Hepathrombin H rectal ointment – prednisolone, heparin and lauromacrogol for haemorrhoids

Hepathrombin H rectal ointment is a Hemofarm combination medicine with three active substances: prednisolone acetate (a corticosteroid with anti-inflammatory action), heparin sodium (prevents blood clotting in haemorrhoids) and lauromacrogol 400 (relieves pain and itching locally).

According to the approved leaflet, it is intended for short-term symptomatic treatment of haemorrhoids – relief of itching, burning, stinging, pain, swelling, inflammation and weeping in the perianal region. The 20 g tube comes with an applicator for internal haemorrhoids.

What is Hepathrombin H rectal ointment used for and how should it be applied?

Key facts about the medicine

What is Hepathrombin H rectal ointment used for?

The medicine is intended for short-term symptomatic treatment of haemorrhoids in the perianal region, i.e. to relieve:

• itching, burning and stinging
• pain
• swelling and inflammation
• weeping

Prednisolone has an anti-inflammatory effect, heparin prevents blood clotting in haemorrhoids, and lauromacrogol 400 has a local anaesthetic and anti-itch effect.

How is it used and dosed?

• External haemorrhoids: apply the ointment to the affected area twice a day after bowel movements. On the first day of treatment it may be applied up to 4 times for faster relief.
• Internal haemorrhoids: attach the supplied applicator to the tube, insert it into the end of the large intestine and squeeze out a small amount of ointment with light pressure.
• Treatment should not last longer than 7 days; if there is no improvement, the cause of the symptoms should be investigated.

The leaflet mentions that a separate form – Hepathrombin H suppositories – may also be used for internal haemorrhoids; it has its own dosing and is not covered on this page.

Special patient groups

• Children: the official documentation gives no recommendations for use in children – consult a doctor.
• Elderly and people with kidney or liver impairment: no specific dose adjustment is mentioned.
• Pregnant women: contraindicated in the first trimester; in the second and third trimester only after a doctor's assessment.

Contraindications – when the medicine must not be used

• infection around the anus
• increased tendency to bleed
• first trimester of pregnancy

Precautions and warnings

• The leaflet lists no special warnings, but use is limited to a short period (up to 7 days).
• Prolonged use may slow the healing of small wounds of the skin and mucosa and lead to systemic corticosteroid effects.
• The medicine contains lanolin, which may cause local skin reactions (e.g. contact dermatitis).
• Rectal bleeding, changes in stools or recurring symptoms require a doctor's examination.

Interactions with other medicines, alcohol and food

Use of Hepathrombin H rectal ointment together with other rectal medicines is not recommended. Tell your doctor or pharmacist about all medicines you use.

Pregnancy and breastfeeding

The medicine must not be used in the first trimester of pregnancy. In the second and third trimester it may be used with caution, with the decision made by a doctor after careful assessment. During breastfeeding it is used only when necessary, as decided by a doctor.

Driving and using machines

Hepathrombin H rectal ointment has no effect on the ability to drive or use machines.

Possible side effects

• Prolonged use: delayed healing of small wounds of the skin and mucosa and possible systemic effects of prednisolone.
• Extremely rare: hypersensitivity reactions and local irritation (small possibility of allergy to lauromacrogol 400).
• Lanolin may cause contact dermatitis.

Suspected side effects can be reported to a doctor, pharmacist or ALIMS.

Overdose, missed dose and stopping treatment

• Overdose or accidental use by another person: contact a doctor, pharmacist or the nearest healthcare facility immediately.
• Missed dose: apply it as soon as possible; if the next one is due soon, continue as scheduled. Do not apply a double dose.
• Stopping treatment: the leaflet advises not to stop without consulting a doctor; treatment should not last longer than 7 days.

Related information

• How are hemorrhoids treated in pregnant women?

For additional care and support with haemorrhoids, see also the Hemorrhoids category – products in this category do not replace the medicine you have been prescribed.

Composition, packaging and manufacturer

• 1 g rectal ointment contains 2.233 mg prednisolone acetate, 65 IU heparin sodium and 30 mg lauromacrogol 400.
• Excipients: hard paraffin, liquid paraffin, lanolin, colloidal anhydrous silica.
• Appearance: yellowish-white, translucent, gel-like ointment with a characteristic smell.
• Pack: aluminium tube with 20 g ointment, plastic applicator with cap and leaflet.
• Marketing authorisation holder and manufacturer: Hemofarm AD Vršac, Beogradski put bb, Vršac, Serbia.

Storage

• Store below 25 °C.
• After first opening keep the tube closed and use within 28 days.
• Keep out of the sight and reach of children; do not use after the expiry date.
• Return unused medicine to a pharmacy that collects unused medicines.

Frequently asked questions

How many times a day is Hepathrombin H ointment applied?

For external haemorrhoids twice a day after bowel movements; on the first day of treatment it may be applied up to 4 times. Treatment should not last longer than 7 days.

Can Hepathrombin H be used during pregnancy?

Not in the first trimester. In the second and third trimester it may be used only with caution and as decided by a doctor after assessment.

How is Hepathrombin H used for internal haemorrhoids?

The supplied applicator is attached to the tube, inserted into the end of the large intestine, and a small amount of ointment is squeezed out with light pressure.

Why should Hepathrombin H not be used for longer than 7 days?

It contains the corticosteroid prednisolone; prolonged use may slow the healing of small wounds of the skin and mucosa and lead to systemic corticosteroid effects. If there is no improvement within 7 days, the cause should be investigated by a doctor.

Sources

• ALIMS – Patient leaflet Hepathrombin H, 2.233 mg/g + 65 IU/g + 30 mg/g, rectal ointment (authorisation 515-01-03798-22-001 of 25.10.2023, approved October 2023)
• ALIMS – Summary of product characteristics Hepathrombin H, rectal ointment

Date sources were checked: 23 October 2026.