Proper Use of This Medicine

For safe and effective use of this medicine:

• Rectal anesthetics usually come with patient directions. Read them carefully before using the medicine, even if it was prescribed by your doctor. Check with your pharmacist if you have any questions about how to use the product.
• Follow your doctor's instructions if this medicine was prescribed.
• Follow the manufacturer's package directions if you are treating yourself.
• Do not use more of this medicine, do not use it more often, and do not use it for a longer time than directed . To do so may increase the chance of absorption into the body and the chance of unwanted effects.

This medicine should be used only for conditions being treated by your doctor or for problems listed on the package label. Do not use it for other problems without first checking with your doctor . This medicine should not be used if certain kinds of infections are present.

For applying a rectal anesthetic to the area around the rectum :

• First, clean the area, using mild soap and water or a cleansing wipe. Rinse the area carefully and dry it gently with a soft towel or toilet paper.
• Apply a small amount of medicine to the sore area, using a piece of gauze, a tissue, or a ``finger cot.''

For inserting a rectal cream or ointment inside the rectum :

• Use only products that come packaged in pre-filled applicators or that come packaged with a special inserter called a rectal tube.
• If you are using a product that has an inserter (rectal tube) packaged separately from the tube of cream or ointment:
  • Remove the cap from the tube of cream or ointment. Attach the inserter to the top of the tube. Squeeze the tube until a little cream or ointment comes out on the inserter. Then spread the cream or ointment over the inserter.
  • Place the inserter into your rectum and squeeze the tube until a small amount of medicine comes out. Then remove the inserter from your body.
  • Remove the inserter from the tube and replace the cap. Then wash the applicator carefully.
• If you are using the product that comes in pre-filled applicators:
  • Follow the manufacturer's directions for using the applicator and inserting the medicine. Each applicator is meant to be used only once. Throw the applicator away after using it.

For inserting the rectal aerosol foam (e.g., Proctofoam/nonsteroid) into the rectum :

• Do not insert the container itself into your rectum. Use the applicator provided.
• To fill the container—First, shake the container hard for several seconds. Then, holding the container upright, insert it into the applicator. Press the cap of the container until the foam reaches the fill line of the applicator. Remove the applicator from the container.
• To use the medicine—Place a small amount of foam on the tip of the applicator. Insert the applicator into your rectum, then push the plunger as far as possible. Remove the applicator. Then take it apart and wash it carefully.

Dosing—The dose of rectal anesthetics will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

For benzocaine
• For pain and itching of hemorrhoids or other problems in the rectal area:
  • For rectal ointment dosage form:
    • Adults—Apply a small amount of ointment to the area around the rectum up to six times a day.
    • Children—Use and dose must be determined by the doctor.

For dibucaine
• For pain and itching of hemorrhoids or other problems in the rectal area:
  • For rectal ointment dosage form:
    • Adults—Insert a small amount of ointment into the rectum three or four times a day, in the morning, in the evening, and after bowel movements. Or, apply a small amount of ointment to the area around the rectum three or four times a day.
    • Children—Use and dose must be determined by the doctor.

For pramoxine
• For pain and itching of hemorrhoids or other problems in the rectal area:
  • For rectal cream dosage form:
    • Adults—Apply a small amount to the area around the rectum up to five times a day, in the morning, in the evening, and after bowel movements.
    • Children—Use and dose must be determined by the doctor.
  • For rectal ointment dosage form:
    • Adults—Insert a small amount of ointment into the rectum up to five times a day, in the morning, in the evening, and after bowel movements. Or, apply a small amount to the area around the rectum up to five times a day, in the morning, in the evening, and after bowel movements.
  • For the rectal aerosol foam dosage form:
    • Adults—Insert 1 applicatorful into the rectum two or three times a day. Or, apply a small amount to the area around the rectum two or three times a day.
    • Children—Use and dose must be determined by the doctor.

For tetracaine and for tetracaine and menthol
• For pain and itching of hemorrhoids or other problems in the rectal area:
  • For the rectal cream or rectal ointment dosage form:
    • Adults—Insert a small amount into the rectum up to six times a day. Or, apply a small amount to the area around the rectum up to six times a day.
    • Children—Use and dose must be determined by the doctor.

Missed dose—If your doctor has directed you to use this medicine on a regular schedule and you miss a dose, use it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing.
• Do not puncture, break, or burn the pramoxine aerosol foam container, even after it is empty.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.