Lancashire and South Cumbria
Formulary
 
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1 Gastro-intestinal system
01-07-04 Management of anal fissures

Botulinum toxin type A
Formulary

Recommended maximum of two courses of botulinum toxin type A injection in the treatment of chronic anal fissure which has not healed despite a minimum course of at least 8 weeks of topical management

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Glyceryl Trinitrate 0.4% Rectogesic®
Formulary

Ointment

First Line

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Diltiazem 2%
Formulary

Cream, Ointment 

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