by NeuropathicGuy » 29 Jul 2011, 22:14
I wouldn't read too much into the concentrations or the fact that they're in the same class of drugs. It's all about how your individual biochemistry reacts to the drug. 2% is a higher concentration than 0.3%, of course, but what if Nifedipine is much more biologically active, is eliminated slower, or has higher serum bioavailability due to better gastrointestinal absorption? I don't know any of that's actually true, but it's possible. There are lots of factors to consider, so I'd base my judgment on which you feel like is doing you more good.
FWIW I tried all of the typical fissure ointments and liked nitroglycerin the best (most effective), followed by Diltiazem (somewhat effective but with some local skin irritation), and finally Nifedipine (no side effects but also didn't do much for me). Others have the order reversed, however, so it all depends :)
I'd wager that the compound becoming watery after a while is a non-issue. That sounds like the base breaking down a bit due to either heat, moisture, or light exposure. It probably makes the stuff a bit trickier to apply and less likely to adhere to where you put it, but aside from that I doubt it would affect the active ingredient's potency.
As for the itching, IMO it's hard to say what's causing that. It could be the Diltiazem, the lidocaine, or the base. The only good way to figure out would be by process of elimination, e.g., leave out the lidocaine next time for example (or if you're really curious maybe buy a small tube of OTC lidocaine from the drug store and put a dab on your finger or arm to see if you're allergic to lidocaine). Mine never had lidocaine and I also didn't find lidocaine to be very useful at all for fissure pain anyway. A different pharmacy may use a different base, so it's possible that switching pharmacies would alleviate the itching, but that's probably something you'll never know unless you do it, unfortunately.