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Summary

Hemorrhoids, also known as piles, are swollen and distended veins in the lower rectum and the anus. Simply put, they are ‘varicose veins of the anus and the rectum’. Piles can be internal (develop inside the rectum) or external (under the skin around the anus).

Hemorrhoids can be caused due to several reasons, although the exact cause may often be unknown. They could be the result of overstraining during bowel movements or due to increased pressure on the rectal veins during pregnancy. The symptoms vary from mild itching and discomfort to bleeding and prolapse depending on the severity of piles. The treatment depends on the symptoms and the severity of piles. Treatment could be as simple as incorporating some lifestyle changes such as consuming fibrous foods to use of topical pain relievers or even surgery. The complications of piles are usually rare. If left untreated, piles or hemorrhoids can become chronic and inflamed and be prone to thrombosis (clot formation) and ulceration.

Hemorrhoids are usually not dangerous and need to be treated only if they are bothersome. Those occurring during pregnancy usually improve on their own after delivery. For hemorrhoids caused due to constipation, important changes to diet and lifestyle ensure a good prognosis. Surgical correction of piles also yields satisfactory results.

  1. Types of Piles
  2. Stages of Piles
  3. Piles Symptoms
  4. Piles Causes
  5. Prevention of Piles
  6. Diagnosis of Piles
  7. Piles Treatment
  8. Piles Risks & Complications
  9. What to avoid if you have Piles
  10. What to eat if you have Piles
  11. What are Piles?
  12. Ayurvedic medicine, treatment and remedies for Piles
  13. Homeopathic medicine, treatment and remedies for Piles
  14. Medicines for Piles
  15. Doctors for Piles

Types of Piles

There are two types of hemorrhoids: 

Internal Hemorrhoids

Internal hemorrhoids from within the anus beneath the mucus lining. These are usually painless although bleeding is a common symptom. Being painless in nature, you may realize that you have internal hemorrhoids only when you see bright red blood on the toilet paper or oozing in the toilet. Internal hemorrhoids may also prolapse or extend beyond the anus, which can cause complications. When hemorrhoid protrudes or prolapses, it can collect small amounts of mucus and tiny stool particles, which can cause discomfort and itching; trying to relieve the itch by wiping constantly can worsen the problem. A protruding internal hemorrhoid can appear like a small, grape-like mass. Usually, protruding hemorrhoids can be pushed back into the anus with a fingertip.

External Hemorrhoids

External hemorrhoids or external piles develop under the skin around the anus. Since there are many pain-sensing nerves in the skin, external piles cause pain in addition to bleeding. They can also cause difficulty in keeping the anal region clean after bowel movements. External piles can sometimes develop a blood clot inside them (thrombosis), usually after a period of diarrhoea or constipation. In such cases, a sudden, painful swelling or lumps around the rim of the anus can develop. You might notice or feel a lump around the anus. The blood clot usually dissolves, leaving behind an excess of skin (a skin tag), which may cause itching.

Stages of Piles

Hemorrhoids or piles have four stages or degrees depending on the severity of the symptoms 

First degree (only bleeding, no prolapse)
The nature of the bleeding is characteristically separate from the passage of stools. It may appear on the toilet paper upon wiping or as a splash in the toilet bowl.

Second degree (prolapse present but reduces spontaneously)
There is an appearance of a lump from the anal opening while passing stools. This lump then moves back in on its own.

Third degree (prolapse present and must be manually reduced
Here, the prolapsed or protruding piles do not move back in on their own their passing stools and have to be pushed in manually.

Fourth degree (permanent prolapse)
This is also called permanent prolapse. This means that the piles are protruding permanently outside and it is not possible to push them back manually.

Piles Symptoms

Symptoms of hemorrhoids include:

  • Bright red bleeding on the toilet paper after passing stools or a splash of blood in the toilet. This bleeding is usually painless and occurs especially if the stool was very hard or very large.
  • Discharge of mucus from the anal opening.
  • Itching, redness or soreness of the area around the anus
  • Feeling of bowel fullness even after passing stools
  • Pain while passing stools
  • For hemorrhoids that are prolapsed, a soft, grape-like lump can be felt protruding from the anus.
  • External hemorrhoids may also cause intermittent swelling, irritation, and discomfort, especially after diarrhea or constipation.
  • If external hemorrhoid has clots, the lump may have a bluish or purple tint and a painful lump, which may discharge blood and may suddenly appear at the rim of the anus.
  • In severe cases, there may be excessive anal bleeding, infection, strangulation of hemorrhoids, anal fistula formation, and fecal incontinence.

Painful hemorrhoids must be differentiated from other painful bleeding conditions, such as anal fissure, Crohn's disease, ulcerative colitis, anal fistula, and colorectal cancer.

Piles Causes

Causes

The veins around the anus tend to stretch under pressure and may swell or bulge due to which piles can develop. The pressure in the lower part of the rectum increases due to

  • Straining while passing stools
  • Chronic diarrhea or constipation
  • Sitting for long durations of time on the toilet seat

All the above factors interfere with the blood flow to and from the rectal area, cause the blood to pool, thereby enlarging the blood vessels. Also, straining during a bowel movement increases the pressure in the anal canal, pushing the hemorrhoids against the sphincter muscle.

  • Advanced age
    The tissues that support and hold hemorrhoids in place can weaken with age, thus causing the hemorrhoids to bulge and prolapse.
  • Obesity
    Here, the intra-abdominal pressure is raised causing engorgement of the rectal veins.
  • Pregnancy
    Apart from an increase in the intra-abdominal pressure, the enlarging uterus presses on the rectal veins causing them to swell.
  • Anal intercourse.

Risk Factors

A risk factor for hemorrhoids is any factor that increases the chance of having hemorrhoids. The factors known to increase the risk of having hemorrhoids are listed below:

  • Chronic constipation
    It causes excessive straining while passing stools thus increasing the pressure in the anal canal.
  • Low fiber intake
    It is associated with the reduced bulk of stools.
  • Sedentary lifestyle 
    It can worsen constipation and cause weight gain, thereby causing the muscles to lose their tone.
  • Inadequate water intake 
    Drinking less water can contribute to constipation, increasing the chances of hemorrhoids.

