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Verapamil HCl 8% Rectal Ointment

Verapamil HCl 8% Rectal Ointment is a semi-solid pharmaceutical preparation intended for rectal administration. This ointment is dispensed in a tube and is characterized by its greasy or oily base, which facilitates the localized delivery of the active ingredient, Verapamil HCl. The ointment base provides a protective barrier that promotes the absorption of the medication into the surrounding tissues.

Verapamil HCl, the active component, is a calcium channel blocker that is commonly used in the management of anal fissures. By promoting blood flow and reducing muscle spasms in the rectal area, this ointment aids in the healing of fissures and alleviates associated pain. Additionally, the formulation may be utilized in the treatment of chronic anal fissures where smooth muscle relaxation is desired to facilitate healing.

The use of this ointment should be under the guidance of a healthcare professional, and it is specifically formulated to address the aforementioned disease states, providing targeted relief and therapeutic benefits directly to the affected area.

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Topical Ointment
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Formula Information

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Verapamil HCl 8% Rectal Ointment is a specially compounded semi-solid formulation designed for rectal administration to provide localized treatment. This ointment is dispensed in a tube and is intended for external application to the rectal area. The base of the ointment is greasy or oily, which not only facilitates the application but also enhances the absorption of the active ingredient, Verapamil HCl, through the rectal mucosa. Verapamil is a calcium channel blocker that is commonly used systemically to treat high blood pressure, angina, and certain heart rhythm disorders. However, when formulated as an 8% rectal ointment, it serves a different purpose.

In this localized application, Verapamil HCl can exert its effects directly on the surrounding tissues. It is often used off-label for the treatment of anal fissures, a condition characterized by a painful tear in the lining of the anus, which can lead to spasms of the anal sphincter. The application of Verapamil HCl as a rectal ointment can help to relax the anal sphincter, improve blood flow to the area, and promote healing of the fissure. The ointment may also be used in other conditions where localized relaxation of smooth muscle can be beneficial.

Patients prescribed with Verapamil HCl 8% Rectal Ointment should be instructed on proper application techniques, including hygiene measures and the amount of ointment to use. Prescribers should consider the patient's overall medical condition and any potential interactions with other medications. It is important to note that this formulation is specifically compounded based on a prescriber's order and is not available as a commercially manufactured product. Therefore, it should be used under the guidance and supervision of a healthcare professional familiar with its use in the treatment of anal fissures or other applicable conditions.

For patients and prescribers interested in using this formulation, it is essential to understand that the effectiveness and safety of Verapamil HCl 8% Rectal Ointment are based on the individual patient's response and tolerance to the treatment. Monitoring for potential side effects, such as local irritation or systemic effects, is recommended. If you have any questions or require further information about this formulation, please reach out to us at Bayview Pharmacy. Our team of knowledgeable compounding pharmacists is here to provide guidance and support to ensure the best possible outcomes for our patients.

Drug Interactions

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Verapamil HCl is a calcium channel blocker that is primarily used to treat high blood pressure, angina, and certain heart rhythm disorders when taken systemically. However, when formulated as an 8% rectal ointment, it is intended for localized treatment and may be used off-label for conditions such as anal fissures where it works by relaxing the smooth muscles and improving blood flow to the affected area, thereby promoting healing. Despite its localized application, it is important to consider potential systemic absorption and drug interactions.

Patients using this verapamil rectal ointment should be aware that interactions can occur with other medications that affect heart rhythm and blood pressure. Concurrent use with beta-blockers, digoxin, or other antiarrhythmic agents can lead to additive effects on heart rate and blood pressure, potentially resulting in bradycardia or hypotension. Careful monitoring by a healthcare provider is recommended when these medications are used together.

