chronic

Haemorrhoids in pregnancy

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lactulose monograph) · Uniroid-HC (cinchocaine + hydrocortisone) Suppositories SmPC sections 4.2-4.4 (eMC product 1599) · Fontem RF, Eyvazzadeh D. Internal Hemorrhoid. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan- . [Updated 2023 Jul 31]. Bookshelf ID: NBK537182. PMID: 30725867.

Verified against2 documents

Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lactulose monograph)
Uniroid-HC (cinchocaine + hydrocortisone) Suppositories SmPC sections 4.2-4.4 (eMC product 1599)

Verified date2026-08

LACTULOSE

1st line

Formoral.liquid

Adult dose and duration

15-30 mL once or twice daily, adjusted according to stool consistency - As long as the stool needs softening - through the pregnancy and into the early postpartum weeks

Paediatric dose

Adult-only condition - paediatric section not applicable

Dose source

Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lactulose monograph)

Why

Constipation is what makes piles in pregnancy, and softening the stool is the treatment that actually changes the outcome. Lactulose is not absorbed, which is why it is the laxative of choice here.

Cautions

Fibre, fluids, and not straining or sitting long on the toilet do more than any ointment. This is the part of the consultation worth spending time on.
May cause flatulence and abdominal cramps initially.
Stimulant laxatives such as senna can provoke uterine cramping and are second choice in pregnancy; an osmotic agent is the safer starting point.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
FARCOLAC 667GM/L SYRUP 120 ML	PHARCO	7.50 EGP
LACTOLINE 50% SYRUP 200ML	ALEXANDRIA	9.25 EGP
LAEVOLAC 67GM/100ML SYRUP 120 ML	SIGMA > FRESENIUS KABI	12.00 EGP
SEDALAC 3.35GM/5ML SYRUP 120ML	SEDICO	20.00 EGP
LAXOLAC 3.35GM/5ML SYRUP 300ML	MUP	40.00 EGP
LAXOLAC 3.35GM/5ML SYRUP 120ML	MUP	50.00 EGP
DUPHALAC 667GM/L SYRUP 200ML	ABBOTT LABORATORIES	143.00 EGP
LACTULOSE-AUG PHARMA 3.35GM/5ML SYRUP 320ML	AUG PHARMA	170.00 EGP
VILLAPURG 67% SYRUP 120 ML? strength differs? different route - not oral liquid	AL ESRAA PHARMACEUTICAL OPTIMA	12.00 EGP
VILLAPURG 67% SYRUP 200 ML? strength differs? different route - not oral liquid	AL ESRAA PHARMACEUTICAL OPTIMA	17.75 EGP

CINCHOCAINE + HYDROCORTISONE

add-on - not a substitute

Formtopical

Adult dose and duration

Apply ointment or insert 1 suppository rectally twice daily (morning and night) and after defecation x 7 days maximum; if the piles are no better by then, review rather than repeat

Paediatric dose

Adult-only condition - paediatric section not applicable

Dose source

Uniroid-HC (cinchocaine + hydrocortisone) Suppositories SmPC sections 4.2-4.4 (eMC product 1599)

Why

Short-term relief of the pain and itch while the stool is being softened. It numbs and calms the area; it does not shrink the pile, and it is added to the laxative rather than used instead of it.

Cautions

The label says topical corticosteroids should not be used extensively in pregnancy, meaning large quantities or prolonged courses. A short 7-day course to a small area is how it is used here.
Hydrocortisone may pass into breast milk. The label prefers it avoided while breastfeeding unless the benefit to the mother clearly justifies it.
LIMIT TO 7 DAYS MAX: prolonged rectal corticosteroid use causes mucosal atrophy and systemic absorption.
Cinchocaine sensitises on repeated use - a rash that appears after a few courses is often the anaesthetic, not the piles.
A sudden, exquisitely painful lump at the anal margin is a thrombosed external pile. Within the first 72 hours it can be excised under local anaesthetic; after that it is managed with analgesia and settles on its own.
Do not simply assume rectal bleeding in pregnancy is piles. Look, and if bleeding persists after delivery, examine properly.
Most haemorrhoids of pregnancy settle within weeks of delivery. Surgery is deferred until then.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
SEDIPROCT TOPICAL CREAM 20 GM	MUP	42.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.