Prevention of Piles

The best way to prevent piles is to keep your stools soft so that they are easy to pass. Apart from regular physical activity, food also plays a major role in maintaining soft stools.

Aim for 25-30 grams or more of high fibrous food every day. High-fiber food usually has a mix of soluble and insoluble fiber both. If you are not used to it, gradually increase fiber in your diet as having too much too fast can cause flatus and bloating.

Here are some ways by which you can decrease the chances of developing piles or hemorrhoids: 

  • Avoid sitting on the pot for long durations
    The more time you spend sitting on the pot, the more likely are you to strain for passing stools. Also, the seated position exerts additional stress on the blood vessels of the anal region. Keep the stack of magazines and the smartphones out of the loo! See bathroom time as a necessity and not as an extended escape time!
     
  • Drink more water
    Step up your water intake as water is essential for soft stools. Softer stools mean less straining.
     
  • Do not delay your need to go 
    If you have a habit of delaying your bowel movement, it can cause your stools to become hard and dry, which in turn causes strain in passing stools, eventually causing pressure on the anal venous cushion.
    Also, do not unnecessarily force a bowel movement when u do not get the urge to pass stools naturally.
     
  • Have fiber-rich foods
    Include leafy vegetables, fresh fruits, whole grains, and cereals in your diet. You may also add a natural fiber, such as psyllium husk, in your diet. However, be careful to incorporate it slowly into your daily diet as it may cause gas and bloat in some people.
     
  • Exercise regularly
    Being physically active stimulates bowel movements. If you have never exercised before, do not jump into an intense exercise regimen, such as abdominal crunches or lifting heavy weights. Also, do not try to cram exercises at the weekend if you do not exercise throughout the week. Go slow and follow a simple and effective exercise routine. Even as little as a 20-minute walk every day can help in having regular and good bowel movements.
     
  • Stay Active
    If you have a desk job or a sedentary lifestyle, make sure you get up from your desk every hour or so for a 2-3 minute break. Incorporate short walks around your office space. Opt for stairs instead of the elevator. Park your car at the farthest parking slot to allow you more time to walk.

Diagnosis of Piles

Diagnosis

Hemorrhoids or piles can usually be diagnosed from a simple medical history and a physical examination of the anal region.

External hemorrhoids are usually apparent only by examination of the anal region by the doctor. 
To diagnose internal hemorrhoids, your doctor may perform some tests and examine your anal canal and rectum. These include;

  • Digital examination
    During a digital rectal exam, your doctor inserts a gloved and lubricated finger into your rectum and feels for anything unusual, such as growths. The digital examination suggests to your doctor whether further testing is needed.
     
  • Visual inspection
    Your doctor may also examine the lower portion of your colon and rectum with an anoscope, proctoscope, or sigmoidoscope to rule out any other causes of bleeding, such as colorectal cancer or colorectal polyps, especially in people over 45 years of age.

Piles Treatment

Non-invasive treatment options

If you have only mild discomfort due to your hemorrhoids, your doctor may suggest over-the-counter creams, ointments, suppositories, or pads. These products contain ingredients, such as hydrocortisone and lidocaine, which can temporarily relieve pain and itching.

Minimally invasive treatment options
For persistent bleeding or painful hemorrhoids, your doctor may recommend one of the following minimally invasive procedures. These procedures usually do not require anesthesia and can be done in the doctor's office only.

  • Rubber band ligation
    One or two small rubber bands are placed around the base of internal hemorrhoid to ensure that the rubber bands cut off the circulation of engorged hemorrhoid. Hemorrhoid then withers and falls off within a week or so. This procedure usually works very well for many people. However, hemorrhoid banding can be uncomfortable and may cause bleeding, which might actually occur 2-4 days after the procedure is performed. It is rarely severe but occasionally serious complications can occur.
     
  • Injection (sclerotherapy)
    In this procedure, your doctor injects a chemical solution into the affected hemorrhoids. This helps in shrinkage of the hemorrhoidal tissue. This procedure causes minimal or no pain but may be less effective than rubber band ligation.
     
  • Coagulation (infrared, laser, or bipolar)
    This procedure uses laser or infrared light or heat. It causes the small, bleeding, internal hemorrhoids to harden and shrivel up. Coagulation has few side effects but is associated with a higher rate of hemorrhoids recurrence compared to the rubber band treatment.

Surgical treatment options

Surgery for hemorrhoids is called as haemorrhoidectomy. Indications for haemorrhoidectomy are:

  • Third- and fourth-degree hemorrhoids.
  • Second-degree hemorrhoids that have not been cured by non-operative procedures.
  • Fibrosed hemorrhoids.
  • Intero-external hemorrhoids when the external hemorrhoid is well defined.

The surgery may be performed under local (combined with sedation), spinal, or general anesthesia. Surgery is the most effective treatment modality to treat severe or recurring hemorrhoids. The patient can go back home the same day and can get back to his routine in about 7-10 days.
Complications from surgery may include temporary difficulty in emptying your bladder and may result in urinary tract infections.

  • Hemorrhoid stapling (stapled hemorrhoidectomy or stapled hemorrhoidopexy)
    An alternative to hemorrhoidectomy, this procedure blocks blood flow to the hemorrhoidal tissue and is used only for internal hemorrhoids. It generally involves less pain than hemorrhoidectomy, although it has been associated with a greater risk of recurrence and rectal prolapse compared to a hemorrhoidectomy. Complications can also include bleeding, urinary retention, and pain and rarely a life-threatening blood infection (sepsis). Talk to your doctor about the best options for you.

Self-care

  • Try Sitz Bath
    A Sitz ("sitzen" means "to sit" in German) bath is a warm water bath for the buttocks and hips, which can relieve irritation and itching in the anal region and relax the anal sphincter muscle. You can use a small plastic tub that fits over the toilet seat or you can sit in a regular bathtub filled with few inches of warm water. A 20-minute Sitz bath after each bowel movement, 2-3 times a day helps. Thereafter, gently pat the anal area dry; do not wipe hard or try to rub.
     
  • Apply ice pack
    Keeping an ice pack at the anal region can help in reducing swelling and pain.
     
  • Use a cushion/soft surface
    Sitting on a cushion or a soft surface rather than a hard surface helps in reducing the swelling of the existing piles. It also prevents new hemorrhoids from forming.
     
