MTW NHS Trust West Kent CCG

Drug Status Key

  • Preferred
  • Second Line
  • Third Line
  • Specialist Initiation
  • Hospital Only
  • Not Approved for Formulary

Anal fissures

Drug Safety update

 December 2014: Botulinum toxin products: rare but serious risks

Following conservative treatment failure:

  • Glyceryl trinitrate or Diltiazem can be used. Maximum 8 weeks treatment only. Needs medical review if problem persists beyond this time.
  • Botulinum A toxin was agreed by DTMMC for chronic anal fissure as an unlicensed indication.