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

It is used to treat:

• bruises
• internal bruising (haematoma)
• varicose veins and other inflamed veins (phlebitis)
• piles (haemorrhoids) and itchy bottom

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.

• 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.

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

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.

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.

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

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.

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:

• blood-thinning medicines such as warfarin
• non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin for pain relief

Mixing heparinoid with herbal remedies and supplements

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