  • Try topical medications
    Over-the-counter hemorrhoid ointments containing a local anesthetic can temporarily relieve pain and have no harmful effects.
     
  • Elevate your feet
    When you sit on the western commode, try elevating your feet a bit by placing a step stool. This changes the position of the rectum and it allows easier passage of stools.

Piles Risks & Complications

Prognosis

  • Hemorrhoids generally need treatment if they are bothersome.
  • Hemorrhoids that occur during pregnancy and usually spontaneously reduce after childbirth.
  • For hemorrhoids related to constipation, the prognosis is good if necessary changes are made in the diet and lifestyle.
  • For hemorrhoids that require surgical intervention or minimally invasive procedures, the results are usually very good.

Complications

Hemorrhoids if untreated may cause the following complications:

  • Profuse bleeding from the hemorrhoids usually occurs in cases of external piles.
  • Strangulation and thrombosis.
  • Ulceration can occur due to tissue death from pressure (tissue necrosis)
  • Gangrene can occur if the blood supply to a hemorrhoid is cut off.
  • Portal infection.
  • Fibrosis-thickening and scarring of the affected tissue can occur.

What to avoid if you have Piles

Any food with little or no fiber can cause or aggravate constipation. So, avoid or limit their intake as much as possible. These include:

  • Refined carbohydrates, including white bread.
  • Dairy products, including cheese.
  • Meat.
  • Processed foods, such as frozen meals and fast food.
  • Spicy food.
  • Alcohol.
  • Caffeine.
  • Salt
    Excess salt intake can cause water retention, which puts more pressure on your blood vessels, including the veins in the anal region.
  • Iron supplements can cause constipation. So, talk to your doctor before you take them.

What to eat if you have Piles

  • Add or substitute beans for meat in soups, as beans and nuts are high in fiber. Include legumes in your diet.
     
  • Grains, cooked oats, and barley will give you soluble fiber. Substitute white bread, pasta, and crackers with their whole grain counterparts.
     
  • Whenever possible, try to have fruits and vegetables whole, without peeling the skin on the apples, plums, potatoes, and pears, since the skin is a rich source of insoluble fibers. Avoid cooking green vegetables to the point that their color fades. A cup of greens, such as broccoli, green peas, or Brussels sprouts provides 4-5 grams of fiber. Vegetables and fruits, such as celery, cucumber, and watermelon, have fiber plus a lot of water. Add such vegetables into your diet. Snack on dried fruits, such as figs, apricots, and dates.

What are Piles?

Hemorrhoids are a very common health problem. They are usually not serious but can be very unpleasant and cause discomfort, thereby affecting the quality of life. The prevalence of piles is not selective for age or sex. However, old age is a risk factor for piles. Piles are less prevalent in the underdeveloped countries. The typical low-fibre, high-fat diet usually that is a norm in western countries is associated with straining and constipation, which consequently leads to the development of hemorrhoids.

Piles mean swollen and distended veins of the lower rectum and the anus. It is essential to understand that hemorrhoids are part of the normal human anatomy. The hemorrhoids form an anal cushion of veins present under the mucous membranes that line the lowermost part of the rectum and the anal canal. It is only when these veins are swollen and distended and may cause symptoms, we say a person has developed piles or hemorrhoids. The blood vessels involved must continuously fight gravity to get blood back up to the heart.

Dr. Mahesh Kumar Gupta

Dr. Mahesh Kumar Gupta

गैस्ट्रोएंटरोलॉजी

Dr. Raajeev Hingorani

Dr. Raajeev Hingorani

गैस्ट्रोएंटरोलॉजी

Dr. Vineet Mishra

Dr. Vineet Mishra

गैस्ट्रोएंटरोलॉजी

Medicines for Piles

Medicines listed below are available for Piles. Please note that you should not take any medicines without doctor consultation. Taking any medicine without doctor's consultation can cause serious problems.

