Alternatives to Anusol HC If You Can't Fill Your Prescription

Anusol HC (hydrocortisone acetate) is one of several prescription rectal anti-inflammatory medications. If your pharmacy is out of stock, your insurance doesn't cover it, or the cost is prohibitive, there are solid alternatives your doctor can consider. Some are therapeutically identical — same drug, different brand name. Others are in the same class but add additional ingredients. Here's a comprehensive breakdown.

Direct Generic Substitutes (Same Drug, Lower Cost)

The simplest alternative to Anusol HC is a generic version of the same medication. These contain identical active ingredients and must meet the same FDA bioequivalence standards:

• Anucort-HC: A generic hydrocortisone acetate 25 mg rectal suppository. Identical to Anusol HC suppositories. Made by Cosette Pharmaceuticals. Often the most available and least expensive option.
• Proctocort: Another generic brand of hydrocortisone acetate rectal suppositories (25 mg). Widely stocked and often available when brand-name Anusol HC is not.
• Hemril-30 / Hemmorex-HC: Other brand names for generic hydrocortisone acetate rectal products. Less commonly stocked but may be available at independent pharmacies.

If your prescription is written for "Anusol HC" without specifying "dispense as written," your pharmacist can typically substitute any of these generics automatically.

Same-Class Alternatives (Hydrocortisone, Different Format or Concentration)

These medications use the same active ingredient (hydrocortisone) but in a different formulation, strength, or delivery method:

• Proctosol-HC (hydrocortisone rectal cream 2.5%): A cream formulation rather than suppository. Useful for perianal and external application. Available by prescription.
• Proctozone HC (hydrocortisone rectal cream 2.5%): Similar to Proctosol-HC. Can be found for as low as $18.99 with a GoodRx coupon, making it one of the more affordable prescription options.
• Cortenema (hydrocortisone retention enema 100 mg/60 mL): A rectal enema used for ulcerative colitis. A different delivery mechanism — used at bedtime and retained overnight. Prescribed for more extensive rectal inflammation.
• Cortifoam (hydrocortisone acetate 10% rectal foam): An aerosol foam applicator for internal rectal use. Used once or twice daily. An option if you find suppositories difficult to use.
• OTC Hydrocortisone 1% cream: Available without a prescription under brand names like Preparation H Hydrocortisone, Cortizone-10, and many store brands. Lower potency than prescription-strength (1% vs. 2.5%), but appropriate for mild external hemorrhoid symptoms.

Combination Alternatives (Hydrocortisone + Anesthetic)

These combination products add a local anesthetic (pramoxine or lidocaine) for additional pain and itch relief:

• Proctofoam HC (hydrocortisone 1% / pramoxine 1% foam): Combines anti-inflammatory and numbing action. Good for patients with significant pain in addition to itching. Note: Proctofoam HC itself has availability challenges in 2026.
• Analpram HC / Pramosone (hydrocortisone + pramoxine cream): A cream combining hydrocortisone (1% or 2.5%) and pramoxine (1%). Useful for both internal and external application. Generally better stocked than Proctofoam HC.
• Ana-Lex (hydrocortisone + lidocaine): Combines hydrocortisone with lidocaine for numbing. Prescribed for pain management along with inflammation control.

Non-Steroidal Alternatives

For patients who cannot tolerate steroids or where steroid use is contraindicated, there are non-steroidal options:

• Witch hazel pads (Tucks): OTC astringent pads that reduce swelling and soothe irritation. Not as powerful as prescription hydrocortisone but appropriate for mild cases.
• Recticare (lidocaine 5% anorectal cream): A local anesthetic for temporary pain relief. Does not have anti-inflammatory properties but numbs the affected area. Available OTC.
• Preparation H (phenylephrine + mineral oil): OTC hemorrhoid treatment using a vasoconstrictor (phenylephrine) to shrink swollen vessels. For mild hemorrhoid symptoms without significant inflammation.

How to Talk to Your Doctor About Switching

When calling your doctor's office to request an alternative, it helps to have a specific suggestion ready. Try this script:

"My pharmacy doesn't have Anusol HC in stock. Can you send over a prescription for generic hydrocortisone acetate 25 mg suppositories (Anucort-HC or Proctocort) or Proctozone HC cream instead?"

Most providers can handle this with a quick call or message through your patient portal. No office visit needed.

Still Having Trouble Finding Anusol HC?

Before switching medications, it's worth making sure Anusol HC isn't available somewhere nearby. medfinder calls pharmacies near you and texts you results — faster than calling yourself. Read our guide on how to find Anusol HC in stock near you for more strategies.