When Proctofoam Isn't Available, You Still Have Options

Being told your pharmacy can't fill your Proctofoam HC prescription is stressful — especially when you're dealing with the pain and itching of hemorrhoids or anal fissures. But you're not stuck. There are several alternative medications that work in similar ways, and your doctor can help you find the right one.

In this guide, we'll explain what Proctofoam is, how it works, and walk through the best alternatives available in 2026. If you want to understand why it's so hard to find, read our explainer: Why Is Proctofoam So Hard to Find?

What Is Proctofoam HC and How Does It Work?

Proctofoam HC is a prescription aerosol foam that contains two active ingredients:

• Hydrocortisone Acetate 1% — a corticosteroid that reduces inflammation, redness, and swelling in the rectal area
• Pramoxine Hydrochloride 1% — a local anesthetic that blocks nerve signals to temporarily stop pain and itching

This dual-action formula is what makes Proctofoam effective: it tackles both the inflammation and the discomfort at the same time. The foam formulation is also unique — it spreads easily and is generally comfortable to apply.

For a deeper dive into how it works, check out: How Does Proctofoam Work? Mechanism of Action Explained.

Alternative 1: Pramosone Cream

Pramosone is the closest alternative to Proctofoam HC because it contains the exact same active ingredients: Hydrocortisone Acetate 1% and Pramoxine Hydrochloride 1%. The main difference is the formulation — Pramosone comes as a cream, lotion, or ointment rather than an aerosol foam.

Pros:

• Same active ingredients and concentrations as Proctofoam
• Available in cream, lotion, and ointment forms
• Generally easier to find than the foam formulation
• Generic versions are widely available

Cons:

• Cream may not spread as easily in the anal area as foam
• Some patients find cream messier or less comfortable to apply
• Still requires a prescription

Typical cost: $30 to $80 for generic cream with a discount card; brand name can be $150+.

Alternative 2: Anusol-HC (Hydrocortisone Rectal Cream)

Anusol-HC contains Hydrocortisone 2.5% in a rectal cream formulation. It doesn't contain Pramoxine (the numbing agent), so it focuses on reducing inflammation rather than providing direct pain relief.

Pros:

• Higher concentration of Hydrocortisone (2.5% vs 1%)
• Well-established product with good availability
• Effective for reducing inflammation and itching
• Generic versions (Hydrocortisone rectal cream 2.5%) are affordable

Cons:

• No local anesthetic component — won't numb pain like Proctofoam does
• Cream formulation only
• Prescription required for 2.5% strength

Typical cost: $15 to $50 for generic Hydrocortisone rectal cream 2.5%.

Alternative 3: Preparation H Hydrocortisone (OTC)

Preparation H with Hydrocortisone is available over the counter and contains Hydrocortisone 1%. It comes in cream and suppository forms. Because it's OTC, you don't need a prescription.

Pros:

• No prescription needed
• Widely available at virtually every pharmacy and retail store
• Affordable — typically $8 to $15
• Multiple forms: cream, ointment, suppositories

Cons:

• Lower concentration of Hydrocortisone (1%)
• No Pramoxine — no numbing effect
• May not be strong enough for moderate to severe symptoms

Typical cost: $8 to $15 at most pharmacies.

Alternative 4: Epifoam

Epifoam is another aerosol foam that contains Hydrocortisone Acetate 1% and Pramoxine Hydrochloride 1% — the same active ingredients as Proctofoam HC. However, Epifoam is typically marketed for topical skin use rather than specifically for rectal application.

Pros:

• Same active ingredients as Proctofoam
• Foam formulation similar to Proctofoam
• May be easier to find in some areas

Cons:

• Not specifically labeled for rectal use (your doctor would need to prescribe it off-label)
• May also face availability issues as a foam product
• Can be expensive without insurance

Typical cost: $100 to $300+ depending on pharmacy and insurance.

How to Choose the Right Alternative

The best alternative depends on your specific situation:

• If you want the closest match to Proctofoam: Ask your doctor about Pramosone cream or Epifoam — both have the same active ingredients.
• If inflammation is your main concern: Anusol-HC's higher Hydrocortisone concentration (2.5%) may work better.
• If you need something right now without a prescription: Preparation H Hydrocortisone is available OTC at any pharmacy.
• If cost is a major factor: Generic Hydrocortisone rectal cream or OTC Preparation H are the most affordable options.

Always talk to your doctor before switching medications. They can help you choose the best alternative based on your symptoms and medical history.

Don't Give Up on Finding Proctofoam

Even while exploring alternatives, it's worth continuing to look for Proctofoam if it works well for you. Use Medfinder to check real-time availability at pharmacies near you, and read our tips for locating it: How to Find Proctofoam in Stock Near You.

Final Thoughts

Not being able to fill your Proctofoam prescription is frustrating, but you have real alternatives. Whether you opt for Pramosone cream with the same ingredients, Anusol-HC for stronger anti-inflammatory power, or OTC Preparation H for quick relief, there's a path to managing your symptoms.

Talk to your doctor, explore your options, and use tools like Medfinder to stay on top of availability. You don't have to suffer while you search.