Medicine NamePack SizePrice (Rs.)
EscotEscot 100 Mg Tablet57.0
FluolFluol 0.025% Mg/1% Mg Cream54.86
GenticynGenticyn 10 Mg Injection45.0
AcucortAcucort 100 Mg Injection43.05
Cort SCort S 100 Mg Injection36.0
FmpFmp Tablet55.38
HisoneHisone 10 Mg Tablet77.24
HydrolinHydrolin 100 Mg Injection41.32
Lycortin SLycortin S Injection43.5
PrimacortPrimacort 100 Mg Injection36.36
Solu CortSolu Cort 1000 Mg Injection756.25
SuccicortSuccicort 100 Mg Injection59.0
TroycortTroycort 100 Mg Injection40.9
AlcortAlcort 100 Mg Injection28.5
Biosone(Biochem)Biosone 100 Mg Injection18.75
CortisumCortisum 100 Mg Injection26.25
EfcorlinEfcorlin 0.02%/0.025% Nasal Drops25.0
H CortH Cort 100 Mg Injection38.47
HycortHycort 100 Mg Injection43.05
Hydrocort(Phc)Hydrocort 100 Mg Injection26.87
HydrocortisoneHydrocortisone Sodium 100 Mg Injection38.8
LabocortLabocort 100 Mg Injection28.0
MulticortMulticort 100 Mg Injection21.25
NiticortNiticort 100 Mg Injection42.5
Pilcort HPilcort H 100 Mg Injection52.25
UltracortUltracort 100 Mg Injection57.46
UnicortUnicort 100 Mg Injection15.95
CortgeeCortgee 100 Mg Injection20.0
CortilupCortilup 100 Mg Injection48.0
CortipenCortipen Injection23.75
DexelexDexelex 100 Mg Injection600.0
EntofoamEntofoam 2 Gm Inhaler536.5
Hydrocort(Cip)Hydrocort Injection20.81
Hys 100Hys 100 1 Gm Injection43.06
IcortIcort Tablet34.2
IntacorlinIntacorlin 100 Mg Injection37.5
StecortStecort 1 Gm Injection26.25
WosoneWosone 100 Mg Injection18.75
WycortWycort 25 Mg Injection46.02
Anas DeeAnas Dee Gel37.17
BiocaineBiocaine 2% Injection12.5
Lignocaine (Neon)Lignocaine 2% Injection17.0
Lox HeavyLox Heavy 2% Injection18.75
LoxicardLoxicard 2% Infusion52.0
NummitNummit 15% W/W Spray220.0
WocaineWocaine 2% Gel27.06
Xylocaine AdrenalineXylocaine Adrenaline 2% Injection30.7
Xynova LonzengeXynova Lonzenge 200 Mg Tablet52.56
AnescaineAnescaine 2% Gel38.0
LidfastLidfast 2% Injection31.25
LidocynLidocyn Gel53.9
Lidocyn PlusLidocyn Plus Injection41.5
LignoxLignox 1% Injection26.97
Lox (Neon)Lox 2% Injection32.5
OculanOculan 1% Injection144.2
ResocaineResocaine 2% Gel29.0
Xylo(Astra)Xylo 2% Infusion36.22
XylocaineXylocaine 1%W/V Injection34.5
Xylocaine HeavyXylocaine Heavy 5% Injection4.5
XylocardXylocard 2% Injection43.0
XyloxXylox 0.2% Gel37.17
AlocaineAlocaine Injection18.0
LcaineLcaine Injection30.0
NircaineNircaine Injection80.92
UnicainUnicain 2% Injection14.5
Wocaine AWocaine A Injection583.31
XylonumbXylonumb 2% Injection26.0
XynovaXynova 2% Gel39.65
ZelcaineZelcaine Injection16.58
Lignocaine (Azp)Lignocaine (Azp) 4% Cream11.87
LignocareLignocare Gel19.37
OcukaneOcukane 4% Solution27.48
PilenilPilenil 0.70% Ointment80.0
BiosoreBiosore 2% Gel38.5
CalignoCaligno Jelly37.5
GesicainGesicain 5% Ointment29.76
Suhagra DuralongSuhagra Duralong Spray264.0
Vigora SprayVigora 15 Gm Spray170.0
Xynova EndoXynova Endo 200 Mg Lozenges59.0
Zenegra LidoZenegra Lido Spray69.87
ZyloZylo 5% Ointment18.75
CabisylCabisyl Capsule118.0
DobesilDobesil 500 Mg Capsule140.0
DobestDobest 100 Mg Tablet94.5
Dobewin DDobewin D Capsule30.37
DobimustDobimust 500 Mg Capsule130.0
DovasDovas 500 Mg Capsule125.0
EfloEflo Capsule95.22
LogisilLogisil Capsule110.0
Swift (Invision)Swift Capsule111.0
VenosufVenosuf 500 Mg Capsule119.9
AlvitralAlvitral Tablet59.4
CaldobCaldob 500 Mg Capsule120.0
DobiletDobilet Capsule130.0
DosilDosil Capsule103.16
DoxiumDoxium Capsule106.17
MobiumMobium Capsule137.8
Osil Osil 500 Mg Capsule130.0
RhythmRhythm 500 Mg Capsule91.17
ZobilateZobilate Capsule98.52
BaycortBaycort 2% Cream24.06
Beclo 17 21Beclo 17 21 0.25% Lotion46.4
Beclo CBeclo C Lotion47.7
BeclodermBecloderm 0.025% Cream20.0
BetadermBetaderm 0.05% Cream60.0
DermaspanDermaspan 0.025%/1%/0.1% Cream32.72
GalvateGalvate 0.025% Lotion114.0
Propynate NfPropynate Nf 0.025% W/W Cream155.0
Rovate LotionRovate 0.05% W/V Lotion13.13
ZovateZovate 0.03% Ointment20.92
BetnitekBetnitek Lotion50.0
DiprobecDiprobec 0.025% Cream46.0
DipromildDipromild 0.0125% Cream30.75
GebicGebic Cream34.72
PilovatePilovate Cream20.62
CortimycinCortimycin Ointment60.0
CutisoftCutisoft 1% W/W Cream75.0
DaktacortDaktacort Gel53.68
DrocortDrocort Cream64.76
EldercoidEldercoid 0.1% Lotion42.0
HysoftHysoft 0.12% Cream92.61
LocoidLocoid 0.1% Lotion36.0
LocortLocort 1% Cream49.0
