FAST & FREE 📦 2-DAY SHIPPING!*
If you want maximum-strength 5% lidocaine plus 0.25% phenylephrine in one cream, the two FDA-registered options on US shelves are Revivol-XR® Advanced and RectiCare® Advanced. Revivol-XR currently runs around $18 per ounce in a 1.5 oz tube. RectiCare Advanced runs around $29 per ounce in a smaller 1.06 oz tube. For the same active-ingredient combination, Revivol-XR is the better value per ounce as of May 2026.
If you only want phenylephrine and pramoxine (no lidocaine), Preparation H® Maximum Strength is the household name, and Walmart's Equate® is the same formulation at about a quarter of the price. Both work for symptom relief ... they just don't include lidocaine for numbing.
Full disclosure: Hemorrhoid.com and Revivol-XR are part of the same company. And YES -we make one of the products in the comparison below. We've kept everything to label-confirmed facts and current retail prices seen as of this blog posting. Every active ingredient links to its FDA DailyMed entry so you can verify. Don't take our word for it. Take the FDA's label and drug facts.
Five things drive the differences between OTC hemorrhoid creams:
The brands worth comparing are the ones that combine two or three of these.
Active ingredients are pulled straight from each product's current DailyMed label (the FDA's official source for OTC drug labeling). Tube sizes and prices come from current Amazon listings, captured May 22, 2026. Prices move ... verify before buying.
| Brand | Product | Active ingredients | Tube | Price | Per oz |
|---|---|---|---|---|---|
| Revivol-XR® | Advanced Hemorrhoid Cream | Glycerin 14.4%, Lidocaine 5%, Petrolatum 15%, Phenylephrine HCl 0.25% | 1.5 oz | $26.99 | $17.99 |
| RectiCare® | Advanced Hemorrhoidal Cream | Lidocaine 5%, Mineral Oil, Phenylephrine HCl 0.25%, White Petrolatum | 30 g (1.06 oz) | $31.20 | ~$29.43 |
| Doctor Butler's® | Hemorrhoid & Fissure Ointment (standard) | Lidocaine 4%, Phenylephrine HCl 0.25% | 1.0 oz | ~$24 | ~$24.00 |
| Preparation H® | Hemorrhoid Cream with Lidocaine | Lidocaine 5% | 0.9 oz | ~$27 | ~$30.00 |
| RectiCare® | Hemorrhoidal Cream (standard) | Lidocaine 5% | 30 g (1.06 oz) | ~$35.81 | ~$33.78 |
| Doctor Butler's® | Advanced Hemorrhoid & Fissure Ointment | Glycerin 37.5%, Lanolin 12.5%, Lidocaine 4%, Zinc Oxide 5% | 1.5 oz | $29.99 | $19.99 |
| Preparation H® | Maximum Strength (no lidocaine) | Glycerin 14.4%, Petrolatum 15%, Phenylephrine HCl 0.25%, Pramoxine HCl 1% | 1.8 oz | ~$36 | ~$20.00 |
| Equate® (Walmart) | Hemorrhoidal Cream (no lidocaine) | Glycerin, Phenylephrine HCl 0.25%, Pramoxine HCl 1%, White Petrolatum | 1.8 oz | ~$11 | ~$6.11 |
| Anusol® | Plus Hemorrhoidal Ointment (US) | Pramoxine HCl 1%, Zinc Sulfate 0.5% | 30 g | Varies | Varies |
The two creams that combine maximum-strength 5% lidocaine with 0.25% phenylephrine in a single tube are Revivol-XR Advanced and RectiCare Advanced. Same actives, same concentrations. Revivol-XR is $17.99 per ounce. RectiCare Advanced is roughly $29.43 per ounce ... about 64% more for the same combination. Doctor Butler's standard ointment uses the same combination at a lower 4% lidocaine concentration and runs around $24 per ounce.
Math aside: at $17.99/oz in a 1.5 oz tube, Revivol-XR is the cheapest cost-per-ounce in the entire lidocaine + phenylephrine segment, and the largest tube of the three combo products.
Single-ingredient 5% lidocaine creams run $30 to $34 per ounce in this category ... Preparation H Hemorrhoid Cream with Lidocaine is around $30 per ounce, RectiCare standard is around $34 per ounce. Revivol-XR gives you the same 5% lidocaine plus 0.25% phenylephrine for $17.99 per ounce. You're paying less for more.
Walmart's Equate Hemorrhoidal Cream is the cheapest option in the comparison at around $6 per ounce. It uses the same phenylephrine + pramoxine formulation as Preparation H Maximum Strength. It contains no lidocaine. If your symptoms are mostly swelling and discomfort and you don't need numbing, Equate is hard to beat on price. If pain or burning is part of what you're dealing with, you'll want lidocaine ... and a 5% lidocaine product is going to feel different.