Verapamil is known to inhibit the cytochrome P450 3A4 (CYP3A4) enzyme system, which can affect the metabolism of other drugs. Medications that are substrates of CYP3A4 may have increased plasma concentrations when used concurrently with verapamil, potentially leading to toxicity. Examples include, but are not limited to, statins (such as simvastatin and atorvastatin), certain immunosuppressants (like cyclosporine), and some antifungal agents (such as ketoconazole). Patients should inform their healthcare provider of all medications they are taking, including over-the-counter drugs and herbal supplements.

Additionally, verapamil can interact with drugs that have a narrow therapeutic index, such as theophylline, lithium, and carbamazepine, requiring close monitoring of drug levels and clinical effects. Patients taking these medications may need dosage adjustments or more frequent monitoring to prevent adverse effects.

Grapefruit juice can also interact with verapamil by inhibiting CYP3A4, leading to increased levels of verapamil in the blood. Patients should avoid consuming grapefruit juice while using this medication. Alcohol may exacerbate the blood pressure-lowering effects of verapamil and should be used with caution.

It is important to note that while the systemic absorption of verapamil from a rectal ointment is expected to be lower than from oral administration, the potential for systemic effects and drug interactions still exists. Patients should be counseled on the signs and symptoms of hypotension, bradycardia, and heart block, and instructed to seek medical attention if they experience dizziness, fainting, or an irregular heartbeat.

Prescribers should evaluate the patient's medication profile for potential interactions before prescribing verapamil rectal ointment and continue to monitor the patient throughout treatment. If you have any questions or require further information regarding the use of Verapamil HCl 8% Rectal Ointment and its potential drug interactions, please reach out to us at Bayview Pharmacy for assistance.

How Does it Work

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Verapamil HCl 8% Rectal Ointment is a specially compounded medication designed for rectal administration to treat conditions such as anal fissures. Verapamil is a calcium channel blocker that, when applied locally, can help to relax the smooth muscles in the rectal area. This relaxation can reduce the spasm of the sphincter and improve blood flow, which in turn may facilitate the healing of anal fissures and reduce associated pain and discomfort.

The ointment is formulated as a semi-solid base, which allows for the sustained release of Verapamil HCl when applied to the affected area. The base is greasy or oily, which not only helps in the delivery of the active medication but also provides a protective barrier that can prevent further irritation during bowel movements. The ointment is typically applied externally to the perianal area, but it can also be applied inside the anal canal depending on the specific needs of the patient and the prescriber's instructions.

For patients, it is important to understand that this medication is intended for rectal use and should be applied as directed by a healthcare professional. The ointment should be used consistently at the dose and frequency recommended to achieve the best therapeutic outcomes. Patients should also be aware of potential side effects, which may include local irritation or a burning sensation upon application. It is crucial to report any adverse effects or concerns to the prescribing healthcare provider.

Prescribers considering Verapamil HCl 8% Rectal Ointment for their patients should be aware of the pharmacological action of Verapamil as a calcium channel blocker and its specific application in the treatment of anal fissures. The compounding pharmacists at Bayview Pharmacy can provide additional information on the formulation, including its stability, compatibility with other medications, and any other clinical considerations.

If you have any questions about the Verapamil HCl 8% Rectal Ointment or its use in treating anal fissures, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of knowledgeable compounding pharmacists is here to support both patients and healthcare providers with information and guidance on our compounded medications.

Other Uses

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Verapamil HCl 8% Rectal Ointment, despite its specific designation, can have other uses beyond the treatment of rectal conditions such as anal fissures or hemorrhoids. This compound, due to its inherent pharmacological properties, might also be investigated for use in conditions characterized by localized smooth muscle spasms or for the delivery of verapamil’s calcium channel blocking effects to a targeted area. For example, it has been considered for the management of superficial arteriovenous malformations due to its ability to reduce blood vessel constriction, although such use would be off-label and requires careful clinical evaluation. Additionally, given the anti-inflammatory effects of calcium channel blockers, there may be potential application in conditions with an inflammatory component, such as certain types of chronic skin ulcers or localized inflammatory diseases, though this would be considered experimental and should be closely monitored by a healthcare provider.

