Related guidance:

Haemorrhoids (CKS July 2021)

Haemorrhoids: treatment during pregnancy (SPS January 2022)

Therapeutic AreaFormulary ChoicesCost for 28
(unless otherwise stated)
Rationale for decision / comments
Antiseptic, astringent and emollientZinc oxide, bismuth oxide and balsam Peru as

Green crossAnusol®
suitable for self-care
Cream: £2.70 (23g)
Ointment: £2.70 (25g)
Suppository: £2.42 (12)

CorticosteroidsCinchocaine with prednisolone

as Scheriproct®
Ointment: £3.23 (30g)
Suppository: £1.52 (12)
Proctosedyl® is not cost effective.
NitratesGlyceryl Trinitrate

as Rectogesic®

0.4% ointment: £39.30 (30g)For the management of anal fissure. Maximum duration of use is 8 weeks.

Diltiazem is available via secondary care who are commissioned to provide full treatment course where person deemed contraindicated to Rectogesic.