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Imescard is a topical combination ointment developed by the Hospital de Clínicas de Porto Alegre for the treatment of hemorrhoidal disease. It contains a mixture of adrenalin (epinephrine), benzocaine, hamamelis (*Hamamelis virginiana*), and water smartweed (*Polygonum hydropiperoides*). The drug exerts its therapeutic effects through multiple mechanisms: adrenalin acts as a vasoconstrictor to reduce blood vessel swelling; benzocaine provides local anesthesia to alleviate pain; hamamelis serves as an astringent and desiccative agent due to its tannin content; and water smartweed contributes anti-inflammatory and anti-hyperalgesic properties. It is manufactured by Laboratórios Osório de Moraes and is registered with Brazil's National Sanitary Surveillance Agency (ANVISA) for the management of 2nd to 4th degree hemorrhoids.
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