Nifedipine and diltiazem for treatment of chronic anal fissures

Nifedipine and diltiazem are calcium channel blockers. These medicines, which are taken by mouth (orally) to lower blood pressure, have been found to have some benefit in healing long-term (chronic) tears, or fissures, in the anus.1

One cause of fissures is increased tension (called resting pressure) and spasm in the internal anal sphincter, one of two muscles that control the anus. These medicines work by relaxing the smooth muscle, allowing the fissure to heal.

A review of many studies showed that calcium channel blockers were no better at healing anal fissure than nitroglycerin ointment.2 More research needs to be done on how well calcium channel blockers can help anal fissures heal.


  1. Nelson R (2007). Anal fissure (chronic), search date January 2007. Online version of BMJ Clinical Evidence. Also available online:
  2. Nelson R (2006, amended 2006). Non-surgical therapy for anal fissure. Cochrane Database of Systematic Reviews (4). Oxford: Update Software.

Last Updated: May 30, 2008

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