LycorLycor 1% Cream88.5
TendroneTendrone 0.5% Cream104.0
AtokidzAtokidz Lotion88.57
CutispotCutispot Cream180.0
DelsterDelster 1% Cream66.0
EfficortEfficort 0.127% W/W Cream160.0
Locoid LippoLocoid Lippo Cream43.0
Urea HcUrea Hc Cream46.47
BeclateBeclate 200 Mcg Inhaler340.0
BecorideBecoride 100 Mcg Inhaler282.96
MedivenMediven Cream36.0
RhinaseRhinase 0.025% Nasal Drops85.0
ZydipZydip 0.05% W/W Lotion135.0
DosminDosmin Tablet98.1
Venusmin(Martin&Amp; Harris)Venusmin 150 Mg Injection7.05
Venusmin(Water Bushnell)Venusmin 900 Mg Tablet308.2
Mamdew BabyMamdew Baby 7.50% Gel31.75
MucopainMucopain Gel50.0
T JelT Jel 7.50% Ointment38.45
OmnisootheOmnisoothe 10 Mg Lozenges16.0
Oragard BOragard B 20% Gel192.37
DobesioDobesio 0. 5 % Ointment37.13
OxeruteOxerute Cd 500 Mg Tablet195.0
AcdermAcderm 0.025%/1%/0.1% Cream36.87
Beclolab CgBeclolab Cg 0.25%/0.1%/1% Cream8.75
Beclotis CgBeclotis Cg 0.025%/1%/0.1% Cream12.5
Biomet CBiomet C 0.025%/1%/0.1% Cream29.25
Biomet CgBiomet Cg 0.025%/1%/0.1% Ointment28.5
Canditas BgnCanditas Bgn 0.1% Cream8.75
Clomax BgClomax Bg 0.25%/0.1%/1% Cream38.5
Decand BgDecand Bg 0.025%/1%/0.1% Cream11.2
Dewderm (Dew Drops Lab)Dewderm Ointment28.75
Fungi BcFungi Bc Drop34.28
Lamonte BLamonte B 0.025%/1%/0.1% Cream23.47
Lamonte BgLamonte Bg 0.025%/1%/0.1% Cream35.16
Lotril BgLotril Bg Cream60.5
Maxiderm RfMaxiderm Rf 0.025%/1%/0.1% Cream20.18
MydermMyderm 0.025%/1%/0.1% Ointment5.93
Refur PlusRefur Plus Cream28.87
SigmadermSigmaderm 0.025%/1%/0.1% Cream55.07
Translipo TripleTranslipo Triple 0.025%/1%/0.1% Cream47.02
Triben PlusTriben Plus Cream49.0
ZydermZyderm 0.025%/1%/0.1% Ointment9.53
Betsonir CgBetsonir Cg Cream2.5
Cloz GbCloz Gb 0.5%W/W/0.10%W/W/1%W/W Cream36.0
DiprodermDiproderm 0.025%W/W/0.1%W/W/1%W/W Cream33.65
QtecQtec 0.025%/1%/0.1% Ointment5.93
Qtec PlusQtec Plus Ointment9.0
SuperdermSuperderm 0.25%/0.1%/1% Cream42.35
AerocortAerocort 100 Mcg/50 Mcg Inhaler170.0
Aerocort ForteAerocort Forte 200 Mcg/200 Mcg Rotacap65.0
Aerocort HfaAerocort Hfa 100 Mcg/50 Mcg Inhaler170.0
Derisone LDerisone L Forte Respicap70.0
Durabec Breath InhalerDurabec Breath Inhaler111.0
VentorideVentoride 100 Mcg/50 Mg Inhaler104.2
Vent Plus Easecaps CapsuleVent Plus Easecaps 200 Mcg/100 Mcg Capsule30.12
Aerotide Forte DisketteAerotide Forte 400 Mcg/200 Mcg Diskette14.57
AerotideAerotide 200 Mcg/100 Mcg Inhaler59.2
Aerovent InhalerAerovent Inhaler158.75
Derisone RespicapDerisone 200 Mcg/100 Mcg Respicap19.0
Oflox DOflox D 0.3%W/V/0.1%W/V Eye Drop13.0
AnomexAnomex Suppository54.0
CorectCorect Suppository66.0
PileumPileum Suppository60.0
AnovateAnovate Cream83.5
Pilo GoPilo Go Cream55.0
Proctosedyl BdProctosedyl Bd Cream58.85
ProctosedylProctosedyl Ointment53.6
Tretcee HQ CreamTretcee Hq Cream89.0
Lomela LiteLomela Lite Cream75.0
NolasmaNolasma Cream90.47
Audisol DropAudisol Drop34.0
WaxolveWaxolve Ear Drop65.89
WaxonilWaxonil Ear Drop74.0
AudoticAudotic Ear Drops58.78
Obpex Eye DropsObpex Eye Drops29.0
OtiflamOtiflam Ear Drops51.6
OtorestOtorest Ear Drop52.0
Otras OtOtras Ot Drops42.0
Bestoflox ClBestoflox Cl Ear Drops33.93
Clodibiotic Ear DropClodibiotic Ear Drop48.0
DrepDrep Ear Drop46.55
Myclin OMyclin O Ear Drops30.5
BeclocidBeclocid Lotion37.5
CanditopCanditop 0.025%/1% Cream26.05
Canison BCanison B Cream44.0
Clofung GmClofung Gm Ointment18.82
Clofung GClofung G Ointment36.25
ClogentClogent Ointment40.0
Clomax BClomax B 0.025%W/W/1%W/W Cream47.0
Clona BClona B Ointment30.0
Fluol BFluol B 0.025% W/W/1% W/W Cream54.86
Fungnil BFungnil B 0.025%W/V/1%W/V Cream13.75
Lotril BLotril B Cream58.05
Moncid BMoncid B 0.025%W/V/1%W/V Solution114.0
Nifugal BNifugal B 0.025%/1% Ointment21.5
Ocan BOcan B Cream18.58
Strodent MouthStrodent Mouth Paint46.5
Surfaz BSurfaz B Cream57.76
Topcan BTopcan B Cream48.21
Topcan BgTopcan Bg Cream50.0
Trim BTrim B 0.025%W/W/1%W/W Cream32.0
Vg Can BVg Can B Cream53.0
Abzorb BAbzorb B Cream60.0
BecloromBeclorom Cream38.0
Candex BCandex B Lotion31.3
Candy BCandy B 0.025%/1% Cream34.5
Clen BClen B Cream18.08
Cloben 15Cloben 15 Cream36.1
Clozol B (Biochem)Clozol B Ointment31.0
DefunginDefungin Cream28.57
Exelvate BExelvate B Cream42.86
ExfungExfung 0.025%/1% Cream34.68
Fulcin (Kim Lab)Fulcin Drops35.0
Itchgo BItchgo B Cream10.0
