Diltiazem gel tópico para el tratamiento de las fisuras anales

Resumen

The treatment of choice for anal fissures that do not heal with a conservative treatment has been traditionally the lateral internal sphincterotomy. But, an important percentage of patients present, to some extent, fecal incontinence. Medicamentosus sphincterotomy constitutes an efficient alternative to surgery. The most employed drug until now, topical nitroglycerin, presents a high incidence of cephalea; forcing to a suspension of the treatment in several occasions. The diltiazem gel supposes a new alternative that presents a lower incidence of adverse effects. The objective is to describe the working system for preparing a magistral formula of 2% diltiazem gel. It is prepared with diltiazem, propylene glycol and hydroxyethylcellulose. The final result is a transparent gel that is placed in 30-gram tubes; the necessary approximate quantity for a month of treatment. Since October 2002, 74 patients have been treated and, although statistical data are not yet available, the treatment efficacy seems similar to that outlined in the bibliography