Comprehensive medication guide to Hydrocortisone/Pramoxine including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$10–$50 copay for generic cream on most commercial plans (Tier 1–2); brand-name products may require prior authorization or higher-tier copays. Medicare Part D typically does not cover brand Analpram-HC; eligible commercially insured patients can use the Analpram HC savings card to pay as little as $20 per fill.
Estimated Cash Pricing
Generic cream (2.5%/1%, 30g) retails around $140 but can be found for as low as $43 with a GoodRx coupon. Brand-name Analpram-HC runs $272–$428 cash price; Pramosone around $223 for 28.4g. Foam formulations (Proctofoam HC) cost $200–$500+ brand-name or $50–$150 generic with a discount card.
Medfinder Findability Score
72/100
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Hydrocortisone/Pramoxine is a prescription combination topical medication that combines two active ingredients: hydrocortisone (a low-potency corticosteroid) and pramoxine hydrochloride (a local anesthetic). FDA-approved since August 1976, it is available under more than 18 brand names including Analpram-HC, Pramosone, Proctofoam HC, and Epifoam.
This dual-action topical is used primarily to treat conditions causing inflammation, pain, and itching in the anorectal area and on the skin. It is available as cream, lotion, ointment, and aerosol foam. The cream and lotion formulations are widely available; the aerosol foam (Proctofoam HC) faces ongoing structural availability issues due to complex manufacturing requirements.
Conditions treated include hemorrhoids, anal fissures, proctitis, eczema, psoriasis, contact dermatitis, and other corticosteroid-responsive dermatoses. Standard dosing is 3-4 times daily (every 6-8 hours), applied in the smallest amount needed, for no more than 14 consecutive days.
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Hydrocortisone/Pramoxine works through two distinct and complementary mechanisms. Hydrocortisone is a synthetic glucocorticoid that reduces inflammation by suppressing the migration of inflammatory white blood cells (polymorphonuclear leukocytes), inhibiting the release of inflammatory mediators like prostaglandins and histamines, constricting blood vessels to reduce redness and swelling, and stabilizing cell membranes to prevent further inflammatory cascade.
Pramoxine is a topical local anesthetic with a unique chemical structure distinct from both amide anesthetics (like lidocaine) and ester anesthetics (like benzocaine). It stabilizes the neuronal membrane of nerve endings by blocking sodium ion channels, preventing the transmission of pain and itch signals to the brain. This numbing effect occurs within minutes of application and provides rapid symptomatic relief while the hydrocortisone's anti-inflammatory effects build over hours and days of consistent use.
Percutaneous absorption of hydrocortisone depends on the vehicle, skin integrity, application area size, and whether occlusive dressings are used. Absorbed hydrocortisone is handled through pharmacokinetic pathways similar to systemically administered corticosteroids, which is why prolonged use or use over large areas carries systemic risk.
Hydrocortisone 1% / Pramoxine 1% — cream
Most widely available concentration; FDA-approved for topical and rectal use
Hydrocortisone 2.5% / Pramoxine 1% — cream
Higher-strength hydrocortisone option; widely available as generic
Hydrocortisone 1% / Pramoxine 1% — lotion
Available in 1%/1% and 2.5%/1%; good option for larger skin areas
Hydrocortisone 2.5% / Pramoxine 1% — lotion
Higher-strength lotion; may require special order at some pharmacies
Hydrocortisone 1% / Pramoxine 1% — foam
Aerosol foam; hard to find due to manufacturing complexity and limited producers
Hydrocortisone 1% / Pramoxine 1% — ointment
Available but less commonly stocked; some formulations not FDA-approved
Availability varies significantly by formulation. Hydrocortisone/Pramoxine cream and lotion are generally well-stocked at most retail and independent pharmacies — multiple generic manufacturers produce these formulations, providing a robust supply. Most patients prescribed cream or lotion can fill their prescription without significant difficulty.
The aerosol foam formulation (Proctofoam HC) presents a different picture. The original brand-name product has been largely discontinued, and generic foam versions are produced by only a small number of manufacturers with specialized aerosol manufacturing infrastructure. This creates fragile supply chains where a single producer disruption can cause widespread unavailability. Foam formulations are not on the FDA's official shortage list as of 2026 but are consistently difficult to find at many pharmacies.
If you're struggling to find your specific formulation, medfinder calls pharmacies near you to find which ones have your exact medication in stock, saving you from hours of phone calls.
Hydrocortisone/Pramoxine is not a controlled substance and has no DEA scheduling restrictions. Any licensed prescriber can write a prescription for it without special registration or limitations. This makes it widely accessible through routine healthcare contacts.
