Some medications for hemorrhoids, such as ibuprofen, acetaminophen, docusate, hydrocortisone + lidocaine, or witch hazel, can help relieve the symptoms of internal or external hemorrhoids, such as pain, burning sensation, itching, or bleeding.

These medications have anti-inflammatory, analgesic, or soothing properties and should be used under the guidance of a proctologist or primary care doctor, who can recommend the most appropriate treatment based on the type of hemorrhoid.

During treatment, it is important to stay hydrated by drinking plenty of water and to follow a high-fiber diet. In addition, some home remedies, such as sitz baths for hemorrhoids, can help relieve symptoms and speed up recovery, complementing the treatment recommended by the doctor.

Medications list

Medications for hemorrhoids that your doctor may prescribe include:

1. Zinc oxide ointments

Zinc oxide ointments act as skin protectants that create a barrier over irritated areas, helping to reduce friction and protect the skin from further irritation. For hemorrhoids, this barrier effect can help soothe discomfort, minimize burning, and support healing of the surrounding skin.

How to use: apply a thin layer of the ointment to the affected area up to several times a day, especially after bowel movements and cleansing the anal region. These ointments can be used alone for mild irritation or alongside other doctor-recommended hemorrhoid treatments.

2. Hydrocortisone 1% cream

Hydrocortisone 1% cream is an over-the-counter corticosteroid cream that can help relieve itching, swelling, and inflammation caused by hemorrhoids. It is generally recommended for short-term use to control symptoms.

How to use: apply a small amount of cream to the affected external area up to 3 to 4 times daily, preferably after bowel movements and cleaning the area. Hydrocortisone cream should not be used for longer than 1 week without medical advice, as prolonged use may cause skin thinning.

3. Ibuprofen

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that may be recommended by a doctor to help reduce inflammation and pain caused by hemorrhoids.

This medication can be found in tablets or liquid form, as a generic or under brand names such as Advil or Motrin. Ibuprofen can also be prescribed after hemorrhoid surgery to relieve pain and discomfort.

How to use: the dosage varies according to the amount of ibuprofen in the tablet. For a 400 mg tablet, the recommended adult dose is usually 1 tablet every 6 to 8 hours, as directed by a doctor.

4. Acetaminophen

Acetaminophen, like ibuprofen, can also be recommended for hemorrhoids, as it has analgesic action to help relieve pain.

This medication is available in 325 mg, 500 mg, or 650 mg tablets and should be used as directed by a doctor, as prolonged use or high doses may cause liver damage or medication-induced hepatitis, which can be life-threatening.

How to use: for adults, the usual dose is 500 to 1000 mg every 4 to 6 hours, not exceeding 3000 mg per day unless otherwise directed by a healthcare provider.

5. Docusate

Docusate is a stool softener in tablet or capsule form that helps soften stools, reducing straining and excessive pressure during bowel movements, which can prevent external hemorrhoids from worsening or causing more pain. This medication should only be used with medical advice.

How to use: the recommended adult dose is 50 to 400 mg daily, divided into one or two doses, preferably in the evening. Treatment duration should be guided by a doctor.

6. Horse chestnut

Horse chestnut (Aesculus hippocastanum) is a dietary supplement made from the seed extract of this medicinal plant. It has anti-inflammatory properties that may help reduce swelling and relieve symptoms of hemorrhoids.

However, horse chestnut supplements are not FDA-approved as a hemorrhoid medication and should only be used with medical guidance. It is contraindicated during pregnancy, in children, or in people taking anticoagulants.

How to use: follow the dosage instructions on the product label or as directed by a healthcare provider, as concentrations can vary between supplements.

7. Hydrocortisone + lidocaine

Hydrocortisone + lidocaine is a rectal cream that can be prescribed for internal or external hemorrhoids to relieve pain and inflammation, as it combines a corticosteroid with a local anesthetic. This cream can be found in various brand formulations in the US and should be used rectally.

How to use: apply the cream after a bowel movement and cleaning the anal area. For external hemorrhoids, place a small amount on a finger and gently apply to the hemorrhoid. For internal hemorrhoids, use the applicator provided in the package and insert gently into the anus.

The recommended adult dose is 2 applications per day, in the morning and at night, which may be reduced to once daily as symptoms improve. Treatment usually lasts up to 2 weeks, as directed by a doctor.

8. Witch hazel

Witch hazel (Hamamelis virginiana) is a topical natural product that can help relieve inflammation, swelling, and discomfort from internal or external hemorrhoids. It is available in the US in pads, wipes, and ointments, such as Tucks pads.

How to use: apply witch hazel to the affected area 2 to 6 times daily, preferably after bowel movements and cleaning the anal region. For internal use, only use witch hazel products that are specifically labeled for intrarectal application and follow package instructions.

9. Phenylephrine + pramoxine + glycerin

Phenylephrine + pramoxine + glycerin is a medicated suppository or ointment that can be used for internal hemorrhoids. Phenylephrine reduces swelling by constricting blood vessels, pramoxine acts as a local anesthetic, and glycerin helps protect irritated tissue.

These products are available in the US in over-the-counter hemorrhoid medications such as Preparation H.

How to use: for suppositories, insert deeply into the rectum up to 4 times daily, preferably after a bowel movement. For ointments, apply externally or internally with the supplied applicator, up to 4 times daily.

10. Hydrocortisone suppositories

Hydrocortisone suppositories may be prescribed for internal hemorrhoids to reduce inflammation, pain, and swelling. They are available by prescription in the US under various brand names and strengths.

How to use: insert the suppository deeply into the rectum 2 to 3 times a day, as directed by a doctor. It is recommended to evacuate and clean the anal area before insertion.

Hemorrhoid medication during pregnancy

Medications for hemorrhoids during pregnancy should be recommended by an obstetrician, and acetaminophen may be suggested to relieve symptoms, as it is considered to have the lowest risk for the baby. However, it should be used at the lowest effective dose for the shortest possible time.

Pregnant women should also drink plenty of water, avoid standing for long periods, and may use sitz baths to help relieve symptoms.

Home remedy options

Some home remedies, such as a sitz bath with witch hazel or cypress, may help relieve hemorrhoid symptoms due to their vasoconstrictive and anti-inflammatory properties and can be used to complement the treatment recommended by a doctor. Check-out home remedies for hemorrhoids to help you achieve relief naturally.

Home remedies should not replace prescribed medications but may help reduce pain and speed up recovery.

How to increase the effectiveness of medications

In addition to using doctor-recommended medications to reduce discomfort from hemorrhoids, it is important to:

Follow a high-fiber diet with foods like fruits and seeds - read more about the hemorrhoid diet
Drink at least 2 liters of water per day to help keep stools soft
Avoid straining during bowel movements and go to the bathroom whenever you feel the urge
Use donut-shaped cushions when sitting to help reduce pain
Take sitz baths for 15 to 20 minutes, about twice a day, to relieve pain
Avoid using toilet paper, washing the area with water and mild soap whenever possible

In some cases, surgery may be necessary to remove hemorrhoids, which is usually done when other treatments have not been effective in controlling pain, discomfort, and bleeding, especially during bowel movements.

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