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ANA-LEX (HYDROCORTISONE ACETATE/LIDOCAINE HCL/ALOE VERA)
- Hemorrhoids
- Anal fissure
- Proctitis
- Pruritus ani
2 %-2 % rectal kit
- Insert the contents of 1 tube by rectal route 2 times per day via applicator
Anal fissure
- Insert the contents of 1 tube by rectal route 2 times per day via applicator
- Apply to the affected area(s) by topical route 2 times per day
Hemorrhoids
- Insert the contents of 1 tube by rectal route 2 times per day via applicator
- Apply to the affected area(s) by topical route 2 times per day
Proctitis
- Insert the contents of 1 tube by rectal route 2 times per day via applicator
- Apply to the affected area(s) by topical route 2 times per day
Pruritus ani
- Insert the contents of 1 tube by rectal route 2 times per day via applicator
- Apply to the affected area(s) by topical route 2 times per day
- None
Contraindicated
- None
Severe
Moderate
- None
- Intestinal abscess
- Methemoglobinemia
- Untreated systemic fungal infection
Contraindicated
- Active tuberculosis
- Diabetes mellitus
- Glucose-6-phosphate dehydrogenase (g6Pd) deficiency
- Heart block
- Hemolytic anemia from PK and g6PD deficiencies
- Infection
- Intestinal anastomosis
- Ocular herpes simplex
- Ocular hypertension
- Shock
Severe
Moderate
- Chronic heart failure
- Diverticulitis of gastrointestinal tract
- Gastrointestinal fistula
- Herpes simplex infection
- Hypertension
- Hyperthyroidism
- Hypothyroidism
- Kidney disease with reduction in GFR
- Measles
- Open angle glaucoma
- Osteoporosis
- Psychotic disorder
- Varicella zoster virus infection
ANA-LEX (HYDROCORTISONE ACETATE/LIDOCAINE HCL/ALOE VERA)
- Hemorrhoids
- Anal fissure
- Proctitis
- Pruritus ani
- Infection
- Increased appetite
More Frequent
Severe
Less Severe
- Adrenal cortical insufficiency
- Angioedema
- Dermatitis due to topical drug
- Erythema
- Hypercortisolism
- Pruritus of skin
- Skin rash
- Stinging of skin
- Urticaria
- Irregular menstrual periods
- Nausea
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Abdominal distension
- Abnormal hepatic function tests
- Acute confusion
- Acute respiratory insufficiency
- Anaphylaxis
- Body fluid retention
- Bradycardia
- Cardiac arrhythmia
- Cataracts
- Chronic heart failure
- CNS toxicity
- Cyanosis
- Delirium
- Drowsy
- Drug-induced psychosis
- Dyspnea
- Excitement
- Eyelid edema
- Gastrointestinal hemorrhage
- Glaucoma
- Glycosuria
- Hallucinations
- Headache disorder
- Hepatomegaly
- Hyperglycemia
- Hypertension
- Hypotension
- Idiopathic intracranial hypertension
- Impaired wound healing
- Intestinal perforation
- Methemoglobinemia
- Myopathy
- Ocular hypertension
- Osteoporosis
- Paranoid disorder
- Peptic ulcer
- Personality disorders
- Pulmonary edema
- Respiratory depression
- Seizure disorder
- Thromboembolic disorder
- Tremor
- Unconsciousness
Less Severe
- Acne vulgaris
- Acute confusion
- Allergic dermatitis
- Apprehension
- Blurred vision
- Depression
- Dizziness
- Edema
- Euphoria
- Flushing
- Hirsutism
- Insomnia
- Lipodystrophy
- Mood changes
- Nervousness
- Rectal irritation
- Sensation of cold
- Sensation of warmth
- Sleep disorder
- Tinnitus
- Twitching
- Vomiting
Contraindicated
None
Severe Precaution
Lidocaine (Select routes)
Rare risk of methemoglobinemia in infants age < 6 months. Risk of systemic toxicity. Monitor for CNS toxicity (e.g. restlessness, dizziness, drowsiness, blurred vision) with prolonged infusion, repeated injections or application. Limited safety data available.
