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Did Anal Absorption of Prep H Raise BP

Have you ever suffered from hemorrhoids? The itch can be unbearable. Did you know that anal absorption of ingredients in Prep H could raise blood pressure?
Did Anal Absorption of Prep H Raise BP
Doctor holding suppository for hemorrhoid treatment and woman suffering from pain, closeup

There are lots of ways to get medicine into your body. Swallowing pills is the most obvious route. Injections are also understandable. Topical seems a bit harder for people to comprehend, though. Even the FDA seemed surprised to learn that sunscreen ingredients can be absorbed through the skin.  Another way drugs can get into the blood stream is through anal absorption, as this reader discovered by accident.

Anal Absorption of Preparation H?

Q. I used Preparation H twice yesterday and once today. I noticed a headache yesterday and attributed it to a lack of sleep.

When I applied the Prep H today, my headache returned. I checked my blood pressure and it was 16 points higher than normal. My typical BP reading with meds is 117/78. A diastolic reading of 94 concerns me.

I understand that the problem with Preparation H is the phenylephrine. Do I need to avoid this medicine?

A. There was a time when Preparation H advertised its hemorrhoid remedy as having “oxygen action.” Bryan Cranston, of Breaking Bad fame, performed in a Prep H commercial back in the early 1980s. This classic video took our breath away. You might enjoy the video too at this link. Here are his now classic lines:

“You expect a hemorrhoid medicine to relieve your pain and itch. But you get extra therapeutic relief with Preparation H. It helps speed relief to inflamed hemorrhoidal tissue with oxygen action. A special medicine in Preparation H accelerates the absorption of pure oxygen to help shrink swelling of inflamed hemorrhoidal tissue fast…When you choose a hemorrhoid medicine, remember, oxygen action is special with Preparation H.”

We’re not sure what the “oxygen action” was all about.

In an interview on The Tonight Show with Jimmy Fallon (Nov. 21, 2017), Bryan Cranston admitted that he didn’t know what “oxygen action” was either. You will have to wait till the end of the interview to learn about Bryan’s career as a shill for Preparation H. We think you will find his Preparation H discussion quite amusing at this link.

The Old Preparation H:

So, what was in Preparation H back in the good old days? The “all natural” ingredients that were advertised to help shrink the swelling of hemorrhoidal tissues, reduce inflammation and heal injured tissue were:

  • An antiseptic (phenylmercuric nitrate)
  • 2,000 units of “skin respiratory factor” obtained from “live yeast cell derivative” or LYCD
  • 3% shark liver oil

The New Preparation H:

The FDA determined in its infinite wisdom that the live yeast cell derivative in old Preparation H belonged in its Category III:

“data insufficient to support effectiveness.”

As a result, the maker of Prep H changed the formula in the mid 1990s.

The active ingredients in Preparation H Hemorrhoidal Ointment now include mineral oil, petrolatum (petroleum jelly) and phenylephrine. The phenylephrine constricts blood vessels. That is why it is also found in some decongestant nasal sprays.

The instructions that come with Preparation H state:

“Ask a doctor before use if you have heart disease; high blood pressure; thyroid disease; diabetes; difficulty in urination due to enlargement of the prostate gland.”

Anal Absorption of Phenylephrine?

People on blood pressure medication should generally avoid products containing vasoconstrictors like phenylephrine. That’s because anal absorption of a drug that constricts blood vessels does not just impact the nether region. Medications that are absorbed into the blood from this highly vascular area can circulate throughout the body and exert a systemic effect.

Reader Reports of Anal Absorption:

Another reader reported that using Preparation H for a week:

“…resulted in severely elevated blood pressure.”

Ray “almost broke” his doctor’s blood pressure monitor:

“The blood pressure increase happened to me. I went in for a normal check-up. I had used Preparation H that morning. I almost broke the blood pressure machine at my doctor’s office. They took my blood pressure three times to make sure the number was accurate.

“I was trying to think what I had taken to raise my blood pressure. Then I read the label on Preparation H and put 2 and 2 together. I came to this website and read your articles on Preparation H. It’s a good thing I am healthy. It makes you wonder how many people have been sent to the emergency room because they couldn’t handle this stuff. The warning should be more obvious.”

There are a number of drugs to avoid if you have a tendency towards hypertension. All NSAIDs would be on the no-no list. That includes celecoxib, diclofenac, ibuprofen, meloxicam and naproxen. And stay away from natural black licorice. It too can raise blood pressure! 

To learn more about measuring blood pressure correctly, drugs to avoid and strategies to control hypertension, you may wish to read our eGuide to Blood Pressure Solutions. This recently revised electronic resource is available in the Health eGuides section of www.PeoplesPharmacy.com.

Share your own experience with Preparation H. Did you ever use the original formula to fight wrinkles? What about to stop itching from scars? Add your comment below. And let us know what you think about Bryan Cranston’s Prep H commercial

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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