Mazoderm BMazoderm B Cream27.66
Monila PlusMonila Plus 0.025%W/W/1%W/W Cream49.0
Stoma CareStoma Care Liquid77.0
Topiclo BTopiclo B 0.025%/1% Ointment34.48
ZedermZederm Cream36.0
Beclolab NBeclolab N 0.025%/0.5% Cream13.12
Beclomark NBeclomark N 0.025%/0.1% Cream20.5
Biomet NBiomet N 0.025%/0.5% Cream38.5
Beclocort NBeclocort N 0.025%/0.5% Cream14.9
Beclosone NBeclosone N 0.025%/0.5% Cream17.85
Beclotas NBeclotas N Ointment27.0
Beclotec NBeclotec N Ointment9.37
Becmet NBecmet N Cream28.5
Betabiotic PlusBetabiotic Plus Drops26.0
Betawok NBetawok N Cream12.5
Betsonir NBetsonir N Cream15.75
Daily MDaily M Tablet50.0
Beclomethasone 0.025% + Clotrimazole 1% + Gentamycin 0.1% CreamBeclomethasone 0.025% + Clotrimazole 1% + Gentamycin 0.1% Cream10.95
CandidermaCandiderma Cream42.8
Clowin GmClowin Gm Cream9.42
CuticareCuticare Cream55.0
DiproliteDiprolite Cream11.25
Siloderm MixiSiloderm Mixi Cream49.25
BeclosalBeclosal 0.025%/3% Cream29.0
Ephytol SEphytol S 0.025%W/W/3%W/W Ointment51.22
Zovate SZovate S 0.025%W/W/3%W/W Cream35.85
BiosalicBiosalic Ointment45.0
Belmycetine CBelmycetine C Ointment46.51
Chlorocol HChlorocol H Ointment70.0
Cortison OptichlorCortison Optichlor 10 Mg/5 Mg Ointment62.0
Renicol HRenicol H 1%/0.5% Eye Ointment0.0
Cd (Hicare)Cd Eye Ointment59.0
ChlorocortChlorocort Ointment61.01
ChloronixChloronix Eye Ointment57.15
Corti KemicetineCorti Kemicetine Ointment21.4
HcolHcol Eye Ointment39.93
ZemoistZemoist Eye Drops73.65
BencreamBencream Cream58.59
CandivateCandivate 0.025%/0.5%/1% Cream15.0
Canison BnCanison Bn Cream51.0
Clomax BnClomax Bn 0.025%/0.5%/1% Cream53.0
Clomazole SnClomazole Sn 0.025%/0.5%/1% Cream65.0
Cnb (Als)Cnb 0.025%/0.5%/1% Cream25.0
DermikemDermikem 0.025%/0.5%/1% Cream9.37
InfadermInfaderm Cream41.0
Naderm RfNaderm Rf 0.025%/0.5%/1% Cream21.15
OndermOnderm 0.025%W/W/0.5%W/W/1%W/W Ointment39.0
OtobioticOtobiotic 0.025%/0.5%/1% Ear Drop53.0
Qualis RfQualis Rf 0.025%/0.5%/1% Cream32.0
Ring OutRing Out 0.025%/0.5%/1% Cream20.0
Trizole BTrizole B Cream70.0
ZefacortZefacort 0.025%/0.5%/1% Cream18.0
ArdermaArderma 0.025%/0.5%/1% Cream17.46
Becsone NBecsone N Cream12.81
Burnol PrickdermBurnol Prickderm Cream23.56
Candex BgCandex Bg 0.025%/0.5%/1% Cream33.0
CutigardCutigard 0.025%/0.5%/1% Cream30.2
Czson NbCzson Nb Cream27.0
DermitrustDermitrust Cream7.35
FungihealFungiheal Cream33.22
Fungitop RfFungitop Rf Cream13.12
GerdermGerderm Cream8.75
GetridGetrid 0.025%/0.5%/1% Cream36.0
Mazoderm BnMazoderm Bn Cream15.0
MegadermMegaderm Cream7.5
Nb ClozNb Cloz 0.025%/0.5%/1% Cream32.8
PerisanPerisan Cream57.9
ZenodermZenoderm Ointment12.5
Betapro CBetapro C Lotion36.91
Candid BCandid B Cream98.0
Canesten SCanesten S Cream63.4
Rizole BRizole B Cream48.8
Triben BTriben B Cream73.0
Zydip CZydip C 0.025% W/V/1% W/V Cream99.0
Beczol CreamBeczol Cream65.0
Cantop BCantop B Cream9.68
Clocip BClocip B Cream40.0
Czson BCzson B Cream40.0
Kivzole BKivzole B Cream86.58
ObedermObederm Cream47.13
Biosone CBiosone C Ointment50.0
Cecort (Optica)Cecort Ointment45.0
Retichlor HRetichlor H Ointment60.0
CandibioticCandibiotic Ear Drop65.0
Orecure PlusOrecure Plus Ear Drops59.7
AlbioticAlbiotic Ear Drop52.0
GlybioticGlybiotic Ear Drop45.0
MycoticMycotic Ear Drop48.0
OtidropOtidrop Ear Drops25.33
OtocinOtocin Ear Drop39.6
CortecyclineCortecycline Eye Ointment9.4
TerracortTerracort Eye/Ear Drops29.62
CortigenCortigen Eye Drops53.43
Genticyn HcGenticyn Hc Eye Drop17.93
Smuth SuspensionSmuth Suspension65.15
Crotorax HcCrotorax Hc Cream43.4
DbioticDbiotic Eye Drops43.31
ErcobErcob 0.3%/0.025%/1% Ear Drop44.7
Mix BioticMix Biotic Drop50.0
OtichekOtichek 0.3%/0.025%/% Eye Drop46.44
OtifloxOtiflox 0.3%/0.025%/1% Ear Drop44.44
Otobiotic PlusOtobiotic Plus 0.3%/0.025%/1% Drop56.0
Candid OCandid O Ear Drop62.0
OtinexOtinex Ear Drops26.2
Otolux OOtolux O Ear Drop41.37
OtonormOtonorm Ear Drop50.0
DentacainDentacain 8.7%/2% Gel58.0
CurasilCurasil Gel32.0
Orogard SgOrogard Sg Ointment20.0
SelenoSeleno Gel45.0
DesolDesol Drop46.67
OtorexOtorex Drop75.6
Vovax Ear DropsVovax Ear Drops32.0
EclospanEclospan 0.025%/2%/0.5% Cream44.5
MegaspanMegaspan Cream22.9
NovacorNovacor Cream30.0
ValbetValbet Cream21.0
CatarnilCatarnil Drops25.25
Fexit BFexit B 0.025%/2% Cream61.53
