Therapeutic AreaFormulary ChoicesCost for 28
(unless otherwise stated)
Rationale for decision / comments
Rectal soothing agentsGreen crossAnusol®
suitable for self-care
Cream: £2.45 (23g)
Ointment: £2.45 (25g)
Suppositories: £2.26 (12)
Available as cream, ointment and suppositories.
Available OTC.
Rectal corticosteroidsScheriproct®Ointment: £2.94 (30g)
Suppositories: £1.38 (12)
Scheriproct® is recommended over the traditionally widely used Proctosedyl®, as the latter is one of the most costly preparations of its type at £10.34 per tube.
Preparations for anal fissuresRectogesic®

(Glyceryl Trinitrate Ointment 0.4%)
Ointment: £39.30 (30g)Glyceryl Trinitrate for the management of anal fissure should be prescribed as Rectogesic®, which is the only available licensed product for this indication. Prescriptions for other strengths will require the dispensing of “specials” which are unlicensed, often have a short shelf life and usually cost in excess of £100 per pack.
Maximum duration of use: 8 weeks
All other external preparations of diltiazem are unlicensed specials and are non-formulary. Acute trust commissioned to provide full treatment course where patient deemed contraindicated to Rectogesic.