Lidocaine (Lignocaine) + Metronidazole + Sucralfate is a topical combination medicine used to manage painful anorectal conditions such as anal fissures, haemorrhoids, and post-operative wounds. It provides a triple action effect where Lidocaine helps relieve pain by numbing the affected area, Metronidazole helps manage bacterial infection in the local region, and Sucralfate forms a protective barrier over the tissue to support healing. It is commonly used under medical supervision to reduce pain, prevent infection, and promote recovery in inflamed or damaged anorectal tissue. It is available as creams or ointments for external or intra-anal use under medical supervision.

Lidocaine (Lignocaine) + Metronidazole + Sucralfate is a topical combination medicine containing Lidocaine, a local anaesthetic of the amide class, Metronidazole, a nitroimidazole antibacterial agent, and Sucralfate, a cytoprotective compound. It is used in adults for the management of anorectal conditions such as anal fissures, haemorrhoids, and for relief following anorectal procedures.

This combination works through complementary actions that help relieve symptoms and support healing. Lidocaine reduces pain by blocking sodium channels in nerve endings, thereby preventing the transmission of pain signals from the affected area. Metronidazole helps control infection by acting against anaerobic bacteria commonly present in contaminated or inflamed anorectal tissue, which may otherwise delay healing. Sucralfate binds to proteins at the site of injury and forms a protective layer over the mucosa, helping shield the tissue from further mechanical irritation and supporting natural repair processes.

Together, these actions help reduce pain, minimise local infection risk, and promote healing of fissures or inflamed anorectal tissue. The medicine is commonly used as part of conservative treatment to manage symptoms and support recovery without the need for immediate surgical intervention in appropriate cases.

Lidocaine (Lignocaine) + Metronidazole + Sucralfate is available as topical creams or ointments for external application or intra-anal use under medical supervision. The duration of treatment depends on the severity of the condition and the patient’s clinical response. Supportive measures such as a high-fibre diet, adequate fluid intake, and avoidance of straining during bowel movements may further improve outcomes and reduce recurrence.

Lidocaine (Lignocaine) + Metronidazole + Sucralfate may be indicated by your doctor for:

Anal Fissures

For the treatment of acute and chronic tears in the anal lining to relieve pain and stimulate healing.

Haemorrhoids

To provide relief from pain, inflammation, and discomfort associated with internal or external haemorrhoids.

Post-operative Care

For wound management and pain relief following anorectal surgical procedures, such as a haemorrhoidectomy.

Anorectal Inflammation

To manage symptoms of burning and irritation in the rectal area while preventing bacterial complications.

Lidocaine (Lignocaine) + Metronidazole + Sucralfate may provide benefits such as:

• Provides rapid numbing of intense pain, itching, and burning sensations.

• Forms a protective physical "bandage" over the fissure to shield it from stool irritants.

• Targets anaerobic bacteria to reduce inflammation and prevent secondary infections.

• Supports faster tissue regeneration and wound closure.

• Minimises discomfort during bowel movements by coating the sensitive area.

• Offers a non-surgical alternative for managing chronic anal wounds.

• Features a localised action with minimal risk of internal side effects.

Lidocaine (Lignocaine) + Metronidazole + Sucralfate is generally well tolerated when used as directed. Most side effects, if they occur, are mild and localised to the application site.

Common side effects may include

• Mild burning or stinging sensation at the site of application

• Local irritation or redness

• Itching or discomfort

• Temporary increased sensitivity in the treated area

Uncommon side effects may include

• Dryness or peeling of the skin or mucosa

• Mild swelling or rash at the application site

• Headache or Dizziness (rare, usually if systemic absorption occurs)

Rare but important side effects may include

• Allergic skin reaction, such as severe rash or hives

• Persistent irritation or worsening of local symptoms

• Signs of hypersensitivity, such as swelling of the treated area

• If any side effects persist, worsen, or feel unusual, it is important to consult your doctor for further guidance.

Use Lidocaine (Lignocaine) + Metronidazole + Sucralfate exactly as directed by your doctor based on the prescribed form.

• Wash your hands thoroughly before and after applying the medication.

• Clean and gently dry the affected area before application.

