metronidazole + diltiazem + lidocaine

This is a topical combination medication containing metronidazole, diltiazem, and lidocaine used primarily for the treatment of acute anal fissures. The combination provides multiple therapeutic benefits: metronidazole acts as an antibiotic effective against anaerobic bacteria that may cause subclinical infection in anal fissures, diltiazem functions as a calcium channel blocker to relax the internal anal sphincter, and lidocaine provides local anesthetic effects to reduce pain. Clinical studies have shown that this combination therapy offers superior outcomes compared to conventional treatments alone, including faster pain reduction, improved healing rates, and decreased need for surgical intervention.