Do FISURIN and a pharmacy nifedipine ointment contain the same medicine?
Yes, in the part that matters most. Both contain nifedipine, a calcium channel blocker that, applied to the anal canal, lowers the resting pressure of the internal sphincter. That relaxation restores blood flow to the tear, which is what a chronic fissure needs to heal. The ASCRS 2023 and ACPGBI 2023 guidelines place topical calcium channel blockers (nifedipine or diltiazem) alongside nitroglycerin as first-line medical treatment, and the Cochrane review of non-surgical therapy found that calcium channel blockers match nitroglycerin’s efficacy with fewer adverse effects.
In many countries, including the US, the UK and Australia, nifedipine ointment for fissures is not a factory-made product: it is prepared by a compounding pharmacy on a prescription, usually at 0.2 to 0.3 %. FISURIN is also a compounded preparation, prescribed by our surgeons in Peru. So this is not a comparison between a "real drug" and an "alternative". It is a comparison between two preparations built on the same active ingredient, with different things around it.
If you want the background on how compounded fissure ointments are prescribed and prepared, read Compounded fissure cream: what it is, how to get one and why it doesn’t travel. For nifedipine itself (dose, application, what to expect at 8 weeks), see Nifedipine cream for anal fissure: dose, application, side effects and the 8-week plan.
What are the real differences between them?
| FISURIN | Typical pharmacy nifedipine ointment | |
|---|---|---|
| Sphincter relaxant | Nifedipine | Nifedipine, usually 0.2–0.3 % |
| Local anesthetic | Lidocaine included | Only if the prescription asks for it |
| Base | Water-based hydrogel | Usually petroleum jelly or another oily base |
| Steroids | None | None, unless prescribed |
| Instructions | Written 6-week protocol with fiber, sitz baths and check-up | Whatever the prescriber explains |
| Follow-up | Colorectal surgeons, in person or by message | Depends on your doctor |
| Where | Peru only, with prescription | Any country with compounding pharmacies |
Two points deserve a closer look: the base and the lidocaine. The rest (protocol and follow-up) is about how the treatment is run rather than what is in the jar, and it matters more than people expect.
Hydrogel or petroleum jelly: does the base change the result?
A petroleum jelly base is oily and occlusive: it stays on the skin for hours, keeps it supple and is cheap and stable, which is why pharmacies use it so often. It also feels greasy, stains underwear and does not rinse off with water. A hydrogel is mostly water thickened with a polymer: it spreads in a thin film over a sore area, does not stain and comes off in a sitz bath, but it forms a thinner layer, so applying it on schedule matters.
Has anyone shown that one base heals fissures better? No. Nifedipine has worked in a 0.2 % gel in acute fissures (Antropoli, 1999) and in an ointment with lidocaine in chronic fissures (Perrotti, 2002), but no trial has compared vehicles head to head. So we do not claim that the hydrogel makes FISURIN more effective. We chose it because patients find it easier to use two to three times a day for six weeks, and a treatment that gets used beats one that sits in a drawer. Our article on Gel, cream, ointment or paste: which form is best for an anal fissure? explains the differences between bases in detail.
Does adding lidocaine make a difference?
Lidocaine does not relax the sphincter and, alone, does not close a chronic fissure. Its job is the pain. In the first weeks, before nifedipine has done its work, each bowel movement can still hurt for hours. Pain makes people hold back stools, harder stools tear the fissure again, and the cycle restarts. A local anesthetic in the same application breaks that link.
The combination has been tested. In a randomized double-blind trial, nifedipine 0.3 % with lidocaine 1.5 % healed 94.5 % of chronic fissures at 6 weeks, against 16.4 % in the active control group (Perrotti, 2002), and the Italian SIUCP 2023 guideline lists that combination as a first-line option. Those figures belong to the combination studied in the trial; they are not FISURIN results, and we do not publish healing percentages of our own.
A pharmacy can also add lidocaine to a nifedipine ointment if the doctor writes it in the prescription, or you can use a separate lidocaine gel before bowel movements. FISURIN simply puts both in one product. For how lidocaine fits into fissure care, see Lidocaine cream for anal fissure: why it eases the pain but does not close the tear.
