Anusol HC ointment and suppositories can be bought over-the-counter without a prescription from your pharmacy.

What is Anusol HC Ointment/Suppositories used for

• This medication is used to treat minor pain, itching, swelling, and discomfort caused by hemorrhoids and other problems of the anal area (e.g., anal fissures, itching). Hydrocortisone is a corticosteroid that reduces redness, itching, and swelling.
• The cream and ointment can be used for both internal and external piles, while the suppositories are only useful for internal piles or itching, or also be used following ano-rectal surgery. 

How Anusol HC work

• The active ingredients in Anusol Plus HC ointment and suppositories are: hydrocortisone acetate, benzyl benzoate, bismuth oxide, bismuth subgallate, balsam peru and zinc oxide. 
• Hydrocortisone acetate is a type of medicine called a corticosteroid. It works by reducing inflammation, which reduces swelling and itching.
• Bismuth oxide, bismuth subgallate, balsam peru and zinc oxide have mild antiseptic, protective and astringent properties (this means they constrict blood vessels). Balsam peru is also believed to promote the growth of new skin cells.
• When Anusol Plus HC is administered into or around the back-passage (rectum), it relieves the discomfort caused by internal and external piles and other irritations in the anal area.

How do I use Anusol HC

• Wash your hands thoroughly before and after using this medicine.
• Before use, clean the affected area with mild soap and water, rinse well, and pat dry.
• Anusol Plus HC suppositories: Adults should should insert one suppository into the rectum in the morning, at night and after a bowel movement. Don't use more than three suppositories in a day. 
• Anusol Plus HC ointment/cream: Adults should use a small amount of the ointment in the morning, at night and after a bowel movement. Don't use more than four applications in a day.
• You can apply the ointment externally over the anal area (apply thinly), or use the nozzle supplied to insert the ointment into the back passage.
• For application into the back passage, the nozzle provided with the ointment should be screwed onto the tube. The nozzle should then be gently inserted into the rectum and a small amount of ointment squeezed out. The nozzle should be withdrawn slowly. The nozzle should be thoroughly cleaned after each use.
• Don't use Anusol Plus HC ointment or suppositories for longer than seven days. Consult your doctor if you still have symptoms after this time.
•  Wash your hands after using Anusol.
• Do not use for more than 7 consecutive days.

Do not use more of this product, use it more often, or keep using it longer than prescribed by your doctor. If you have been using this medication for a long time or in high doses, do not suddenly stop using it without your doctor's approval. Some conditions may become worse when this drug is suddenly stopped. Your dose may need to be gradually decreased.

Inform your doctor if your condition does not improve or if it worsens after 1 to 2 weeks.

Who shouldn't use Anusol HC

• Children under 18 years of age.
• People with viral infections such as genital herpes.
• People with fungal infections such as thrush.
• People with skin sores caused by tuberculosis.
• If you have blood in your stools or are unsure whether any rectal bleeding you have experienced is caused by piles, you should consult your doctor before using Anusol HC.
• Don’t use Anusol HC if you are allergic to any of its ingredients. If you feel you have experienced an allergic reaction, stop using this medicine and consult your doctor or pharmacist.

Can I use Anusol HC while pregnant or breastfeeding

• Anusol Plus HC should not be used in pregnancy or while breastfeeding unless it has been prescribed by your doctor. Get medical advice from your doctor before using this medicine if you are pregnant or breastfeeding.

What are the possible side effects of Anusol HC

Stop using Anusol HC and consult your doctor if you experience any of these:

• Sensitisation or allergic reactions such as a rash. 
• Irritation on application, such as a burning sensation, redness or itching.
• Contact dermatitis.

Side Effects

• Redness, burning, or itching at the application site may occur. If any of these effects persist or worsen, contact your doctor or pharmacist promptly.
• Tell your doctor right away if any of these unlikely but serious side effects occur: rectal bleeding, change in skin appearance (e.g., color, thickness), skin redness/tenderness/pus or other signs of infection.
• Rarely, it is possible this medication will be absorbed into the bloodstream. This can lead to side effects of too much corticosteroid. These side effects are more likely in children and people who use this medication for a long time. Tell your doctor right away if any of the following side effects occur: unusual/extreme tiredness, weight loss, headache, swelling ankles/feet, increased thirst/urination, vision problems.
• Tell your doctor right away if any of these rare but very serious side effects occur: signs of serious infection (e.g., fever, persistent sore throat).
• A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Precautions

• Before using this product, tell your doctor or pharmacist if you are allergic to hydrocortisone; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems.
• Before using this medication, tell your doctor or pharmacist your medical history, especially of: diabetes, eye problems, infections (especially rectal sores/infections), liver disease, stomach/intestinal problems.
• Rarely, using corticosteroid medications for a long time can make it more difficult for your body to respond to physical stress. Therefore, before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used this medication within the past few months.
• Caution is advised when using this drug in children. Do not use this product over a large area or use tight-fitting diapers/plastic pants unless directed by your doctor.
• Though it is unlikely, this medication may temporarily slow down a child's growth if used for a long time. See the doctor regularly so your child's height can be checked.
• During pregnancy, this medication should be used only when clearly needed. It should not be used for long periods of time or in large amounts. Discuss the risks and benefits with your doctor.
• It is not known if this medication passes into breast milk. Consult your doctor before breast-feeding.

Can I use Anusol HC with other medicines

Anusol Plus HC is not known to affect other medicines. However, if you are already using any other medicines, particularly other corticosteroid medicines, eg for inflammatory bowel disease, asthma, eczema or hayfever, you should check with your pharmacist before using this one as well.

Interactions

• Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.
• Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: other corticosteroids/immunosuppressants (e.g., prednisone), other rectal products.

Missed Dose

If you miss a dose, use it as soon as you remember unless it is almost time for the next dose. In that case, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

References:

https://www.netdoctor.co.uk/medicines/digestion/a6222/anusol-plus-hc/
https://www.webmd.com/drugs/2/drug-7949-3245/anusol-hc-rectal/hydrocortisone-cream-ointment-rectal/details
https://www.medicines.org.uk/emc/product/1719/smpc
https://www.medicines.org.uk/emc/product/1486/smpc
https://www.medicines.org.uk/emc/product/1471/smpc