Hi, i've recently been prescribed diltiazem, but don't have any real instruction on how to use it, just says apply twice daily, prior to using this I was using nitro which I thought was similar in terms of application but now it seems not, as nitro can be inserted into the rectum and is clearly marked on the packaging (rectal use), diltiazem can only be applied externally (says on the tub), or can it be used inside the rectum too?
Thanks in advance for your help

I'm using the Diltiazem cream and I was also told to apply it externally only. I just use a pea size amount 3x's a day. I've been using it for 3 and a half weeks and it seems to have started providing me relief. My doctors office told me not to expect any results until about 2 weeks of use though.

Thanks mmb, I have applied it already (externally) I don't have a headache like with nitro so all is good, I won't expect any results then for at least a couple of weeks, i'm trying to be optimistic, but it's quite hard since no other treatments have worked yet, anyway thanks for the info :)

Steve,
I was told by my Mayo CRS to get the Diliatzem inward at least 1 cm, and that is always what I tried to do (with an applicator). Good luck!

Hey cheryl, i'll give that a try, don't know about an applicator as I haven't got one, so i'll just use my finger :oops:
Sounds the same as when I used nitro, I was told to try and get that at least 1cm into the rectum.

Some people used a finger cot, which I never tried. I think you have to get it up inward to work, but that is just my opinion (and the opinion of my doc). Why else would they give me an applicator with the tube of ointment???????????

I haven't used diltiazem but have used nifedipine and nitro. In the beginning, when the spasm was real bad, I "shot" it inside the rectum using a baby syringe. That made it hard to get an accurate dose but seemed to help the spasm more. Once the spasm let up a little bit, applying it with my finger just around the lip of the anus was enough.

My medicine didn't come in a tube so that might be where the difference in application instructions comes from between my doc and Cheryl's. My medicine was compounded with the diltiazem, hydrocortisone, and lidocaine (i think that's what it's called) into a cream. The cream is in a medicine like bottle. I was going out of my mind with the pain and have been using it for 3 weeks. During the 1st week no relief what so ever (I actually called the doc crying!), the 2nd week some days were ok, the 3rd week has been mostly pain free. I go to the doctor again next Wednesday for him to check things out, but with no bleeding and no pain I'm starting to be optimistic. I'm still doing all of my treatments though... baths, fiber, good diet, cream, stool softeners, mag. supplement, & praying.

Mine hasn't come in a tube either, it's in a tub, like vaseline or nappy rash cream with no applicator, so i'm just going to carry on applying it round the anus and pop a bit inside if necessary, I guess it'll be trial and error for a while.
Like you mmb, i'm still doing all the regular stuff, diet, plenty of water and 4 stool softeners a day, I don't think i'll ever give up the stool softeners tbh, it's just not worth the risk of having a hard BM and ending back at square one, I know there's risks with taking stool softeners long term but the pain of a fissure far outweighs them

I agree Steve! I definitely don't want to go backwards! I'm going to talk to my doctor on Wednesday about the stool softeners, but they tell me to keep taking them so they must not be that terrible!