Cremagel

Diltiazem

Price range: $12.00 through $56.00

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🗂️ 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)

  1. 🌿 Warm Tube: Hold under tap 30 s—improves spread.
  2. 💧 Hygiene: Wash hands & anal area; pat dry.
  3. 👉 Pea‑Size: Squeeze ~1 g (finger‑tip unit) onto gloved finger or applicator.
  4. 🔄 Insert 1 cm: Gently smear circumferentially 1 cm inside anus.
  5. 🕒 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

Avoid if allergy to diltiazem; safety in pregnancy Category C—use nitrates or sitz baths instead.


Storage & Travel

  • 15 – 25 °C; do not refrigerate—gel stiffens.
  • Replace cap tightly; discard 8 weeks after first opening.

Indian Companion Links (Internal)

  • Pentasa Suppository – Mesalamine 1 g for proctitis.
  • Ecosprin – Aspirin 75 mg for post‑sphincterotomy thromboprophylaxis.
  • Amlopres – Amlodipine 5 mg if systemic BP still high.
  • Rivaroxaban – DOAC in coexistent AF.

External Authoritative Links

Additional Information

Active

Diltiazem

Tubes

1, 3, 6

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