem cream is a great medication. I needed to get hemorrhoids surgery but I could not until my fissure healed and the bleeding stopped. So my doctor had me use this cream for several months. I would do hot soaks every day and follow up with this cream. My fissure healed and I was able to get surgery. I have been pain free for over six months now. I'm so glad that this cream exists.

By ddljohn — On Jan 10, 2014

My doctor prescribed me diltiazem cream for a fissure. I think it's working but it causes a lot of itching. Sometimes the itching from the cream is more bothersome than the fissure pain.

Is anyone else using diltiazem cream and experiencing itching?

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