Fudic BnfFudic Bnf 0.025% W/W/2% W/W Cream135.0
Fusiate BFusiate B 0.25 Mg/20 Mg Cream95.0
Fusikab BFusikab B 0.025%/2% Cream64.76
Fuson BFuson B 0.25 Mg/20 Mg Cream45.0
Niogenta FNiogenta F 0.025% W/W/2% W/W Cream169.0
FusiateFusiate Cream115.0
Fusi BFusi B Cream77.15
Fucidin HFucidin H 1%/2% Cream156.5
Fuseal HFuseal H 2%W/W/1%W/W Ointment118.0
Fuson HFuson H 1%W/W/2%W/W Cream50.0
Fusee BFusee B 0.025%W/W/2%W/W Cream185.0
Fusidil BFusidil B Cream68.0
Fusigen DpFusigen Dp Cream64.3
Fuseal BFuseal B Cream68.4
Gentalene PlusGentalene Plus Cream76.0
Nuforce GmNuforce Gm 0.025% W/W/1% W/W/0.5% W/W Cream33.0
Quadriderm RfQuadriderm Rf Cream97.0
Toprap NcToprap Nc Cream28.85
TrijekTrijek Cream40.0
TrinilTrinil 0.025%/1%/0.5% Lotion43.8
BageeBagee Cream39.8
Bestopic NBestopic N Cream45.0
Candiderma PlusCandiderma Plus Cream72.0
Cloben GCloben G Cream84.0
Dermolin GmDermolin Gm Cream34.9
Fungid NcFungid Nc Cream38.67
Gentalene C PlusGentalene C Plus Cream66.18
MegaseptMegasept Ointment59.0
SkintopSkintop Cream58.0
Sriderm CreamSriderm Cream22.0
TotaldermTotalderm Cream37.0
Healex PlusHealex Plus 0.36%/6.5% Spray176.73
KeralinKeralin Ointment70.0
KetonateKetonate 0.03%/22% Cream36.5
LidocamLidocam Mouth Wash84.75
Lignocad AdrLignocad Adr Injection12.5
Lignox+AdrenlineLignox+Adrenline 0.005 Mg/2% Injection25.86
XicaineXicaine 0.022 Mg/2% Injection21.5
Mugel Freshora 8.7%W/W/2.0%W/W GelMugel Freshora 8.7%W/W/2.0%W/W Gel40.0
Oraflora LaOraflora La 8.70% W/W/2% W/W Gel48.4
ViloralViloral 8.7%W/W/2%W/W Gel51.9
Anabel CtAnabel Ct 8.7% W/W/2% W/W Gel53.0
DentogelDentogel 8.7%/2% Gel57.7
MyclinMyclin 1%W/W/2%W/W Ear Drops25.0
RaystatRaystat 1%W/W/2%W/W Eye/Ear Drops44.45
NumbexNumbex Cream160.0
XyloplusXyloplus Ointment37.0
AsthesiaAsthesia Cream530.0
DolocaineDolocaine Cream137.9
Xynova PXynova P Cream144.0
OcoticOcotic Drops29.0
OticlorOticlor Eye Drops21.0
OtigardOtigard Ear Drops19.42
OtilanOtilan Ear Drop54.0
ClocibioticClocibiotic Ear Drops33.66
ClodideClodide Ear Drops19.96
OtiscotOtiscot 5%/1%/0.025% Drop24.57
Oflo BmOflo Bm Ointment20.5
Ofloxamac DOfloxamac D 0.3%W/V/0.1%W/V/0.02%W/V Eye Drop9.45
Onabet BOnabet B 0.025% W/W/2% W/W Cream129.0
Sertacide BSertacide B Cream119.0
Orabliss 2%/2% GelOrabliss 2%/2% Gel61.0
Orex 8.7%W/W/10%W/W CreamOrex 8.7%W/W/10%W/W Cream59.0
Otobiotic Sf 0.3%W/V/1%W/V/2%W/V Eye DropOtobiotic Sf 0.3%W/V/1%W/V/2%W/V Eye Drop39.0
PentadermPentaderm Cream32.0
Quik KoolQuik Kool Gel65.0
Ora FastOra Fast Cream40.0
Orex LoOrex Lo Gel58.3
Manforce StaylongManforce Staylong Condom Pineapple24.92
Sii HibroSii Hibro 1933 To/10 Mcg Injection360.57
Softee(Leo)Softee Laxative Syrup94.9
Sufrate LaSufrate La Cream75.0
TricozolTricozol Ear Drop50.5
Tympalin CTympalin C Drops45.0
PilcarePilcare Cream29.0
Hairmax ForteHairmax Forte Solution584.0
Lignocaine 2% InjectionLignocaine 2% Injection15.13
Lignocaine (Cdl)Lignocaine 213 Mg Injection10.0
Lignocip 2 % InjectionLignocip 2 % Injection29.96
XcinXcin Gel138.1
ADEL Acid Mur DilutionAcid Muriaticum Dilution 1 M155.0
Dr. Reckeweg Aconite Nap DilutionAconite Nap Dilution 1 M155.0
ADEL Aconite Nap DilutionAconitum Napellus Dilution 1 M155.0
Schwabe Aconitum PentarkanAconitum Pentarkan Tablet140.0
ADEL 15Adel 15 Fluofin Drop215.0
Adel 1Adel1 Apo Dolor Drop215.0
ADEL 22Adel 22 Renelix Drop215.0
ADEL 2Adel 2 Apo Ham Drop215.0
ADEL 32Adel 32 Opsonat Drop215.0
ADEL 33Adel 33 Apo Oedem Drop215.0
ADEL 34Adel 34 Ailgeno Drop215.0
ADEL 44Adel 44 Venorbis Drop215.0
ADEL 48Adel 48 Itires Drop215.0
ADEL 54Adel 54 Cangust Drop215.0
ADEL 5Adel 5 Apo Stom Drop215.0
ADEL 6Adel 6 Apo Strum Drop215.0
ADEL 78Adel 78 Dercut Ointment360.0
ADEL 85 TonicAdel 85 Neu Regen Drinking 10 Ml Ampoule880.0
ADEL 86Adel 86 Verintex N External Drop215.0
ADEL Alfalfa Tonic with GinsengAdel Alfalfa Tonic230.0
Dr. Reckeweg Aesculus Hip. DilutionAesculus Hip Dilution 1 M155.0
ADEL Aesculus Hip DilutionAesculus Hippocastanum Dilution 1 M155.0
Schwabe Aesculus PentarkanAesculus Pentarkan Drop280.0
SBL Aesculus OintmentAesculus Ointment55.0
Schwabe Alpha-CFAlpha Cf Tablet93.0
Schwabe Alpha-HAAlpha Ha Drop90.0
Schwabe Alpha-MSAlpha Ms Tablet93.0
Schwabe Alpha-RCAlpha Rc Tablet186.0
Mama Natura AnekindAnekind Globules180.0
Schwabe Berberis PentarkanBerberis Pentarkan Tablet140.0