- 1 Day – 179 Days
- Rare risk of methemoglobinemia in infants age < 6 months. Risk of systemic toxicity. Monitor for CNS toxicity (e.g. restlessness, dizziness, drowsiness, blurred vision) with prolonged infusion, repeated injections or application. Limited safety data available.
- 180 Days – 16 Years
- Rare risk of methemoglobinemia in infants age < 6 months. Risk of systemic toxicity. Monitor for CNS toxicity (e.g. restlessness, dizziness, drowsiness, blurred vision) with prolonged infusion, repeated injections or application. Limited safety data available.
Management or Monitoring Precaution
Hydrocortisone (Top,Ophth,Rect)
Prolonged or extensive use may lead to systemic absorption; may affect growth rate.
- 1 Day – 18 Years
- Prolonged or extensive use may lead to systemic absorption; may affect growth rate.
Hydrocortisone (topical, Non-systemic)
- Severity Level:
2
- Additional Notes: Systemic absorption unknown; insuff human data
Lidocaine
- Severity Level:
2
- Additional Notes: Insufficient human data available.
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
No Known Risk
Hydrocortisone (top., Rectal)
Insufficient data available; limited use may pose little risk
Amount excreted reported to be low with low infant oral bioavailability
| General | Excretion Potential | Effect on Infant | Notes |
| No known risks; does not adversely affect lactation | Unknown | Not known; no or inclusive data | Insufficient data available; limited use may pose little risk |
Lidocaine
Insufficient data available; limited use may pose little risk
Amount excreted reported to be low with low infant oral bioavailability
| General | Excretion Potential | Effect on Infant | Notes |
| No known risks; does not adversely affect lactation | Excreted | Not known; no or inclusive data | Amount excreted reported to be low with low infant oral bioavailability |
Contraindicated
None
Precaution Exists
Select Anesthetics
General-May be more sensitive to CNS and cardiac adverse reactions. Consider dose reduction due to reduced clearance in the elderly.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | N | Y | Y | N | N | N |
BEERS: N HEDIS: N STOPP: N
No Known Risk
None
- None
| Anal fissure | |
| K60.0 | Acute anal fissure |
| K60.1 | Chronic anal fissure |
| K60.2 | Anal fissure, unspecified |
| Hemorrhoids | |
| K64.0 | First degree hemorrhoids |
| K64.8 | Other hemorrhoids |
| K64.9 | Unspecified hemorrhoids |
| O22.4 | Hemorrhoids in pregnancy |
| O22.40 | Hemorrhoids in pregnancy, unspecified trimester |
| O22.41 | Hemorrhoids in pregnancy, first trimester |
| O22.42 | Hemorrhoids in pregnancy, second trimester |
| O22.43 | Hemorrhoids in pregnancy, third trimester |
| O87.2 | Hemorrhoids in the puerperium |
| Proctitis | |
| K62.7 | Radiation proctitis |
| K62.89 | Other specified diseases of anus and rectum |
| Pruritus ani | |
| L29.0 | Pruritus ani |
| L29.3 | Anogenital pruritus, unspecified |
| 0-9 | A-Z |
|---|---|
| K60.0 | Acute anal fissure |
| K60.1 | Chronic anal fissure |
| K60.2 | Anal fissure, unspecified |
| K62.7 | Radiation proctitis |
| K62.89 | Other specified diseases of anus and rectum |
| K64.0 | First degree hemorrhoids |
| K64.8 | Other hemorrhoids |
| K64.9 | Unspecified hemorrhoids |
| L29.0 | Pruritus ani |
| L29.3 | Anogenital pruritus, unspecified |
| O22.4 | Hemorrhoids in pregnancy |
| O22.40 | Hemorrhoids in pregnancy, unspecified trimester |
| O22.41 | Hemorrhoids in pregnancy, first trimester |
| O22.42 | Hemorrhoids in pregnancy, second trimester |
| O22.43 | Hemorrhoids in pregnancy, third trimester |
| O87.2 | Hemorrhoids in the puerperium |
Formulary Reference Tool