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Anotop

Anotop is a cream for anal use.

Anotop

Anotop is a cream for anal use. The active ingredient diltiazem hydrochloride is a calcium antagonist, a medicine that relaxes the muscle around the anus to increase blood flow to the anal area. This reduces the symptoms of anal fissures, such as pain and itching.

Table of contents

What is Anotop?

When is Anotop used?

How is Anotop used?

What doses are available?

What are the side effects of Anotop?

When not to use Anotop?

Can Anotop be used in combination with other medicines?

Where can I buy Anotop?

Can I buy Anotop without a prescription?

Sources

What is Anotop?

Anotop is a medicine for use in the anal area. The active ingredient diltiazem hydrochloride works by relaxing the muscle around the anus. This reduces pressure and increases blood flow to the area, which allows small cuts or tears in the lining of the anus to heal.

When is Anotop used?

Anotop cream is used to treat anal fissures, tears in the skin at the end of the anal canal (back passage). Symptoms of anal fissures include:

  • Pain.
  • Burning sensation.
  • Itching.
  • Bleeding during or after bowel movements.
  • Cramping of the anal sphincter (due to pain).

The above-mentioned symptoms tend to worsen during or after bowel movements.

Anal fissures can be caused by constipation. Passing hard stools or straining to pass stools can tear the tissue around the anus. Inflammatory bowel diseases like Crohn’s disease or anal sex can also cause splits or tears at the end of the anal canal.

Here are some tips to treat anal fissures caused by constipation:

  • Try to avoid constipation and use the toilet when you feel the need.
  • Do not strain to pass a stool.
  • Gently clean yourself using soft toilet paper or a damp wash cloth. Or rinse with lukewarm water. Avoid using wet toilet paper as this will irritate the skin.
  • Do not scratch.
  • Wear cotton underwear.
  • Make lifestyle changes to prevent constipation. Drink plenty of fluids, eat fibre-rich foods and get into an exercise routine.

Fissures that last for more than a few weeks (chronic fissures) can be treated with Anotop. Anotop cream reduces pressure on the fissures and relaxes the muscle around the anus. This helps relieve the pain. Anotop also widens the blood vessels to increase blood flow to the area to promote healing.

How is Anotop used?

This medicine should be used as directed by a doctor. The general guidelines for use are as follows:

  • Use the cream twice daily (morning and evening).
  • Apply just inside and around the anus. A finger covering such as a disposable glove or finger cot may be used to apply the cream (you can get finger cots from a local pharmacy). Wash your hands before and after you use the cream to ensure hygiene is maintained.
  • Do not stop using the cream until the symptoms have cleared up. In most cases, the pain will reduce within two weeks. However, it can take six weeks up to three months for the fissures to heal completely.
  • Consult a doctor if your symptoms have not resolved after eight weeks.
  • If you have forgotten to apply a dose of the cream, you can skip the missed dose and proceed to the upcoming dose.
  • Be careful about drinking alcohol as the cream may affect you more than usual.
  • Stay out of traffic if you experience side effects that make you feel less alert than normal (e.g. dizziness).
  • Anotop cream has a limited shelf life. Do not use the cream after four weeks of opening or after the expiry date on the tube, whichever comes first.

See the package leaflet for more information on the use of this medicine.

What doses are available?

One gram of Anotop cream contains 20 mg diltiazem hydrochloride. General guidelines for use are listed below.

  • Adults: apply a dose of 2.5 cm of the cream (about a fingertip) twice daily in and around the anus.

Anotop is not suitable for children under the age of 18. Read the package leaflet before use.

What are the side effects of Anotop?

Like all medicines Anotop cream may cause side effects, although it is generally well tolerated. The most common side effects that are known to be associated with this medicine include:

  • Irritation in and around the anus (e.g. burning sensation or itching).

  • Dizziness and headache (these side effects are rare and usually disappear once the body adjusts to the use of the medicine).

If the side effects are severe or persistent, consult a doctor. For a complete list of possible side effects, see the package leaflet.

When not to use Anotop?

This medicine is not suitable for everyone. Do not use Anotop if:

  • You are allergic to diltiazem or any other ingredient in this medicine.

  • You have low blood pressure.

  • You have a slow or irregular heartbeat.

  • You suffer from heart failure.

Do you have liver or kidney problems? Then this medicine should be used with caution. Consult a doctor before using Anotop cream.

This medicine is not recommended if you are pregnant, breastfeeding or trying to conceive. Consult a doctor about prescribing an alternative medicine.

For more information on this subject, see the package leaflet.

Can Anotop be used in combination with other medicines?

Some medicines may interfere with the effectiveness of other medicines (drug interaction). The following medicines may interact with Anotop:

  • Dantrolene (a muscle relaxant).

  • Certain blood pressure or heart medications, such as beta blockers, diuretics or ACE inhibitors.

  • Medications that reduce heart rate or blood pressure.

  • Lithium (mood stabiliser medication).

  • Theophylline (asthma medication).

  • Nitrate medication (e.g. nitroglycerin for angina pectoris).

If you are using one of the above-listed medicines, consult a doctor on the use of Anotop to make sure the combination is safe. For more information on interactions, see the package leaflet.

Where can I buy Anotop?

Anotop is only available at pharmacies or online pharmacies.

Can I buy Anotop without a prescription?

Anotop is a prescription-only medicine. This means you need a prescription from a registered doctor to obtain it.

Sources

Royal Dutch Pharmaceutical Society. (2019, 11 September). Topical use of diltiazem. Apotheek.nl. Consulted on 24 July 2020 on https://www.apotheek.nl/medicijnen/diltiazem-op-de-huid#!

Dutch Digestive Diseases Foundation. (n.d.). Anal fissure. Consulted on 24 July 2020 on https://www.mlds.nl/ziekten/anaal-fissuur/

SLA Pharma. (n.d.). Anotop 20 mg/g cream - package leaflet. SLA. Consulted on 24 July 2020 on https://www.slapharma.com/unlicensed-medicines/pharmacist-info/anotop-pharmacist-information/

Dutch National Health Care Institute. (n.d.). Diltiazem (for treatment of anal fissures). FK Online. Consulted on 24 July 2020 on https://www.farmacotherapeutischkompas.nl/bladeren/preparaatteksten/d/diltiazem__bij_anale_fissuur_#samenstelling

Patient Leaflet(s)
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