ADEL Berberis Vulg DilutionBerberis Vulgaris Dilution 1 M155.0
Dr. Reckeweg Berberis Vulg. DilutionBerberis Vulg Dilution 1 M155.0
Bjain BC 4 TabletBiocombination No. 04 Tablet75.0
Bjain BC 17 TabletBiocombination No. 17 Tablet75.0
Bjain BC 18 TabletBiocombination No. 18 Tablet75.0
Dr. Reckeweg BC 18Biocombination No. 18 Tablet135.0
Bjain BC 20 TabletBiocombination No. 20 (Bjain) Tablet75.0
Dr. Reckeweg BC 20Biocombination No. 20 Tablet135.0
Dr. Reckeweg BC 23Biocombination No. 23 Tablet135.0
SBL BC 23Tablet Biocombination No. 2375.0
Dr. Reckeweg BC 26Biocombination No. 26 Tablet135.0
ADEL Calc Fluor DilutionCalcarea Fluor Biochemic Tablet 6 X135.0
SBL Calcarea fluorica TabletCalcarea Fluorica Biochemic Tablet 12 X75.0
Dr. Reckeweg Calcarea Fluor DilutionCalc Fluor Dilution 1 M155.0
Mama Natura CalciokindCalciokind Tablets180.0
Dr. Reckeweg Carduus Mar DilutionCarduus Mar Dilution 1 M155.0
ADEL Carduus Mar DilutionCarduus Marianus Dilution 1 M155.0
Schwabe Carduus Marianus PentarkanCarduus Marianus Pentarkan Tablet140.0
SBL Clearstone DropsClearstone Drop100.0
ADEL Collinsonia DilutionCollinsonia Canadensis Dilution 1 M155.0
Dr. Reckeweg Collinsonia can DilutionCollinsonia Can Dilution 200 C125.0
SBL Curoplus OintmentCuroplus Gel80.0
Mama Natura EnukindEnukind Globules180.0
SBL FP OintmentF.P. 200 Tablet125.0
HadensaHadensa Capsule40.0
SBL Hamamelis OintmentHamamelis Ointment55.0
Dr. Reckeweg Hamamelis virg DilutionHamamelis Virg Dilution 1 M155.0
ADEL Hamamelis Virg DilutionHamamelis Virginiana Dilution 1 M155.0
SBL Kalmegh SyrupKalmegh Paediatric Drop60.0
SBL Liver TonicLiv T Paediatric Tonic105.0
Schwabe Magnesium Phosphoricum PentarkanMagnesium Phosphoricum Pentarkan Tablet140.0
Mama Natura NisikindNisikind Globules180.0
ADEL Nux Vomica DilutionNux Vomica Dilution 1 M155.0
Dr. Reckeweg Nux Vomica DilutionNux Vomica Mother Tincture Q200.0
Omeo Flu TabletsOmeo Flu Tablet109.0
Omeo k-Stone SyrupOmeo K Stone Syrup49.0
Omeo Liver SyrupOmeo Liver Syrup49.0
Omeo PilesOmeo Piles Tablet109.0
ADEL Paeonia Off DilutionPaeonia Officinalis Dilution 1 M155.0
Dr. Reckeweg Paeonia off DilutionPaeonia Officinalis Dilution 1 M155.0
ADEL Petroselinum DilutionPetroselinum Sativum Dilution 1 M155.0
ADEL Ratanhia Mother Tincture QRatanhia Peruviana (Adel) Mother Tincture Q225.0
Dr. Reckeweg Ratanhia DilutionRatanhia Peruviana Dilution 1 M155.0
Dr. Reckeweg R95Reckeweg Alfalfa Tonic490.0
Dr. Reckeweg R11Reckeweg R11 Rheumatism Drop200.0
Dr. Reckeweg R13Reckeweg R13 Hemorrhoidal Drop200.0
Dr. Reckeweg R17Reckeweg R17 Tumour Drop200.0
Dr. Reckeweg R18Reckeweg R18 Kidney And Bladder Drop200.0
Dr. Reckeweg R27Reckeweg R27 Kidney Stone Drop200.0
Dr. Reckeweg R28Reckeweg R28 Exhaustion Due To Loss Of Blood Drop200.0
Dr. Reckeweg R2Reckeweg R2 Essentia Aurea Gold Drop200.0
Dr. Reckeweg R30Reckeweg R30 Universal Ointment510.0
Dr. Reckeweg R34Reckeweg R34 Recalcifying Drop200.0
Dr. Reckeweg R35Reckeweg R35 Teething Aches Drop200.0
Dr. Reckeweg R37Reckeweg R37 Intestinal Colic Drop200.0
Dr. Reckeweg R42Reckeweg R42 Varicose Veins Drop200.0
Dr. Reckeweg R50Reckeweg R50 Gynae Sacroiliac Drop200.0
Dr. Reckeweg R52Reckeweg R52 Travel Sickness Drop200.0
Dr. Reckeweg R55Reckeweg R55 Injuries, Healing Drop200.0
Dr. Reckeweg R5Reckeweg R5 Stomach Drop200.0
Dr. Reckeweg R60Reckeweg R60 Blood Purifier Drop200.0
Dr. Reckeweg R63Reckeweg R63 Impaired Circulation Drop200.0
Dr. Reckeweg R6Reckeweg R6 Influenza Drop200.0
Dr. Reckeweg R70Reckeweg R70 Neuralgia Drop200.0
Dr. Reckeweg R71Reckeweg R71 Sciatica Drop200.0
Dr. Reckeweg R76Reckeweg R76 Asthma Forte Drop200.0
Dr. Reckeweg R78Reckeweg R78 Eye Care Drops For Drinking200.0
Dr. Reckeweg R7Reckeweg R7 Liver And Gall Bladder Drop200.0
Dr. Reckeweg R86Reckeweg R86 Low Blood Sugar Drop230.0
SBL Drops No. 3Sbl Drops No. 3125.0
SBL Drops No. 6Sbl Drops No. 6125.0
Dr. Reckeweg Scrophularia Nod QScrophularia Nod Mother Tincture Q230.0
ADEL Sedum Acre Mother Tincture QSedum Acre Mother Tincture Q265.0
Dr. Reckeweg Sempervivum Tect QSempervivum Tect Mother Tincture Q265.0
Schwabe Silicea PentarkanSilicea Pentarkan Tablet280.0
Soliwax Ear DropSoliwax Ear Drop92.0
SBL Vertefine DropsVertefine Drop90.0

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