Efficacy of diltiazem 2% rectal gel in the treatment of chronic anal fissure: a retrospective observational study




Gabriel Martínez-Orea, Servicio de Farmacia, Hospital Vega Baja de Orihuela, Alicante, España
Francisco J. Rodríguez-Lucena, Servicio de Farmacia, Hospital Vega Baja de Orihuela, Alicante, España
Celia García-González, Servicio de Farmacia, Hospital Vega Baja de Orihuela, Alicante, España
Nieves Cano-Cuenca, Servicio de Farmacia, Hospital Vega Baja de Orihuela, Alicante, España
Ana Candela-Fajardo, Servicio de Farmacia, Hospital Vega Baja de Orihuela, Alicante, España
Rodrigo Bonilla-Peñarrubia, Servicio de Farmacia, Hospital Vega Baja de Orihuela, Alicante, España


Objective: The aim of this study is to describe the effectiveness and safety of a magistral formulation of diltiazem 2% rectal gel as a treatment for chronic anal fissure. Material and methods: A retrospective observational study of all patients that began treatment with diltiazem 2% gel during 2019. The primary endpoint of the study was anal fissure healing. We also looked for differences in effectiveness between those initiating treatment and those who had been previously treated, long-term effectiveness through a 2-year follow-up and frequency of adverse effects. Results: Of the 166 patients included in the study, anal fissure healed in 72.9%. We detected adverse effects in 12 patients, the most common was local irritation. After 2 years of follow-up, 88% of patients did not relapse. Conclusion: In this study, use of topical diltiazem 2% has been shown to be effective and safe in the treatment of anal fissure and should be considered as the first line of therapy.



Keywords: Diltiazem. Fissure in Ano. Administration. Topical.