Why do the protocol and follow-up matter so much?
In our practice, the most common reasons a nifedipine ointment "fails" are not about the ointment:
- Stopping at week 2 or 3 because the pain is gone, before the tear has closed.
- Applying it once a day instead of two to three times.
- Applying it on the outer skin only, instead of at the opening and just inside, where the fissure is.
- Hard stools every morning because fiber and water were never sorted out.
- Mixing it with a steroid hemorrhoid cream for weeks.
FISURIN is prescribed with a written schedule (three times a day for two weeks, then two to three times a day, check-up at week 4, decision at week 8) and a surgeon who answers by message during the six weeks. You can get the same discipline with a pharmacy ointment if your doctor gives you clear instructions and a follow-up date. Our guides on How to apply anal fissure cream correctly: where, how much and when and Four weeks on fissure cream and no better: what to check and what comes next cover both.
Which one should you choose?
It depends mostly on where you live:
- In Peru: both are possible. FISURIN makes sense if you want nifedipine and lidocaine in one non-greasy product with a guided protocol and surgeon follow-up. A pharmacy nifedipine ointment is a reasonable choice if your own doctor follows you closely.
- Outside Peru: the magistral FISURIN is not shipped abroad, so the practical choice is a nifedipine or diltiazem ointment from a compounding pharmacy, or nitroglycerin ointment (Rectiv in the US, Rectogesic in the UK and Australia), prescribed by your doctor. A well-prepared nifedipine ointment, used correctly for 6 to 8 weeks, works.
Whichever you use, ask the pharmacy for the concentration, the base, the preparation date and the use-by date, and keep the container closed and away from heat.
How do the costs compare?
We will not quote figures, because prices change by pharmacy and country. What we can describe is how the cost is built:
- Both are compounded preparations, so the pharmacy sets the price per jar. Adding lidocaine or a hydrogel base can change the cost of any compounded preparation.
- Both need a prescription, so both need a consultation. With FISURIN in Peru the consultation is charged separately and the jar is priced by the pharmacy; ask on WhatsApp for the current price and the 6-week package.
- Over 6 to 8 weeks you will need more than one jar of either product. Compare the total for the course, not the price of one jar.
For a wider picture of what fissure treatment costs, from ointments to surgery, read All guides.
When is neither ointment the answer?
Both ointments are for a typical fissure confirmed by a doctor. See a doctor without delay if you have:
- Bleeding after the age of 45, or blood mixed with the stool.
- Fever, pus or a painful swelling next to the anus.
- A lump that grows, a fissure off the midline or several fissures.
- Unintended weight loss or a change in bowel habit lasting weeks.
- A fissure still open after 8 weeks of correct use.
After a well-used course, the next steps are botulinum toxin or a lateral internal sphincterotomy. See All guides, our page on surgery, the full FISURIN product page and where FISURIN is available.
Frequently asked questions
Is FISURIN better than a nifedipine ointment from the pharmacy?
Not in the active ingredient: both rely on nifedipine. FISURIN adds lidocaine, a hydrogel base and a guided protocol with surgeon follow-up. A well-prepared nifedipine ointment used correctly for 6 to 8 weeks also works.
Can a pharmacy make a nifedipine and lidocaine ointment?
Yes, a compounding pharmacy can prepare it if your doctor prescribes both ingredients and the concentrations.
I live outside Peru. What should I use instead of FISURIN?
Ask your doctor for a compounded nifedipine or diltiazem ointment, or nitroglycerin ointment (Rectiv in the US, Rectogesic in the UK and Australia). The magistral FISURIN is not shipped abroad.
Can I switch from a pharmacy nifedipine ointment to FISURIN?
Yes, in Peru, after a consultation. They act in the same way, so the course continues; do not use both at once.
Does FISURIN work in fewer days than a regular nifedipine ointment?
No. Both need 6 to 8 weeks of regular use. Lidocaine eases pain during bowel movements, but closure takes the same time.