Diltiazem Cream (topical)
• 2% cream, ointment, gel 1
• a 2.5 cm applicator was used to deliver 0.5mL of medication1
-Frequency of use:
• apply three times per day for eight weeks1
-Mechanism of action:
• acts as a vasodilator thereby increasing blood flow to the affected area2
• none reported1
-Results of how the treatment worked in studies:
• a pilot study found 10 out 15 patients had healing of their anal fissures with no side effects reported when treated with topical diltiazem1
• another study found that 75% of patients were healed after using diltiazem for 2-3 months3
• a separate study found that 19 out of 39 patients who had failed nitroglycerin therapy were successfully treated using topical diltiazem4
1) Carapeti EA, Kamm MA, Phillips RK. Topical diltiazem and bethanechol decrease anal sphincter pressure and heal anal fissures without side effects. Dis Colon Rectum 2000; 43:1359.
2) Diltiazem. (2012, August 24). Retrieved from http://web.ebscohost.com.proxy.westernu.edu/dynamed/detail?sid=c31d6089-5bdd-48c5-a91d-c1ab4b5c1ba8@sessionmgr13&vid=1&hid=24&bdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU=
3) Knight JS, Birks M, Farouk R. Topical diltiazem ointment in the treatment of chronic anal fissure. Br J Surg 2001; 88:553.
4) Jonas M, Speake W, Scholefield JH. Diltiazem heals glyceryl trinitrate-resistant chronic anal fissures: a prospective study. Dis Colon Rectum 2002; 45:1091.
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The information on this website regarding Anal and Rectal Fissures is purely informational and should not be used to diagnose, cure or treat any patient without the direction and supervision of a physician. The information listed on this site has not been reviewed or approved by the FDA. If you are interested in using any of the treatments listed on this site or any other treatment for anal fissures make sure to check with your physician first. These and any other therapies should be individualized for you by a prescribing physician that knows you, your medical history, and any current and prior medication history. Most of the treatments listed on this site are not approved by the FDA for the treatment of Anal Fissures and do require a prescription that can only be filled at a compounding pharmacy. Nitroglycerin 0.4% ointment is FDA approved and available at most retail pharmacies.