The classic Preparation H Maximum Strength runs around $20 per ounce in the 1.8 oz tube. Same active ingredients as Equate (phenylephrine + pramoxine, no lidocaine), but at roughly three times the price. You're paying for brand and distribution, not formulation.
Different format, different conversation. Tucks® pads use witch hazel and usually complement a cream rather than replace it. Preparation H suppositories use phenylephrine in a different delivery format for internal symptoms. Doctor Butler's also makes a spray. Mayinglong is a traditional Chinese medicine ointment with a completely different ingredient framework (musk, bezoar, pearl, borneol, zinc carbonate); FDA registration varies by SKU.
Revivol-XR Advanced at $17.99 per ounce. It combines maximum-strength 5% lidocaine with 0.25% phenylephrine in a 1.5 oz tube ... the same active ingredients as RectiCare Advanced ($29.43/oz) and a stronger formulation than Doctor Butler's standard ointment ($24/oz) at a significantly lower price per ounce.
"Strongest" usually means maximum lidocaine. 5% is the legal OTC maximum. Products at 5% lidocaine include Revivol-XR Advanced, RectiCare Advanced, RectiCare standard, and Preparation H Hemorrhoid Cream with Lidocaine. Of those, Revivol-XR is the only one that also includes 0.25% phenylephrine at the lowest per-ounce price.
Different formulations for different needs. Preparation H Maximum Strength uses phenylephrine and pramoxine, no lidocaine. Preparation H Hemorrhoid Cream with Lidocaine uses 5% lidocaine only. Revivol-XR combines both 5% lidocaine and 0.25% phenylephrine in a single 1.5 oz tube at around $18 per ounce ... less per ounce than either Preparation H product. Which is "better" depends on whether you want numbing, swelling relief, or both.
Revivol-XR Advanced and RectiCare Advanced have the same active ingredients ... both contain 5% lidocaine plus 0.25% phenylephrine. Revivol-XR comes in a 1.5 oz tube at $17.99 per ounce; RectiCare Advanced comes in a 30 g (1.06 oz) tube at roughly $29.43 per ounce. Same formulation, different price.
It's the concentration by weight. 5% is the maximum allowed in over-the-counter creams in the US. A 5% lidocaine cream has roughly five times the active ingredient of a 1% OTC pain relief cream.
Creams are water-based and absorb faster, leaving less residue. Ointments are oil-based and sit on the skin longer, forming a more protective barrier. Both deliver the same active ingredients. Pick based on texture preference and how you want it to feel during the day.
If the active ingredients and concentrations are identical, the active ingredient is the same molecule. Walmart's Equate Hemorrhoidal Cream lists the same actives as Preparation H Maximum Strength (phenylephrine + pramoxine, no lidocaine). The inactive ingredients differ ... that's a texture and feel issue, not an effectiveness issue.
Heavy bleeding, severe pain, a lump that keeps getting worse, or symptoms that don't improve after about a week of consistent OTC use. OTC creams manage symptoms while your body does the healing or while you decide whether to see someone. They aren't designed to fix the underlying condition.
This article was researched and written by the Hemorrhoid.com editorial team. Active ingredient claims for every product in the comparison have been verified against current FDA DailyMed structured product labeling — the FDA's official source for over-the-counter drug labeling. Pricing was captured from current Amazon retail listings and is subject to change.
The article was reviewed for factual accuracy and approved for publication by Tenet Wellness Solutions, LLC, the publisher of Hemorrhoid.com. Tenet Wellness Solutions is the manufacturer of Revivol-XR and has disclosed that interest at the top of this article.
This guide is informational and does not constitute medical advice or a recommendation of any specific product for any specific person. For diagnosis, treatment, or questions about your symptoms, please consult a licensed healthcare provider. If you experience heavy bleeding, severe pain, or symptoms that do not improve within about a week of consistent OTC use, see a clinician.
Revivol-XR® is a registered trademark of Tenet Solutions, LLC, the publisher of this article. All other product names, brand names, and trademarks referenced in this article are the property of their respective owners and are used here only for purposes of identification, factual comparison, and editorial commentary. Specifically:
Tenet Wellness Solutions, LLC and Revivol-XR are not affiliated with, endorsed by, sponsored by, or otherwise connected to any of the third-party brands listed above. Comparisons in this article are based on publicly available FDA DailyMed labeling and current retail pricing, and are intended for informational and educational purposes only.
Compiled late May 2026. Informational only, not medical advice. If your symptoms are severe, don't improve within about a week, or include heavy bleeding, talk to a healthcare professional.
