What Is Hydrocortisone/Pramoxine? Uses, Dosage, and What You Need to Know in 2026

Hydrocortisone/Pramoxine is a prescription combination topical medication that has been available since 1976. It's used for a range of conditions affecting the skin and anorectal area — from hemorrhoids and anal fissures to eczema and contact dermatitis. Here's a complete overview of what this medication is, what it treats, and how to use it safely.

What Are the Active Ingredients?

Hydrocortisone/Pramoxine combines two active ingredients:

Hydrocortisone: A low-potency corticosteroid (steroid). It reduces inflammation, redness, and itching by blocking chemicals in the skin that trigger swelling. It also constricts blood vessels to reduce puffiness.

Pramoxine: A local anesthetic (numbing agent). It temporarily blocks nerve signals that cause pain and itching. Unlike many other topical anesthetics, pramoxine has a unique chemical structure that minimizes cross-sensitivity reactions in patients allergic to other local anesthetics.

What Is Hydrocortisone/Pramoxine Used For?

Hydrocortisone/Pramoxine is used to treat conditions that cause inflammation, pain, and itching in the skin or anorectal area:

Hemorrhoids (piles): Reduces swelling, itching, and pain from both internal and external hemorrhoids

Anal fissures: Relieves pain and reduces inflammation around small tears in the anal tissue

Proctitis: Inflammation of the rectal lining

Eczema and dermatitis: Skin conditions that cause itching, redness, and inflammation

Psoriasis: Chronic skin condition with plaques and itching

Insect bites and minor burns: Short-term relief of localized itching and discomfort

What Are the Brand Names?

Hydrocortisone/Pramoxine is available under more than 18 brand names, including:

Analpram-HC (cream)

Pramosone (cream, lotion, ointment)

Proctofoam HC (foam)

Epifoam (foam)

ProCort, Zone-A, Novacort, and others

Generic versions are also available and typically cost significantly less than branded products.

Available Formulations and Strengths

Cream: 1%/1% and 2.5%/1% — most widely available formulation

Lotion: 1%/1% and 2.5%/1%

Ointment: 1%/1% and 2.5%/1% (note: some formulations not FDA-approved)

Aerosol foam: 1%/1% — less widely available due to manufacturing complexity

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How Do You Use Hydrocortisone/Pramoxine?

Always follow your doctor's specific instructions. General dosing guidance includes:

Frequency: Apply 3-4 times daily (every 6-8 hours), depending on severity

Amount: Apply the smallest amount needed to cover the affected area

Duration: Limit use to no more than 14 consecutive days without re-evaluation by your doctor

Hands: Wash hands before and after applying, unless you're treating your hands

Eyes: Not for ophthalmic use — avoid contact with eyes

Is Hydrocortisone/Pramoxine a Controlled Substance?

No. Hydrocortisone/Pramoxine is not a controlled substance and has no DEA scheduling. It requires a prescription but can be prescribed by any licensed provider, including through telehealth.

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How Much Does It Cost?

Generic cream (2.5%/1%, 30g): average retail ~$140; as low as $43 with GoodRx coupon. Brand-name products range from $200-$430+. The foam is the most expensive formulation. Using the generic cream with a discount card is the most cost-effective approach for most patients.

Finding Your Prescription

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