• For external use, apply a small amount of cream or ointment to the affected area as directed.

• For intra-anal use, use the provided applicator. Ensure the applicator is clean before use and follow the specific instructions for insertion.

• It is often most effective to apply the medicine after a bowel movement to ensure the protective barrier stays in place.

• Do not use a larger amount or apply it more often than prescribed by your doctor.

• Clean the applicator with warm water and soap after each use and keep it dry.

Lidocaine (Lignocaine) + Metronidazole + Sucralfate works through a triple mechanism to relieve symptoms and promote healing in anorectal conditions.

Lidocaine acts as a local anaesthetic by blocking voltage-gated sodium channels in nerve endings at the site of application. This prevents the generation and transmission of pain signals, providing rapid relief from burning or discomfort.

Metronidazole is an antibiotic that disrupts the DNA synthesis of anaerobic bacteria. By eliminating these bacteria, it reduces local inflammation and prevents infections that would otherwise stall the healing process.

Sucralfate provides cytoprotection by binding to the protein-rich exudate of the damaged tissue. This forms a sticky, physical barrier that protects the area from irritation by digestive enzymes and stool, while also stabilising local growth factors to assist in tissue repair.

• Apply the medication after a bowel movement and a warm sitz bath for maximum effectiveness.

• Use a finger cot or the provided applicator to ensure the medicine reaches the internal anal canal if directed.

• Avoid straining during bowel movements, as this can worsen fissures and haemorrhoids.

• Consistency is key; use the medication at the same time every day as prescribed by your doctor.

• Inform your doctor if you experience a persistent metallic taste or dizziness.

• Wear loose-fitting cotton underwear to help keep the area dry and reduce irritation.

• Store at room temperature in a cool, dry place away from direct heat and sunlight.

• Keep the tube or container tightly closed when not in use.

• Do not freeze the medication.

• Keep out of the reach of children and pets.

• Do not use the medicine after the expiry date printed on the packaging.

• General Diet (NO CLINICALLY RELEVANT INTERACTION): Food and beverages do not affect the action of this medicine, as it is applied topically and has minimal systemic absorption when used as directed.

• Alcohol (NO DIRECT INTERACTION, CAUTION): No direct interaction is expected. However, alcohol may worsen symptoms of anorectal conditions such as irritation, pain, and delayed healing, particularly in fissures and haemorrhoids.

• Other Topical Anorectal Preparations (CAUTION): Using multiple topical products on the same area may increase local irritation or alter drug distribution. If more than one product is prescribed, they should be applied at different times as directed by a healthcare professional.

• Other Lidocaine-Containing Products (CAUTION): Concurrent use may increase total lidocaine exposure and theoretically increase the risk of systemic effects if applied over large areas.

• Systemic Metronidazole Therapy (CAUTION): If oral or injectable metronidazole is being used, cumulative exposure should be considered to avoid unnecessary overlap.

• Topical Irritants or Strong Antiseptics (CAUTION): Simultaneous use with harsh antiseptics or irritating agents may increase local discomfort and delay mucosal healing.

• Severe Liver Disease (CAUTION): Metronidazole is metabolised in the liver. Although systemic absorption from topical use is low, caution is advised in patients with significant hepatic impairment, especially if used over large areas or for prolonged duration.

• Hypersensitivity to Active Ingredients (SEVERE): Contraindicated in patients with known allergy to Lidocaine, Metronidazole, Sucralfate, or related compounds such as amide-type local anaesthetics or nitroimidazoles.

• Severely Inflamed or Extensive Ulcerated Tissue (CAUTION): Application over large areas of damaged mucosa may slightly increase systemic absorption, although clinically significant effects are uncommon with appropriate use.

An overdose may occur if Lidocaine (Lignocaine) + Metronidazole + Sucralfate is used in larger amounts than recommended or if it is accidentally swallowed. This may increase the risk of local irritation or lead to symptoms such as dizziness or a metallic taste. If you suspect an overdose or accidental ingestion, contact your doctor or seek medical advice promptly.

If you miss a dose, apply it as soon as you remember. If it is almost time for your next scheduled application, skip the missed dose and return to your regular schedule. Do not apply a double amount to make up for a forgotten dose.