NHS Herefordshire Clinical Commissioning Group
Wye Valley NHS Trust

1 Gastro-intestinal system

PPI Guidance

01-07-04 Management of anal fissures

Diltiazem Cream 2%

This is an unlicensed preparation. Prescribe by brand in primary care (Anoheal® or Neozem®) – see specials guidance

Amber View adult BNF  View SPC online  View childrens BNF
Glyceryl Trinitrate 0.4% Rectogesic®

Licensed for pain relief in chroic anal fissure.

Also approved for off-label indication: application to breast flaps following reconstructive surgery to prevent mastectomy skin flap necrosis

Green View adult BNF  View SPC online  View childrens BNF