Patient Information

Things to remember about medicines

•	Before using the cream, please read this leaflet carefully and ask your doctor or pharmacist for advice if you are unsure about anything.
	
•	It is important that you follow the directions carefully. Read the label on the pack and this leaflet for details.
	
•	Keep medicine out of the reach of children.
	
•	Tell medical staff that you are using Anusol Cream, for example if you go into hospital or see a doctor.
	
•	Dispose of all unwanted medicines carefully preferably by returning them to your local pharmacy.

Anusol Cream 23g

Each 100g of cream contains:	Bismuth Oxide 2.14 g
	Zinc Oxide PhEur 10.75 g
	Balsam Peru PhEur 1.80 g

The active ingredients and how they work

Bismuth salts are used for their protective effect on the lining of the anal area, offering some protection from faecal matter and bacteria and allowing healing to take place. They also reduce haemorrhoidal swelling, helping to prevent further damage and easing the condition.
Zinc oxide acts as an adsorbent which reduces skin moisture and friction and discourages certain bacteria from growing. It also has astringent properties which help to reduce haemorrhoidal 'swelling. Zinc oxide helps to protect raw, irritated areas, and reduce itching.
Balsam Peru is an antiseptic which relieves inflammation and promotes healing.

Anusol Cream base also contains: glycerol monostearate propylene glycol, methyl and propyl p-hydroxybenzoates, sorbitan monostearate, liquid paraffin, titanium dioxide polysorbate 60.

Anusol Cream is prepared in a lubricating base to help relieve itching and irritation. The vanishing cream base aids absorption and minimises the problem of staining.

Anusol Cream is marketed by Warner Lambert Healthcare, a division of Parke, Davis & Company. Licensed by Parke, Davis dc Company and manufactured by Parke Davis dc Co. Limited, at Usk Road Pontypool, Gwent, NP4 0YH.

What is Anusol Cream used for?
Anusol Cream is used to relieve the following anal conditions:

Piles or haemorrhoids: These are swollen blood vessels which may occur either inside (internal piles) or outside (external piles) the anus. They can cause varying degrees of discomfort, itch and irritation, particularly during and just after a bowel movement. Piles are caused by a number of different factors. These are discussed on the reverse of this leaflet together with helpful advice for sufferers.	Anusol
cream

Itch (pruritus ani): inflammation of the anal area can lead to itching, particularly where there is cracked, dry skin. Itch frequently accompanies piles, threadworm irritation, or fungal or bacterial infection. It is usually worse when the affected area is restricted and overwarm. The Anusol Cream base helps to moisturise dry skin and the soothing agents relieve itch, general rectal inflammation (pruritus), or lesions in the anal canal (anal fissures).

Possible side effects

Side effects do not occur very often, but if anything unusual happens, consult your doctor.

Very occasionally, a mild irritation or a burning sensation may be experienced. These sensations will usually cease when you stop using the cream.

How to use Anusol Cream

Anusol Cream is for application in the anal region only.

Adults: Wash the anal area thoroughly and dry carefully with a soft towel. Gently smooth or apply Anusol Cream to the affected area, preferably using lint or a cotton wool pad.

Use Anusol Cream in the morning, at night, and after each bowel movement until the condition is controlled.

For internal application: Use the plastic applicator nozzle provided. The nozzle should be washed carefully after each use in hot soapy water and then rinsed thoroughly in clean water convenience, the nozzle can be stored on the tube.

Children: Not recommended for children.

Important information
•	Do not use Anusol Cream if you are allergic to any of the ingredients.
	
•	Anusol Cream is not to be swallowed. If accidental ingestion occurs, seek medical advice.
	
•	Haemorrhoids and other anal conditions are sometimes of a serious nature. In cases of rectal bleeding or a condition that persists or worsens, consult your doctor.

How to store Anusol Cream
•	Store the Cream in a cool, dry place in the original packaging.
	
•	Do not use after the expiry date shown on the box.

Date of last revision: April 1993

continued	

A Healthy Living Plan for Piles Sufferers
At least 40 per cent of people suffer at some time in their lives from piles. Despite the frequency of the condition, many people are too embarrassed to seek advice or treatment and, as a result, suffer continuous discomfort and misery.

Fortunately, once you have been diagnosed as having piles, there is much you can do to ease the situation and relieve the symptoms. Readily available from your local pharmacy, Anusol Cream can help to relieve the pain and discomfort of piles.

What are piles?
Piles (haemorrhoids) are enlarged or swollen blood vessels which can occur inside or outside the anus.

Symptoms of piles
Piles can be present without producing any symptoms at all, but sufferers usually notice the following symptoms

Bleeding: Blood may appear bright red and scanty on toilet tissue. If the blood is dark in colour, or more profuse, you should consult your doctor.

Swelling: The swollen blood vessels may be felt as a lump or blockage in the anus after passing a motion.

Itching, irritation and pain in the anal region.

What causes piles?
A number of factors can contribute to the development of piles:

•	Excessive straining during bowel movement usually the result of constipation. 
	
•	Pregnancy, the pressure of a growing baby within the lower abdomen results in increased pressure in the anal vessels. This may lead to swelling and distension.
	
•	Heredity.
	
•	Competing in games where bursts of high energy movement are required.
	
•	Lifting or heavy manual work resulting in straining or pressure on the lower abdomen.

If you think you might have piles, you should consult your doctor, particularly if:

•	the sufferer is pregnant
•	the sufferer is a child
•	symptoms are severe and/or persistent
•	blood from the anal area is dark in colour
•	any bleeding is profuse or persistent
•	there is a change in normal bowel habit lasting for more than two weeks
•	there is persistent pain in the abdomen.	Anusol
cream

Advice for piles sufferers
Wash with soap and warm water after each bowel motion. Dry with a soft towel and then apply Anusol Cream. Good anal hygiene is important for the treatment of piles.

A regular bowel habit is important. Do not neglect the call to move your bowels; postponing natural bowel action will weaken it. Open your bowels regularly.

Do not try to pass the last part of the stool if this means straining.

The passing of hard stools is not only painful but it may also involve straining and cause bleeding. A good diet helps to ensure good bowel action and the formation of softer bulkier stools. It i5 good to include plenty of fibre in your diet because it helps to hold water and produce well-formed stools. Wheat bran is an effective source of fibre, helping to relieve constipation. Vegetables and fruit fibre vary in their ability to absorb water, but carrots, brussels sprouts, aubergine, spring cabbage, corn, apples, pears, and oranges are known to have good water absorption capacities.

Do not strain during bowel movements. Leaning forward from the hips may help. Prolonged sitting on the toilet as well as straining causes pressure which can lead to piles.

For external and internal piles, cream is available. If extra protection for dry, irritated skin is needed, ointment can b? used. If internal haemorrhoids are the problem, suppositories deliver a measured dose to the affected area.

More information
Many people who suffer from piles are too embarrassed to ask for information. Two free booklets, PILES. Looking After a Common Personal Problem,  which give more detailed information and Discomforts in Pregnancy, which is for pregnant mothers and describes and advises on minor ailments suffered during pregnancy, including piles, are both available from the address below:

Anusol Advisory Bureau, FREEPOST FG 361,17-19 Castle Street, Hertford, SG14 1BR.

Further supplies of Anusol and advice on treatment of piles, can be obtained at your local pharmacy.

Lambert Court, Chestnut Avenue, Eastleigh, Hampshire SO5 3ZQ.

Anusol is a registered trade mark.