Dobesil-LD
Generic Name
Calcium Dobesilate + Lidocaine Hydrochloride Rectal Ointment
Manufacturer
Example Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| dobesil ld 4 2 rectal ointment | ৳ 170.00 | N/A |
Description
Overview of the medicine
Dobesil-LD Rectal Ointment is a combination medication used for the local treatment of haemorrhoids and anal fissures. It contains Calcium Dobesilate, which helps improve capillary resistance and reduce permeability, and Lidocaine Hydrochloride, a local anaesthetic that provides rapid relief from pain, itching, and discomfort.
Uses & Indications
Dosage
Adults
Apply 2-3 times daily, preferably after each bowel movement, to the affected area. For internal haemorrhoids, use the provided applicator.
Elderly
No specific dose adjustment is generally required, but caution is advised in patients with severe hepatic or renal impairment.
Renal_impairment
Use with caution. If systemic absorption occurs, accumulation of Lidocaine metabolites may be a concern in severe renal impairment.
How to Take
For external use, apply a small amount of ointment to the affected perianal area. For internal use, attach the applicator to the tube, insert gently into the rectum, and squeeze the tube to deliver the ointment. Wash hands thoroughly before and after application. Clean the affected area gently before applying.
Mechanism of Action
Calcium Dobesilate acts by normalizing pathological permeability of capillaries, inhibiting hyaluronidase, and increasing capillary resistance. It also exhibits venotonic and anti-inflammatory properties. Lidocaine Hydrochloride, a local anaesthetic, works by blocking voltage-gated sodium channels in neuronal membranes, thereby preventing the initiation and conduction of nerve impulses, leading to local analgesia.
Pharmacokinetics
Onset
Lidocaine: Rapid onset (within 2-5 minutes) of anaesthetic effect.
Excretion
Lidocaine: Metabolites and less than 10% unchanged drug are excreted via the kidneys. Calcium Dobesilate: Primarily excreted unchanged via the kidneys.
Half life
Lidocaine: Approximately 1.5-2 hours (systemic). Calcium Dobesilate: Not well characterized for rectal application; orally, it's about 5 hours.
Absorption
Following rectal application, systemic absorption of Calcium Dobesilate is minimal but may vary. Lidocaine is generally well absorbed from mucous membranes, but systemic absorption from rectal application can be low, though higher than skin. Peak plasma concentrations of Lidocaine occur within minutes to hours depending on the site of application and vascularity.
Metabolism
Lidocaine: Primarily metabolized in the liver by oxidative N-dealkylation to monoethylglycinexylidide (MEGX) and glycinexylidide (GX), which are also active. Calcium Dobesilate: Limited metabolism.
Side Effects
Contraindications
- Hypersensitivity to Calcium Dobesilate, Lidocaine, or any other components of the ointment.
- Patients with severe renal impairment (especially with large or frequent applications due to potential for systemic absorption of Lidocaine).
Drug Interactions
Antiarrhythmics
Concomitant use with other local anaesthetics or Class I antiarrhythmic drugs may have additive cardiac effects.
Beta-blockers/Cimetidine
May reduce the hepatic metabolism of lidocaine, leading to increased systemic concentrations and potential toxicity if significant absorption occurs.
Storage
Store below 30°C, in a cool and dry place. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose is unlikely with proper topical application. If accidentally ingested or excessive amounts are applied leading to significant systemic absorption, symptoms of lidocaine toxicity (e.g., CNS excitation followed by depression, cardiovascular depression) or mild gastrointestinal disturbances from Calcium Dobesilate may occur. Treatment is supportive and symptomatic.
Pregnancy & Lactation
Use during pregnancy and lactation should only be considered if the potential benefit outweighs the potential risk to the fetus or infant. Consult a doctor before use.
Side Effects
Contraindications
- Hypersensitivity to Calcium Dobesilate, Lidocaine, or any other components of the ointment.
- Patients with severe renal impairment (especially with large or frequent applications due to potential for systemic absorption of Lidocaine).
Drug Interactions
Antiarrhythmics
Concomitant use with other local anaesthetics or Class I antiarrhythmic drugs may have additive cardiac effects.
Beta-blockers/Cimetidine
May reduce the hepatic metabolism of lidocaine, leading to increased systemic concentrations and potential toxicity if significant absorption occurs.
Storage
Store below 30°C, in a cool and dry place. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose is unlikely with proper topical application. If accidentally ingested or excessive amounts are applied leading to significant systemic absorption, symptoms of lidocaine toxicity (e.g., CNS excitation followed by depression, cardiovascular depression) or mild gastrointestinal disturbances from Calcium Dobesilate may occur. Treatment is supportive and symptomatic.
Pregnancy & Lactation
Use during pregnancy and lactation should only be considered if the potential benefit outweighs the potential risk to the fetus or infant. Consult a doctor before use.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date.
Availability
Available in pharmacies nationwide
Approval Status
Approved
Patent Status
Generic
Clinical Trials
Clinical trials have demonstrated the efficacy of Calcium Dobesilate and Lidocaine in reducing symptoms of haemorrhoids and anal fissures. Data on this specific combination product's trials may be available from the manufacturer.
Lab Monitoring
- Routine lab monitoring is not typically required for topical rectal application.
Doctor Notes
- Advise patients on proper hygiene and dietary measures to prevent recurrence.
- Caution against prolonged use (>7 days) without re-evaluation.
- Differentiate between simple haemorrhoids/fissures and more serious anorectal conditions.
Patient Guidelines
- Read the leaflet carefully before use.
- Use only as directed by your doctor or pharmacist.
- Do not exceed the recommended dose or duration of treatment.
- Consult a doctor if symptoms persist or worsen after 7 days of treatment.
- Maintain good personal hygiene, especially in the anal area.
Missed Dose Advice
If you miss a dose, apply it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not apply a double dose to make up for a missed one.
Driving Precautions
Dobesil-LD Rectal Ointment is not expected to affect the ability to drive or operate machinery, as systemic absorption is generally minimal.
Lifestyle Advice
- Increase dietary fiber intake (fruits, vegetables, whole grains) and drink plenty of fluids to prevent constipation.
- Avoid straining during bowel movements.
- Take warm sitz baths to relieve discomfort.
- Avoid prolonged sitting or standing.
- Regular physical activity can help improve bowel regularity.
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