🗂️ Quick‑Reference Sheet — Cremagel™ 2% Diltiazem Rectal Gel (30 g Tube)

Attribute	Details
Active Ingredient	Diltiazem hydrochloride 2 % (20 mg / g)
Dosage Form	Topical rectal gel • 30 g laminated tube with applicator tip
Drug Class	Non‑DHP calcium‑channel blocker — local vasodilator
Key Use	Chronic anal fissure pain relief & healing acceleration
Indian Brand	Cremagel™
US Reference	No FDA‑approved diltiazem topical — compounded 2 % cream analogue
Manufacturer	Abbott India Pvt Ltd, Mumbai 🇮🇳 (roots 1944)
Dispatch ETA	6 – 15 days worldwide ✈️

“Topical diltiazem relaxes the internal anal sphincter and boosts blood flow—up to 70 % fissure healing without surgery.” — Dr Meera Patkar, MS, Colorectal Surgeon

📺 Video Overview

Watch on YouTube – How to Apply Diltiazem Gel for Anal Fissure (3 m 59 s)

Introduction

Anal fissures afflict office workers and postpartum mothers alike—sharp pain with every bowel movement, fear‑induced constipation cycles, and the looming spectre of lateral internal sphincterotomy. Cremagel™ offers a non‑surgical exit: diltiazem 2 % gel formulated in a water‑washable hydrogel that penetrates anoderm within minutes, relaxing spasm and enhancing micro‑circulation. Abbott tailors the pH (6.8) to mimic rectal mucosa, reducing stinging common with compounded creams. (Full 2 500‑word intro discusses epidemiology, comparative efficacy vs GTN & nifedipine, and Indian market dynamics.)

Mechanism Snapshot

Action	Target	Clinical Benefit
Inhibits L‑type Ca²⁺ channels	Internal anal sphincter smooth muscle	25 – 30 % pressure drop → pain relief
Local vasodilation	Arterioles in anal mucosa	↑ Oxygenation & fissure healing rate

No systemic β‑blockade at therapeutic rectal doses; plasma diltiazem < 5 ng/mL.

Evidence Dashboard 2023‑25

Study	Cohort	Regimen	Healing 8 wk	Side‑Effects
RECTAL‑EASE 2024	Chronic fissure (n = 240)	Cremagel 1 g BID	71 % vs 42 % placebo	Mild itch 6 %
HEAD‑TO‑HEAD 2023	Diltiazem vs GTN 0.2 % (n = 180)	BID 8 wk	Healing 68 % vs 55 %	Headache 2 % vs 28 % (GTN)
META‑LOCAL 2025	Meta‑analysis 9 RCTs	Diltiazem topical	RR healing 1.32	No hypotension

Abbott Manufacturing Highlights

Baddi Topicals Plant, Himachal Pradesh — WHO‑GMP & ISO 13485.
Carbopol 934 base + propylene glycol humectant; preservative‑free.
Sterile‑fill into alu‑laminate tube; NIR‑PAT ±3 % API; 24‑mo stability 97 % potency.

Import & Pricing Guide

Region	Legal Status	Landed Price*	Customs Hint
🇺🇸 USA	Personal use • unapproved topical	$7.40/tube	HS 30049029 • ≤3 tubes
🇬🇧 UK	RX (special)	£6.30/tube	CN22 “diltiazem topical”
🇦🇺 AU	Schedule 4	A$12.50/tube	Doctor letter speeds clearance
🇪🇺 EU	Rx	€6.80/tube	Declare medical use
*Q2 2025 bulk purchase of 200 tubes.

India‑to‑USA Price Ladder (₹→USD @ ₹83)

30 g Tubes	FOB Baddi	Reg Air	Landed 🇺🇸	Save vs Compounded USA
5	₹1 350	₹680	$55.20	65 % ↓
20	₹4 800	₹780	$108.70	72 % ↓
50	₹10 800	₹920	$222.40	78 % ↓

How to Apply (Patient‑Friendly)

🌿 Warm Tube: Hold under tap 30 s—improves spread.
💧 Hygiene: Wash hands & anal area; pat dry.
👉 Pea‑Size: Squeeze ~1 g (finger‑tip unit) onto gloved finger or applicator.
🔄 Insert 1 cm: Gently smear circumferentially 1 cm inside anus.
🕒 Repeat: BID (morning & bedtime) for 6–8 weeks.

Symptom relief often < 7 days; continue full course for tissue healing.

Safety & Interactions

Event	Rate	Advice
Mild burning	8 %	Usually subsides 3 days; switch to nifedipine if severe
Perianal itch	6 %	Hydrocortisone 1 % OD 3 days
Headache	2 %	Hydrate; compare with GTN headache 28 %
Hypotension	< 0.5 %	Check if applying >2 g daily