Vasoproct
Generic Name
Lidocaine Hydrochloride and Hydrocortisone Acetate Rectal Ointment
Manufacturer
MediCorp Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| vasoproct 4 2 rectal ointment | ৳ 170.00 | N/A |
Description
Overview of the medicine
Vasoproct-4-2 Rectal Ointment is a combination medication containing a local anesthetic (Lidocaine Hydrochloride) and a corticosteroid (Hydrocortisone Acetate). It is used to relieve pain, itching, swelling, and discomfort associated with various anorectal conditions such as hemorrhoids, anal fissures, and proctitis.
Uses & Indications
Dosage
Adults
Apply a small amount of ointment to the affected anorectal area 2-3 times daily, preferably after bowel movements. For internal application, use the provided applicator.
Elderly
Same as adults. Use with caution, especially if there are significant systemic absorption risks (e.g., large areas, broken skin) or compromised renal/hepatic function.
Renal_impairment
Use with caution. Systemic absorption of Lidocaine can be significant, potentially leading to accumulation. Monitor closely for adverse effects, especially with severe impairment.
How to Take
For external rectal use only. Clean the affected area gently with mild soap and water, then dry thoroughly before applying the ointment. For internal hemorrhoids, attach the applicator to the tube and insert it gently into the rectum. Apply a thin layer of ointment. Wash hands thoroughly before and after application.
Mechanism of Action
Lidocaine acts as a local anesthetic by stabilizing the neuronal membrane and inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby producing local anesthesia. Hydrocortisone, a corticosteroid, reduces inflammation, itching, and swelling by inhibiting the release of various inflammatory mediators.
Pharmacokinetics
Onset
Lidocaine: within minutes for local anesthetic effect. Hydrocortisone: anti-inflammatory effects usually onset within hours, full effect within days.
Excretion
Lidocaine and its metabolites are excreted predominantly by the kidneys. Hydrocortisone and its metabolites are excreted mainly via the kidneys.
Half life
Lidocaine (systemic): Approximately 1.5-2 hours. Hydrocortisone (systemic): Approximately 1.5-2 hours, though topical activity duration is much longer.
Absorption
Systemic absorption of Lidocaine can occur through mucous membranes or broken skin, especially with large doses or prolonged use. Hydrocortisone topical absorption is minimal but can increase with inflammation, damaged skin, or occlusive dressings.
Metabolism
Lidocaine is extensively metabolized in the liver by CYP450 enzymes. Hydrocortisone is primarily metabolized in the liver.
Side Effects
Contraindications
- Hypersensitivity to Lidocaine, Hydrocortisone, or any other component of the formulation.
- Viral, fungal, or tubercular lesions of the skin in the treatment area.
- Perforated eardrum.
- Infections not controlled by anti-infective therapy.
Drug Interactions
Class I Antiarrhythmics
Caution with antiarrhythmic drugs like Mexiletine or Tocainide, as their systemic effects may be additive with Lidocaine.
Other Local Anesthetics
Concurrent use of other local anesthetics may increase the risk of systemic toxicity (e.g., CNS or cardiovascular effects).
Corticosteroid Inducers/Inhibitors
Drugs affecting hepatic metabolism (e.g., CYP3A4 inducers like Phenobarbital, Rifampicin; or inhibitors like Ketoconazole, Ritonavir) may alter systemic corticosteroid levels, though minimal with topical use.
Storage
Store below 30°C in a dry place, protected from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Overdose from topical application is rare but can occur with excessive use over large areas or broken skin, leading to systemic absorption. Symptoms of Lidocaine toxicity include CNS effects (dizziness, drowsiness, convulsions) and cardiovascular effects (bradycardia, hypotension). Systemic corticosteroid effects (e.g., Cushing's syndrome, adrenal suppression) can occur with prolonged, extensive use. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Use during pregnancy or lactation should only be considered if the potential benefit outweighs the potential risk to the fetus or infant. Consult a healthcare professional before use. Avoid prolonged or extensive use.
Side Effects
Contraindications
- Hypersensitivity to Lidocaine, Hydrocortisone, or any other component of the formulation.
- Viral, fungal, or tubercular lesions of the skin in the treatment area.
- Perforated eardrum.
- Infections not controlled by anti-infective therapy.
Drug Interactions
Class I Antiarrhythmics
Caution with antiarrhythmic drugs like Mexiletine or Tocainide, as their systemic effects may be additive with Lidocaine.
Other Local Anesthetics
Concurrent use of other local anesthetics may increase the risk of systemic toxicity (e.g., CNS or cardiovascular effects).
Corticosteroid Inducers/Inhibitors
Drugs affecting hepatic metabolism (e.g., CYP3A4 inducers like Phenobarbital, Rifampicin; or inhibitors like Ketoconazole, Ritonavir) may alter systemic corticosteroid levels, though minimal with topical use.
Storage
Store below 30°C in a dry place, protected from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Overdose from topical application is rare but can occur with excessive use over large areas or broken skin, leading to systemic absorption. Symptoms of Lidocaine toxicity include CNS effects (dizziness, drowsiness, convulsions) and cardiovascular effects (bradycardia, hypotension). Systemic corticosteroid effects (e.g., Cushing's syndrome, adrenal suppression) can occur with prolonged, extensive use. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Use during pregnancy or lactation should only be considered if the potential benefit outweighs the potential risk to the fetus or infant. Consult a healthcare professional before use. Avoid prolonged or extensive use.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture, when stored as recommended.
Availability
Pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Generic available
Clinical Trials
Clinical trials have demonstrated the efficacy and safety of Lidocaine and Hydrocortisone combination in reducing symptoms of hemorrhoids and other anorectal conditions. Specific data for 'Vasoproct-4-2' would be available from the manufacturer.
Lab Monitoring
- Not routinely required for typical topical use. In cases of prolonged, extensive use, especially in children or compromised patients, monitor for signs of systemic corticosteroid absorption (e.g., plasma cortisol levels) or Lidocaine toxicity (e.g., Lidocaine blood levels if suspected).
Doctor Notes
- Emphasize to patients the importance of limiting the duration of treatment to avoid local and systemic side effects, particularly corticosteroid-induced skin changes.
- Advise on non-pharmacological measures like dietary fiber, hydration, and sitz baths to manage underlying anorectal conditions.
- Monitor for signs of infection or severe irritation, and advise discontinuation if these occur.
Patient Guidelines
- Do not use this ointment for more than 7 consecutive days without consulting your doctor.
- Avoid contact with eyes. If contact occurs, rinse thoroughly with water.
- Do not swallow the ointment.
- Discontinue use if irritation or sensitization develops.
- Do not apply to open wounds or infected areas without medical advice.
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 double the dose to catch up.
Driving Precautions
Vasoproct-4-2 Rectal Ointment is not expected to affect the ability to drive or operate machinery, as systemic absorption is minimal.
Lifestyle Advice
- Maintain good anal hygiene.
- Avoid straining during bowel movements to prevent exacerbation of hemorrhoids.
- Increase dietary fiber intake and drink plenty of water to ensure soft stools.
- Avoid prolonged sitting or standing.
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