Diltiazem: cream or ointment?

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Diltiazem: cream or ointment?

Postby NeuropathicGuy » 13 Mar 2010, 18:00

Hey fissure friends,
I just picked up some 0.2% diltiazem as my last resort before LIS. My question to you all who have used diltiazem is this: did your diltiazem come as a cream (like hand lotion) or ointment (more oily like vaseline)?
I have used nifedipine and nitroglycerin in the past and both came as an ointment. They were in an oily base and slippery to the touch.
However my diltiazem seems to be a cream, almost exactly like hand lotion. This texture makes it harder to get inside the anus. I used a different pharmacy this time so I don't know if it's supposed to be like that or not.
Any feedback from fellow diltiazem users would be welcome and appreciated.
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Re: Diltiazem: cream or ointment?

Postby jman11 » 13 Mar 2010, 18:49

My prescription is 2%, not 0.2%, I dunno if that's just a typo or not. Mine is an ointment, thicker than a cream. If it's really .2% I'm not sure it'll do much for you, but who knows?
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Re: Diltiazem: cream or ointment?

Postby NeuropathicGuy » 13 Mar 2010, 20:23

Holy crap, you're right. The stuff I got is 0.2% diltiazem but it's supposed to be 2% that's used for fissures! I think the CRS gave me the wrong stuff because I looked at the prescription and it clearly indicated 0.2%. Arrgghhh!!! Stuff cost $50 from the compounding pharmacy too :(
This was the CRS I was going to get LIS with too so now I'm not sure what to think anymore. I'm hoping it was just a mental error on his part since nitroglycerin and nifedipine are both supposed to be 0.2% while diltiazem is supposed to be 2%. Guess I'll call his office on Monday and see.
Thanks for your answer, I would've never noticed on my own!
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Re: Diltiazem: cream or ointment?

Postby Fissulyna » 13 Mar 2010, 21:14

Sheeeshhh - I would ask for a "free refill " - whoever made a mistake !!!! I also had pharmacy making a mistake - making wrong % and doctors do typos also all the time with 0.2 and 2 or not writing clearly %^&^%$#!!! I made mine in different locations (SF, SJ, PAMF etc. ) - there was always "something" I had to go back for LOL - I just got used to it : (((.
I never used Dilitazem, so I do not know about the base substrate used in that cream. Nifed. and Nitro were in petrolatum (Vaseline) base.
Wishing you the best of luck with the new cream : ))) !
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Re: Diltiazem: cream or ointment?

Postby NeuropathicGuy » 14 Mar 2010, 00:30

Hey Fiss, yup, I've had the same thing happen before too with the pharmacy giving me 2% nitroglycerin rather than 0.2% nitroglycerin. So I guess this time I ran into the reverse problem :) I just wish I'd caught the error before filling the prescription. But oh well, mistakes happen, so as long as I can get it fixed it'll be okay. I'm just disappointed because I was so looking forward to trying out the new "magic cream" this weekend -- you know how it is when you're thinking that "this is the one that's going to cure me" :)
I did a little searching since I posted and it does look like diltiazem is supposed to be in a gel (aquaphor/petrolatum) base as well. So not only is the strength wrong but I think the pharmacy used the wrong base as well. Blah, looks like it's me and my old pal nitroglycerin again for at least the weekend Image
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Re: Diltiazem: cream or ointment?

Postby NeuropathicGuy » 14 Mar 2010, 00:32

P.S.
This is reason # 50000000243252 that this forum is great! If I didn't have anyone to tell me that the diltiazem concentration was wrong, I can just imagine the repercussions for my poor arse as I slathered useless cream on it day after day and wondered why my fissure just kept getting worse :)
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Re: Diltiazem: cream or ointment?

Postby jman11 » 14 Mar 2010, 10:24

Once you get the 2% Diltiazem you'll be good to go, the stuff works wonders and is just as effective as nitro if not better. My sphincter relaxes right away and it usually works for several hours (seems like 6+ but I can't be totally sure). Good stuff.
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Re: Diltiazem: cream or ointment?

Postby StevePain » 14 Mar 2010, 10:57

I've just checked mine, thankfully it's 2% ointment and says on the tub Diltiazem HCI in white soft paraffin, it's like a greasy kind of vaseline but a bit thicker it also smells, I still haven't used it inside the rectum as it clearly says on the tub "For external use only" but it seems to be relaxing the sphincter better than nitro did, I am curious though, some people have said they've applied the ointment internally so i'm wondering if there's another kind of ointment meant for internal use?
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Re: Diltiazem: cream or ointment?

Postby cherylk » 14 Mar 2010, 13:38

My tube says "Bethanechol/Ditiazem." It's a clear jel. I always applied it internally (1 cm) per my CRS at the Mayo Clinic. Worked great. It is a compounded Rx.
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Re: Diltiazem: cream or ointment?

Postby NeuropathicGuy » 14 Mar 2010, 14:10

Thanks guys, I just faxed over a bunch of info regarding the Rx mix-up to my doctor's office so that they'll hopefully have it on their desk first thing Monday morning so I can get my hands on the real 2% stuff ASAP. I was expecting a gel too since that's how my nitroglycerin and nifedipine came. I was thinking about asking the doctor's office to cover my replacement Rx cost since the mix-up was definitely on their side, but then I figured maybe I should pick my battles and not nitpick over $50 in case I end up getting LIS through this doctor :) Thanks again for catching this jman!
Steve, I think it's the same ointment whether used internally or externally. My nitroglycerin and nifedipine also say "for external use only" but I've been told that it's okay -- although not usually necessary -- to put it inside the anal canal as well. I do from time to time to no ill effect. It's good to hear from both yourself and jman that diltiazem seems to work a bit better than nitro. It's hard for me to get my hopes up too much at this point, but I'm eager to at least give it a go. I don't see how it can make things worse, that's for sure :)
Cheryl, thanks, I did a quick search for Bethanechol and it appears to be some other kind of drug. Looks like it has a variety of uses. I've never heard of it before -- maybe its inclusion in the compound was related to some of the pelvic floor issues you mentioned before?
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