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Imescard is a topical antihemorrhoidal combination therapy primarily marketed in Brazil. It is formulated as an ointment containing epinephrine (adrenalin), hamamelis (witch hazel) extract, and water smartweed (*Polygonum punctatum*) extract. The drug functions through multiple mechanisms: epinephrine acts as a potent vasoconstrictor to reduce swelling and bleeding; hamamelis provides astringent properties that help shrink swollen tissue and soothe irritation; and water smartweed extract contributes anti-inflammatory and hemostatic effects. It is indicated for the symptomatic relief of hemorrhoidal disease, including pain, inflammation, and bleeding.
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