Moreover, some studies have suggested that topical verapamil may also influence scar tissue formation and has been used in an off-label capacity to treat Peyronie’s disease and keloids. The mechanism here involves the inhibition of fibroblast proliferation and extracellular matrix deposition, which are key factors in scar tissue formation. However, the effectiveness and safety profiles for these applications require further research and medical supervision.

It is important to note that off-label uses of medications should always be guided by the advice and supervision of a healthcare professional. The effectiveness and safety of Verapamil HCl 8% Rectal Ointment for purposes other than its approved indication have not been established, and patients should discuss potential risks and benefits with their healthcare provider. Additionally, as compounding pharmacists, we can offer customized concentrations and formulations to suit the specific needs and requirements of a patient under the direction of a prescriber. If you have any questions about this formulation or its potential uses, please reach out to us at Bayview Pharmacy. We are dedicated to providing comprehensive information and support to both patients and healthcare professionals interested in compounded medication options.

Frequently Asked Questions

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What is Verapamil HCl 8% Rectal Ointment used for?

The Verapamil HCl 8% Rectal Ointment is used for the treatment of conditions requiring localized delivery of Verapamil through the skin. While Verapamil is traditionally used for treating heart conditions and high blood pressure, when applied rectally it may be used for treating ailments such as anal fissures where it can help relax smooth muscles and improve blood flow.

How should I apply Verapamil HCl 8% Rectal Ointment?

Verapamil HCl 8% Rectal Ointment should be applied as directed by a healthcare provider. Generally, a small amount of ointment is applied to the affected area rectally with a clean finger or using an applicator, if provided, usually two to four times a day. Ensure hands are washed before and after the application to maintain hygiene.

Can Verapamil HCl 8% Rectal Ointment be used on other parts of the body?

No, this specific formulation is intended for rectal use only and should not be applied to other parts of the body unless directed by a healthcare provider. Misuse can lead to unwanted side effects or ineffective treatment.

What are the possible side effects of Verapamil HCl 8% Rectal Ointment?

Side effects can include local irritation, burning sensation, itching, or redness at the site of application. Systemic side effects are less common with topical application, but can include dizziness, headache, nausea, or constipation. Contact your healthcare provider if you experience any persistent or concerning symptoms.

Should I use Verapamil HCl 8% Rectal Ointment if I am pregnant or breastfeeding?

You should consult with your healthcare provider before using Verapamil HCl 8% Rectal Ointment if you are pregnant or breastfeeding to ensure safety. Your provider will evaluate the benefits and risks associated with its use.

Can Verapamil HCl 8% Rectal Ointment interact with other medications?

Although limited absorption is expected with rectal application, Verapamil can interact with other medications. Inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements, to avoid any potential interactions.

How should Verapamil HCl 8% Rectal Ointment be stored?

Store the ointment at room temperature away from direct light and heat. Keep the tube tightly closed when not in use. Make sure the medication is kept out of the reach of children and pets.

What should I do if I miss a dose of Verapamil HCl 8% Rectal Ointment?

If you miss a dose, apply it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double-up doses to make up for the missed one.

Is Verapamil HCl 8% Rectal Ointment suitable for children?

The suitability for children will depend on the specific condition being treated and the child's health profile. Always consult a pediatrician or healthcare provider before applying any medication to children.

What should I do in case of an overdose with Verapamil HCl 8% Rectal Ointment?

If you suspect an overdose or experience severe side effects, seek medical attention immediately. Overdose of topical medications is rare but can occur if used improperly, such as by applying too much ointment or ingesting it.

Can I use Verapamil HCl 8% Rectal Ointment with other topical products?

Refrain from using other topical products on the affected area without consulting your healthcare provider, as there could be interactions or increased risk of side effects.

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Formulas and/or material listed are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment. Every patient is unique, and formulas should be adjusted to meet their individual needs.

No compounded medications are reviewed by the FDA for safety or efficacy.