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Common name
Proctosedyl (cinchocaine hydrochloride and hydrocortisone)
Description
Proctosedyl (cinchocaine hydrochloride and hydrocortisone) is supplied as suppositories or as an odourless yellowish-white translucent greasy ointment. Each suppository or gram of ointment contains cinchocaine hydrochloride BP 5mg, hydrocortisone BP 5mg. The rationale of the combination is to combine the local anaesthetic, analgesic and spasmolytic effect of cinchocaine with the antipruritic and anti-inflammatory action of hydrocortisone. These ingredients are presented in emollient vehicles. Cinchocaine hydrochloride is a potent local anaesthetic agent with anti-pyretic properties resulting from its inhibition of the transmission of nerve impulses. It is recognised as being one of the longest acting of those agents commonly employed. It is included in PROCTOSEDYL for the relief of pain and spasm. Topical corticosteroids have anti-inflammatory, anti-pruritic and vasoconstrictive actions. Hydrocortisone is a low potency glucocorticoid which is safe and effective as a topical anti-inflammatory drug in the concentration employed in PROCTOSEDYL.
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Active Ingredients:
cinchocaine hydrochloride and hydrocortisone
Therapeutic actions:
Hydrocortisone
The principle pharmacological actions of hydrocortisone are on gluconeogensis, glycogen deposition, protein and calcium metabolism and inhibition of corticotrophin secretion and anti-inflammatory activity (glucocorticoid actions). When applied topically hydrocortisone causes reduction of inflammation, pruritus and exudation in disorders of the skin and perianal region.
Cinchocaine hydrochloride
Cinchocaine hydrochloride is a local anaesthetic agent and is suitable for surface or spinal anaesthesia and for relaxing sphincteric spasms. It is an anaesthetic of the amide type. It is more toxic than cocaine by local application but its local anaesthetic action is greater so it can be used in lower concentrations. Its action is more prolonged than lignocaine. Surface or topical anaesthetics such as cinchocaine block the sensory nerve endings in the skin preventing transmissions of impulses along the nerve fibres and inhibiting depolarisation and ion-exchange. These effects are reversible. Before this blocking action can occur the lipid soluble anaesthetic base must penetrate the lipoprotein nerve sheath and the effectiveness of the anaesthetic depends on the concentration attained in the nerve fibre. The onset of action varies depending on the anaesthetic used. Cinchocaine has a rapid onset of action and is also long lasting.
What is it used for?:
(Indications:)
For symptomatic relief of external and internal haemorrhoids, anal pruritus, anal fissure. Pre and post-operative treatment of haemorrhoidectomy patients. Post-partum haemorrhoidal conditions. Non-infective proctitis.
Contraindications and cautions
Hypersensitivity to hydrocortisone or cinchocaine. All steroid preparations are contraindicated in uncontrolled infections, viral infections (eg. herpes simplex, herpes zoster and vaccinia), and when infective pathologies of sexually transmissible diseases occur in the area to be treated. When fungal infection is present additional therapy with a topical antimycotic should be instituted. In tuberculosis the use of steroids may exacerbate the disease process.
PRECAUTIONS
As with all preparations containing topical corticosteroids, the possibility of systemic absorption should be considered. Hydrocortisone is systemically bioavailable from suppositories applied to the rectum. Absorption of hydrocortisone may be increased across abraded or inflamed surfaces. Long-term continuous therapy should be avoided. Except on medical advice, the maximum duration of therapy with these products should not exceed that recommended (see DOSAGE AND ADMINISTRATION). If treatment is required beyond seven days, the patient should be advised to consult a physician for assessment of the condition. This may include a proctological examination. Discontinue use if sensitisation occurs. Specific measures against infections, allergy and other causal factors must not be neglected.
Side effects - Proctosedyl (cinchocaine hydrochloride and hydrocortisone):
Certain patients may experience burning upon application, especially if the mucous membrane is not intact.
Interactions:
No interactions with other medicines have been identified
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