Primary care physicians (PCPs) — most common prescribers for hemorrhoids and skin conditions
Nurse practitioners (NPs) — can prescribe in all 50 states; often found in urgent care clinics
Physician assistants (PAs) — can prescribe in all 50 states
Gastroenterologists — commonly prescribe for anorectal conditions
Colorectal surgeons — prescribe for hemorrhoids, anal fissures, and rectal conditions
Dermatologists — prescribe for skin conditions like eczema, psoriasis, and contact dermatitis
OB/GYNs — may prescribe for perianal discomfort during or after pregnancy
Because Hydrocortisone/Pramoxine is non-controlled, it can be prescribed via telehealth for appropriate patients. Platforms like Teladoc, MDLive, and Ro can evaluate symptoms and send prescriptions electronically the same day, making telehealth a fast and convenient path to getting this medication.
No. Hydrocortisone/Pramoxine is not a controlled substance and carries no DEA scheduling classification. It is a prescription-only medication, but it can be prescribed by any licensed healthcare provider — including primary care physicians, nurse practitioners, physician assistants, and telehealth providers — without any special registration or prescribing restrictions.
Because it is not a controlled substance, Hydrocortisone/Pramoxine can be prescribed via telehealth, refilled without additional physician visits (if refills remain on the prescription), and filled at any licensed pharmacy. Patients do not need to go to a specific type of pharmacy or face quantity-limit restrictions related to controlled substance scheduling.
Most patients tolerate Hydrocortisone/Pramoxine well when used as directed for short periods. Common local side effects at the application site include:
Burning or stinging at application site (especially initially)
Itching or irritation of treated skin
Dryness or skin peeling
Folliculitis (bumps around hair follicles)
Acneiform eruptions
Hypopigmentation (skin lightening in treated area)
Adrenal suppression: fatigue, nausea, dizziness, weakness (from prolonged or excessive use)
Cushing's syndrome: moon face, weight gain in upper back/belly, severe headache (from long-term overuse)
Increased blood sugar: especially in diabetic patients
Skin atrophy (thinning) and striae (stretch marks): from prolonged use
Severe allergic reaction: hives, difficulty breathing, facial swelling — seek emergency care
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Anusol-HC
Hydrocortisone 2.5% cream/ointment without pramoxine; widely available, good for inflammation-dominant cases
Preparation H Hydrocortisone
OTC 1% hydrocortisone cream; $8-$15, no prescription needed, appropriate for mild hemorrhoid symptoms
Ana-Lex / Lidamantle HC
Lidocaine/hydrocortisone combinations; same dual-action approach using lidocaine instead of pramoxine
Rectiv (nitroglycerin 0.4%)
For anal fissures specifically; different mechanism, promotes healing via sphincter relaxation
Compounded hydrocortisone/pramoxine
Custom formulations from compounding pharmacies when commercial products are unavailable
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Oral/inhaled corticosteroids (prednisone, fluticasone)
moderateAdditive steroid load increases risk of adrenal suppression, Cushing's syndrome, and blood sugar elevation
Diabetes medications (insulin, metformin, sulfonylureas)
moderateHydrocortisone absorbed through skin can raise blood sugar, potentially requiring medication adjustment
Immunosuppressants (tacrolimus, cyclosporine)
moderateCombined immunosuppression increases infection risk at application site
Warfarin (Coumadin)
minorSystemic corticosteroids may alter warfarin effect; monitor INR if significant absorption expected
Live vaccines
minorSignificant systemic steroid doses may reduce vaccine response; unlikely with proper topical use but mention to provider
Hydrocortisone/Pramoxine is a safe, effective, and well-established combination medication that has been helping patients manage anorectal and dermatological conditions since 1976. When used as directed — in small amounts, on the targeted area, for no longer than 14 consecutive days — it provides meaningful relief from inflammation and pain with a favorable safety profile for most adults.
The cream and lotion formulations are widely accessible and affordable with a GoodRx coupon (as low as $43 for a 30g tube of generic cream). The foam formulation remains structurally limited in supply — patients who need it may need to search more broadly or discuss formulation alternatives with their prescriber.
If you're having trouble finding your prescription, medfinder can call pharmacies in your area to find which ones have your specific formulation and strength in stock — so you spend less time searching and more time getting the relief you need.
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Real-time availability
Medfinder is actively checking pharmacy inventory for Hydrocortisone/Pramoxine. We don't publish a number until we have enough verified pharmacy checks to be accurate — start a search and our team confirms current availability near you, usually within 24 hours.
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