Neoproct (Fluocortolone Pivalate, Anhydrous Lidocaine Hydrochloride)

Neoproct is a topical corticosteroid‑local anesthetic combination used for conditions affecting the anorectal mucosa.

• Hemorrhoidal disease: diminishes swelling, bleeding and pain associated with internal and external hemorrhoids.
• Proctitis (rectal inflammation): reduces mucosal inflammation and associated discomfort.
• Anal fissures: promotes healing and alleviates sharp pain during bowel movements.
• Rectal itching and pain: provides rapid local anaesthesia and anti‑inflammatory relief.

• Fluocortolone pivalate binds to intracellular glucocorticoid receptors, modulating gene transcription to suppress pro‑inflammatory cytokines, prostaglandin synthesis and leukocyte migration. Anhydrous lidocaine hydrochloride blocks voltage‑gated sodium channels in peripheral nerve membranes, preventing depolarisation and delivering local anaesthesia. The combined actions result in reduced inflammation and immediate pain relief at the site of application.

Neoproct may cause local and systemic adverse reactions. Most are mild and reversible.

Common Side Effects

• Burning sensation at the application site
• Mild itching or pruritus
• Local dryness or flaking of the mucosa
• Transient mild discomfort after application
• Slight reddening of the perianal skin

Serious or Rare Side Effects

• Allergic reaction with swelling, rash or urticaria
• Severe hypersensitivity leading to anaphylaxis
• Systemic corticosteroid effects such as adrenal suppression with prolonged use
• Secondary infection of the treated area
• Persistent ulceration or necrosis of rectal tissue

Before initiating Neoproct, clinicians should consider several safety measures.

• Assess for infection: avoid use on overtly infected or ulcerated tissue.
• Limit duration: prolonged therapy may increase systemic corticosteroid exposure.
• Monitor systemic absorption: watch for signs of adrenal suppression in extensive or repeated use.
• Avoid in known hypersensitivity: discontinue if allergic reactions occur.
• Use cautiously in diabetic patients: systemic effects may alter glucose control.
• Store at ambient temperature: keep below 25 °C, in the original packaging, protected from moisture and direct sunlight.

Neoproct can interact with other medicines that affect coagulation, systemic corticosteroid load, or cardiac conduction.

Major Interactions (Avoid)

• Systemic corticosteroids: additive immunosuppression and adrenal suppression.
• Class I anti‑arrhythmic agents (e.g., quinidine, procainamide): increased risk of cardiac conduction abnormalities when lidocaine is absorbed.
• Strong CYP3A4 inhibitors: may raise systemic levels of fluocortolone.

Moderate Interactions (Monitor Closely)

• Non‑steroidal anti‑inflammatory drugs (NSAIDs): heightened risk of gastrointestinal irritation.
• Anticoagulants (warfarin, DOACs): potential for increased bleeding if mucosal integrity is compromised.
• Immunosuppressants (e.g., azathioprine): monitor for enhanced immunosuppressive effect.