Classifications: anesthetic, local (amide-type);
Therapeutic: local anesthetic

Prototype: Procaine
Pregnancy Category: C


1% ointment


Long-acting anesthetic of the amide type and reportedly one of the most potent and most toxic. Appears to inhibit initiation and conduction of nerve impulses by reducing permeability of nerve cell membrane to sodium ions.

Therapeutic Effect

Relief of pain and itching due to inhibiting conduction of nerve impulses.


Fast, temporary relief of pain and itching due to hemorrhoids and other anorectal disorders, nonpoisonous insect bites, sunburn, minor burns, cuts, and scratches.


Hypersensitivity to amide-type anesthetics, pregnancy (category C), children <1 y.

Cautious Use

Lactation, children <12 y.

Route & Dosage

Itching Due to Insect Bites or Hemorrhoids
Adult: Topical Apply skin cream or ointment to affected area as needed [max: 1 oz (28 g)/24 h];  insert rectal ointment morning and evening and after each bowel movement
Child: Topical Apply skin cream or ointment to affected area as needed [max: 1/4 oz (7 g)/24 h]


  • Apply cream preparation after bathing or swimming (water soluble).
  • Store at 15°–30° C (59°–86° F) in tight, light-resistant containers.

Adverse Effects (≥1%)

Skin: Irritation, contact dermatitis; rectal bleeding (suppository).


Absorption: Poorly absorbed from intact skin; readily absorbed from mucous membranes or abraded skin. Onset: 15 min. Duration: 2–4 h.

Nursing Implications

Patient & Family Education

  • Use OTC preparations as directed. Always review package instructions.
  • Discontinue if irritation or rectal bleeding (following use of rectal preparations) develops and consult physician.
  • Hemorrhoids can be caused or worsened by constipation, excessive straining at stool, excessive standing, sitting, and coughing.
  • Physician may prescribe sitz baths 3–4 times/d to reduce the swelling and pain of hemorrhoids.
  • Note: Medication is intended for temporary relief of mild to moderate itching or pain. Seek medical advice for continuing discomfort, pain, bleeding, or sensation of rectal pressure.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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