Ultraproct

What fluocortolone pivalate and fluocortolone hexanoate with cinchocaine hydrochloride is and how it works

Ultraproct is a prescription-only rectal ointment or suppository that combines a corticosteroid (fluocortolone) with a local anaesthetic (cinchocaine) to relieve the pain, swelling, and itching of haemorrhoids (piles), superficial anal fissures, and proctitis. (1) (5)

Use Ultraproct exactly as your prescriber or the product's instructions direct, and only for the short period recommended -- typically no more than about 1-2 weeks, and not beyond 4 weeks in any case. If your symptoms have not clearly improved, or you feel you need to keep using it for longer, contact your prescriber for reassessment rather than continuing on your own.

Mechanism of action: how fluocortolone pivalate and fluocortolone hexanoate with cinchocaine hydrochloride works

Fluocortolone hexanoate and fluocortolone pivalate are two esters of the corticosteroid fluocortolone with different onset/duration profiles (pivalate: rapid-onset; hexanoate: slower-onset, more prolonged), giving a fast-and-lasting anti-inflammatory, antiallergic, and antipruritic effect. Cinchocaine (or, in some markets, lidocaine) is a local anaesthetic providing additional pain relief. Rectal absorption of fluocortolone pivalate is low (roughly 5-15% of the applied dose per the sources reviewed); systemic anaesthetic absorption is low enough, when used as directed, that systemic effects are not expected. (1) (5)

What fluocortolone pivalate and fluocortolone hexanoate with cinchocaine hydrochloride is used for

Before taking fluocortolone pivalate and fluocortolone hexanoate with cinchocaine hydrochloride

Do not take / not appropriate for

• Do not use Ultraproct if you are allergic to fluocortolone, cinchocaine (or, in some markets, lidocaine), or any other ingredient. (all countries) (1)
• Do not use Ultraproct if you have a known sensitivity to local anaesthetics. (all countries) (1)
• Do not use Ultraproct on skin with an untreated viral infection (such as chickenpox, shingles, or cold sores), or an untreated bacterial or fungal infection, unless your prescriber has also arranged appropriate anti-infective treatment. (all countries) (1) (5)
• Do not use on skin affected by tuberculosis or syphilis-related skin conditions. (New Zealand, European Union) (5) (3)

Tell your clinician about

• Any known allergies to corticosteroids or local anaesthetics.
• Any current skin infection (viral, bacterial, or fungal) in the area to be treated.
• If you are pregnant, planning pregnancy, or breastfeeding.
• If you are considering use in a child or adolescent -- Ultraproct's safety has not been specifically studied in this age group.
• If your symptoms have not improved after a short course of treatment -- you may need a proctological examination rather than continued self-treatment.

How to take fluocortolone pivalate and fluocortolone hexanoate with cinchocaine hydrochloride

• Clean the anal area thoroughly, ideally after a bowel movement, before applying.
• Ointment: smear a small (pea-sized) amount around the anus and just inside the anal opening; a nozzle is provided if internal (intrarectal) application is needed.
• Suppositories: insert one suppository well into the rectum, generally once daily; if symptoms are severe, your prescriber's instructions or the product information may allow up to two or three times on the first day or two.
• Wash your hands carefully after each application, and avoid any contact with your eyes.
• Symptoms often improve quickly, but do not stop too soon -- continuing at a lower frequency for about a week after symptoms clear can help prevent relapse.
• Do not use Ultraproct for longer than the short course recommended on your product's label (commonly around 5-7 days, with an absolute upper limit that varies by market from about 2 to 4 weeks) -- if you feel you need it for longer, this is a signal to contact your prescriber for reassessment rather than continuing on your own.

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (5) (6)

Missed dose

If you miss an application, apply it when you next remember and continue your normal short-course schedule. Do not apply extra amounts to make up for a missed dose.

Overdose

No specific overdose syndrome is described for correct topical/rectal use of Ultraproct in the sources reviewed. If Ultraproct is accidentally swallowed by a child, or applied in unusually large amounts over a wide area, contact a poisons information service or seek medical advice, since excessive absorption of the corticosteroid component is a theoretical risk. (1) (5)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Serious warnings

Interactions

• Medicines that strongly inhibit a liver enzyme called CYP3A (including some HIV medicines such as ritonavir or cobicistat-containing products) may increase how much corticosteroid is absorbed into the body from Ultraproct -- this combination should generally be avoided unless your prescriber decides the benefit outweighs the risk, with monitoring for corticosteroid side effects. (1)
• In markets where Ultraproct is formulated with lidocaine rather than cinchocaine, caution is advised if you take anti-arrhythmic heart medicines, since lidocaine can interact with them. (3)

Pregnancy, breastfeeding, kidney/liver function, age

Monitoring

Before starting

• Confirm the diagnosis (haemorrhoids/fissure/proctitis) rather than self-diagnosing persistent or unusual rectal symptoms
• Check for any active local infection that would need separate treatment first or alongside

During treatment

• Watch for skin thinning or unusual local skin changes, especially if use extends beyond the recommended short course.
• Seek reassessment if symptoms do not improve within the expected short timeframe.

Storage

Ointment: store below 25°C (77°F), do not refrigerate. Suppositories: store in a refrigerator (2-8°C/36-46°F); if a suppository has softened from heat, it can be firmed up again by placing it in cold water before removing the wrapper. Keep out of reach of children.

Frequently asked questions

References

1. Ultraproct Ointment -- Summary of Product CharacteristicsMedicines and Healthcare products Regulatory Agency (MHRA), United Kingdom -- official product SmPC · United Kingdom · accessed 2026-07-29 · source 1
2. Ultraproct Suppositories -- Summary of Product CharacteristicsMedicines and Healthcare products Regulatory Agency (MHRA), United Kingdom -- official product SmPC · United Kingdom · accessed 2026-07-29 · source 2
3. Ultraproct, creme rectal / supositorio -- Resumo das Caracteristicas do MedicamentoBayer Portugal, Lda. -- official EU national SmPC (Resumo das Caracteristicas do Medicamento), hosted on bayer.com · European Union · accessed 2026-07-29 · source 3
4. Ultraproct Salbe / Zaepfchen (fluocortolone pivalate/hexanoate + cinchocaine hydrochloride)Bayer Vital GmbH (Germany) and German consumer pharmaceutical reference sites, citing the German-marketed Ultraproct Salbe/Zaepfchen · European Union (Germany) · accessed 2026-07-29 · source 4
5. Ultraproct (ointment and suppositories) -- New Zealand Data SheetMedsafe (New Zealand Medicines and Medical Devices Safety Authority) -- official data sheet · New Zealand · accessed 2026-07-29 · source 5
6. ULTRAPROCT cinchocaine hydrochloride / fluocortolone hexanoate / fluocortolone pivalate ointment tube -- Cancelled under s30(1)(c) of the ActTherapeutic Goods Administration (TGA), Australia -- ARTG cancellation notice · Australia · accessed 2026-07-29 · source 6
7. Search for an Ultraproct-branded product or fluocortolone-containing product in the Health Canada drug product listingsHealth Canada Drug Product Database / product monograph search · Canada · accessed 2026-07-29 · source 7
8. Search for an Ultraproct-branded or fluocortolone-containing product on DailyMedDailyMed (NIH) / FDA product search · United States · accessed 2026-07-29 · source 8

Brand names by country

Single-ingredient fluocortolone pivalate and fluocortolone hexanoate with cinchocaine hydrochloride names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries