DILTIGESIC GEL 30GM

Diltigesic 2% Gel 30g is a specialized, clinically indicated topical rectal preparation manufactured by Troikaa Pharmaceuticals. Formulated specifically for the non-surgical management of both acute and chronic anal fissures, this gel provides highly localized therapeutic action directly to the affected perianal tissues. By acting precisely at the site of discomfort, Diltigesic bypasses the systemic circulatory system, offering a safer profile with minimal risk of the blood pressure fluctuations or severe headaches frequently associated with oral calcium channel blockers or alternative topical nitrates (such as glyceryl trinitrate).

The Pharmacological & Healing Mechanism

The active pharmaceutical ingredient in Diltigesic is Diltiazem Hydrochloride (2.0% w/w), a potent medication belonging to the class of non-dihydropyridine calcium channel blockers.

When applied to the perianal region, the gel targets the underlying smooth muscle fibers of the internal anal sphincter. It works by selectively blocking the influx of extracellular calcium ions through L-type channels into the vascular and sphincter muscle cells. Because calcium is necessary for muscle contraction, preventing this influx forces the hyperactive, tightly constricted muscle fibers to relax. This mechanism addresses the two primary barriers to anal fissure recovery:

1. Interruption of the Pain-Spasm Cycle: Anal fissures cause intense pain, which triggers the internal sphincter to spasm involuntarily. This spasm causes further pain, creating a continuous loop. Diltigesic breaks this cycle by reducing sphincter hypertonia (excessive muscle tension), providing rapid and sustained relief from the sharp, throbbing pain that occurs during and after bowel movements.
2. Restoration of Anoderm Microcirculation: Chronic hypertonia compresses the tiny blood vessels supplying the posterior and anterior midlines of the anal canal—areas already prone to poor blood flow. By forcing the sphincter muscle to relax, Diltigesic removes this vascular compression, restoring localized microcirculation. The resulting surge in oxygenated blood and essential nutrients gives the damaged mucosal lining the biological support it needs to repair the skin tear rapidly

Clinical Indications & Therapeutic Uses

• Acute and Chronic Anal Fissures: Promotes definitive healing of painful linear tears or ulcers in the squamous epithelium of the lower anal canal.
• Internal Anal Sphincter Hypertonia: Effectively relaxes rigid or spasming sphincter muscles to normalize resting anal pressure.
• Alternative to Topical Nitrates: Serves as an excellent first-line or second-line medical therapy for patients who cannot tolerate nitroglycerin ointments due to debilitating systemic side effects like nitrate-induced headaches.

Premium Organogel Base Advantage

Diltigesic is formulated in a specialized, smooth organogel base. This carrier is specifically engineered for optimal stability and enhanced transdermal penetration through the delicate perianal skin layer. The non-greasy, easily-spread texture ensures that a small application covers the affected zone entirely, absorbing smoothly without leaving a messy residue, thus ensuring high patient comfort and compliance during the treatment course.