Using Diltiazem for a week... it sometimes hurts more after its applied, and continues to sting all day long. Is this normal?
Can you use an hemorrhoid anesthetic as well?

Hemorrhoid cream did not do anything for my fissure. Although, the prep H wipes did. I think it was the witch hazel that helped. Diltiazem is used to relax the resting pressure of the sphincter not really relieve pain, but when your not in spasm the pain fades and allows the fissure to heal. Very important to use it every day for 6-8 weeks. Even if you feel like you are healed!!!

How deep into the sphincter (in cm) are you supposed to put it on?
Also should you put it on all 360 degrees of the sphincter?

My CRS told me it would work either inside or outside. If you are too tight to get any in, just put it on the outside as close as you can. It will be absorbed into the blood stream. If you can get it in just put it inside the rim. and you don't have to put it 360 degrees just by the area the fissure is in

After how long should you notice improvement?
Is it a few days or weeks?

everyone is different, for me it was a few days.

Improvement! I read an article about applying diltiazem on the verge of your anus. It caused me so much pain to try applying it inside, so after two days of putting it more comfortably on the edge it has made a huge difference. I highly suggest to anyone using it to apply it approx 2 hours before your BM to relax the muscles at the right time. Also, I applied vaseline just prior to BM, and polysporin afterwards.
My whole day isn't spent in pain anymore!

notmuchfunanymore, if the Diltiazem has lidocaine in it, that could be the sting you are experiencing. I had a reaction to the lidocaine that is usually included in the prescription, so had it made up without it or Vaseline.

I don't think Diltiazem has any lido in it sometimes they do put it in the NTG though.

have been put on to rectogestic now as i was using ano-heal,am only applying a small amout inside and just outside and it was really burning all day,the rectogestic doesn't burn,but i am experiencing terrible headaches,it says on the leaflet headaches should go after 30 mins but mine seem to hang around and i feel a tad nausea as well all time applying small amount as directed just inside every 12 hours should i tell the doctor? he must be sick of seeing me!