Hemorrhoid medications range from gentle OTC creams to prescription procedures. Here are the most effective options.
OTC Medications
Topical Creams
-
5% Lidocaine (Revivol-XR, RectiCare) — pain
-
Phenylephrine (Preparation H) — swelling
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Hydrocortisone 1% — inflammation
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Witch hazel — natural relief
Oral Supplements
-
Diosmin/Hesperidin (Daflon) — strengthens veins
-
Psyllium husk — fiber, prevents constipation
- Stool softeners (Colace)
Suppositories
For internal hemorrhoids — Revivol-XR, Preparation H, generic.
Prescription Medications
For Severe Inflammation
- Stronger hydrocortisone (2.5%)
- Pramoxine-hydrocortisone combos (Proctofoam HC)
For Anal Fissures (Often Co-Occurring)
- Nitroglycerin ointment (Rectiv)
- Calcium channel blockers (compounded)
Medical Procedures
1. Rubber Band Ligation
Most common procedure. Bands cut off blood supply.
2. Sclerotherapy
Injection shrinks hemorrhoid.
3. Infrared Coagulation
Heat seals off blood vessels.
4. Hemorrhoidectomy
Surgical removal for severe cases.
5. Stapled Hemorrhoidopexy
For prolapsed hemorrhoids.
Best Strategy
- Start with OTC creams + lifestyle changes
- Add supplements (Daflon, fiber)
- See doctor if no improvement in 1-2 weeks
- Consider procedures for chronic cases
FAQ
Strongest OTC?
5% lidocaine + phenylephrine combo (Revivol-XR).
When do I need a prescription?
If OTC doesn't help in 1-2 weeks, or for severe inflammation.
Start with maximum-strength OTC — Revivol-XR at hemorrhoid.com.
