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  1. About heparinoid
  2. Key facts
  3. Who can and can't use heparinoid
  4. How and when to use it
  5. Side effects
  6. Pregnancy and breastfeeding
  7. Cautions with other medicines
  8. Common questions

1. About heparinoid

Heparinoid is a medicine that reduces swelling and helps with healing.

It is used to treat:

Heparinoid comes as a cream or gel. The gel has an added cooling effect.

It also comes as an ointment for treating piles and itchy bottom. The ointment contains oxypolyethoxydodecane to soothe any itching.

Heparinoid is available on prescription and to buy from pharmacies and supermarkets.

2. Key facts

  • You'll usually use heparinoid 4 times a day.
  • It's a very safe medicine and does not usually cause any side effects.
  • Some people may get a rash but this is rare.
  • Do not use heparinoid to treat piles or itchy bottom in children younger than 12 years.
  • Brand names for the cream and gel include Hirudoid. The ointment is sold as Anacal.

3. Who can and can't use heparinoid

Most adults and children over the age of 12 years can use heparinoid to treat piles and itchy bottom.

It's used to treat bruises and phlebitis in adults and children over the age of 5 years.

Heparinoid is not suitable for some people. Tell your doctor or pharmacist if you:

  • are allergic to heparinoid or any other medicines
  • have had an allergic reaction to parabens (heparinoid treatments contain propyl parahydroxybenzoate or methyl parahydroxybenzoate as preservatives)
  • are constipated, due to taking other medicines such as codeine. Being constipated means you're more likely to get piles

4. How and when to use it

If you have bought heparinoid from a pharmacy or supermarket, follow the instructions that come with the packet, or ask your pharmacist for advice.

You can use it up to 4 times a day. For piles or an itchy bottom, it's usual to use heparinoid ointment several times a day - first thing in the morning, last thing at night and after having a poo. An ointment is thicker and greasier than a cream.

Always wash your hands after using the cream, gel or ointment.

For phlebitis, bruises and haematomas

You'll usually need to use 5cm to 15cm of cream or gel. It depends on how much skin you need to cover.

If the area you're treating is sore or tender, you can massage the cream or gel into the skin around it.

For external piles

  1. Squeeze a small amount of ointment onto your finger.
  2. Gently put the ointment onto the skin around your bottom (anus).

For internal piles

If you have piles inside your bottom, use the applicator that comes with the ointment. Read the instructions in the leaflet inside the packaging.

  1. Clean around your bottom (anus) with mild soap and water, rinse and pat dry.
  2. Squeeze some ointment into the applicator and spread a little ointment onto the end of the nozzle.
  3. Gently insert the nozzle into your bottom.
  4. Squeeze the tube so the ointment goes into your bottom and slowly pull the applicator out at the same time.
  5. Take the applicator apart and wash it when you've finished.

What if I forget to use it?

If you forget a treatment, do it as soon as you remember. If you do not remember until you are within a few hours of the next one, do not worry - just skip the missed treatment and go on with your usual treatment routine.

What if I use too much?

If you accidentally use too much, it's unlikely to cause any problems.

Non-urgent advice: Contact 111 for advice if:

  • you or your child swallow heparinoid cream, gel or ointment


Go to - for children aged 5 years and older


Call 111

5. Side effects

Heparinoid does not usually cause any side effects.

Some people can get a rash but this is rare. If this happens to you, stop using heparinoid and tell your doctor or pharmacist.

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to heparinoid.

Immediate action required: Call 999 or go to A&E if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of heparinoid. For a full list, see the leaflet inside your medicine packet.


You can report any suspected side effect to the UK safety scheme.

6. Pregnancy and breastfeeding

It's safe to use heparinoid while you're pregnant or breastfeeding.

However, always check with your doctor, midwife or a pharmacist first.

Here's more information on how to treat piles in pregnancy.


Tell your pharmacist or doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.

7. Cautions with other medicines

Using heparinoid will not usually affect how other medicines work. However, it might cause bleeding if you're taking other medicines that increase the risk of bleeding.

Tell your pharmacist or doctor if you're taking:

Mixing heparinoid with herbal remedies and supplements

There is very little information about using heparinoid together with complementary remedies, and vitamins or supplements.


For safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.

8. Common questions

How does heparinoid work?

Heparinoid reduces swelling in your veins. This improves the circulation in small blood vessels under your skin and helps with healing.

It also dissolves small blood clots under the skin.

When will my symptoms improve?

Heparinoid should work within a few days if you're using it to treat a bruise.

For phlebitis, a haematoma or piles it might take longer for your symptoms to get better.

If your symptoms do not improve or if they get worse, speak to your doctor or a pharmacist.

How long will I use it for?

Use the heparinoid gel, cream or ointment until your symptoms have gone away.

Piles should heal within 1 week.

Bruises and haematomas usually go away within 1 to 2 weeks.

Phlebitis can take a few weeks to go away.

If your symptoms have not got better after this time, talk to your doctor.

Is it safe to use heparinoid for a long time?

There is not enough information to say whether it's safe to use heparinoid for a long time.

As a general rule, stop using this medicine as soon as your symptoms have settled down.

Speak to your doctor or a pharmacist if your symptoms do not get better, or if you're using heparinoid for piles and you keep getting them.

Are there other treatments for piles?

There are various types of treatments for piles. Some are available on prescription from your doctor. There are others that you can buy in a pharmacy.

Many treatments contain a local anaesthetic (such as lidocaine) to provide relief for your symptoms.

Some treatments also contain corticosteroids, such as hydrocortisone.

Ask your doctor or a pharmacist about the best treatment options to help with your symptoms. They may recommend:

  • creams to ease the pain, itching and swelling
  • treatment to help constipation and soften poo
  • cold packs to ease discomfort
Can I drink alcohol with it?

Yes, you can drink alcohol with heparinoid.

Is there any food or drink I need to avoid?

Heparinoid will not affect what you can eat or drink.

However, if you're using heparinoid for piles, it's a good idea to get more fibre into your diet. This is so you do not get constipated, as constipation can make your symptoms worse.

Good sources of fibre include porridge oats and wholegrain breakfast cereals, wholemeal or granary bread, brown pasta and brown rice, pulses such as lentils, peas and beans, and potatoes with their skins on.

Other tips for preventing constipation include drinking plenty of fluids and doing some gentle exercise, if you can.

Will it affect my fertility?

There is no firm evidence that heparinoid affects male or female fertility.

Will it affect my contraception?

Heparinoid does not affect any type of contraception, including the combined pill and emergency contraception.

Can I drive or ride a bike?

Heparinoid will not affect you being able to drive or cycle.

Is there any lifestyle advice for piles?

Piles often settle down without treatment but there are some things you can do to help your symptoms.

Piles can be brought on by too much straining on the toilet. Straining is often because of constipation.

You're less likely to get constipated if you:

Skin moisturisers can also help relieve the pain and itching of piles. Ask your pharmacist what they recommend.

Useful resources

Page last reviewed: 28 August 2019
Next review due: 28 August 2022