My surgeon prescribed diltiazem 5% cream for fissure.
I've had this fissure for close to ten years thought it was a hemmeroid but a couple weeks ago I had to be hospitalized with perianal abscess. They also diagnosed the fissure.
So I've been applying this cream and I'm feeling like its constricting my anus muscles. Seems like 2% cream is standard. Maybe this dose is too strong?

Hi Nathan1,
sorry you've been suffering for so long we all made the mistake thinking our fissure was hemmies they are hard to detect. I didnt use diltiazem i use the nitro and it was 0.2%.
I've noticed too that diltiazem mostly used is 2%, 5% seems quite strong it may cause you terrible headaches wont cause your fissure any harm. I wish you well :)

Hi Nathan,
I was on the 2% and it was my saviour! It played a huge role in helping my chronic fissure naturally heal.
I'm not sure what the side-effects might be with a stronger dose? I didn't even think there was a stronger dose actually, so that's interesting.....I can't recall having any effect from using the cream although I did experience some pressure-type sensations in my bum after using the cream for a few weeks and remember finding it really hard to pass wind! I'm not sure if that was the cream though or the fissure just generally going through the healing process. It did however all pass a few weeks after stopping the cream - Perhaps just call your CRS to check???