Over-the-counter drug · OTC MONOGRAPH DRUG
Walgreens Hemorrhoidal Pain Relief NDC 0363-1217
glycerin 14.4%, lidocaine 5%, petrolatum 15%, phenylephrine hcl 0.25% · Lidocaine 5 g/100g + 3 more ingredients · Cream · Topical · Walgreens
NDC codes
FDA NDC Directory| Package NDC | 11-digit (billing) | Package | Copy |
|---|---|---|---|
| 0363-1217-00 | 00363121700 | 2 g in 1 PACKET (0363-1217-00)Marketed from Dec 22, 2023 | |
| 0363-1217-01 | 00363121701 | 28 g in 1 TUBE (0363-1217-01)Marketed from Mar 8, 2023 |
How the 11-digit form is made: The labeler segment has 4 digits, so one leading zero is added to it (4-4-2 → 5-4-2). Formatting the NDC does not by itself make it billable — the product, package and quantity must match what was dispensed or administered, and payer rules apply. Conversion rules
Product information
- Brand name (proprietary)
- Walgreens Hemorrhoidal Pain Relief
- Generic name (nonproprietary)
- glycerin 14.4%, lidocaine 5%, petrolatum 15%, phenylephrine hcl 0.25%
- Active ingredients
- Lidocaine — 5 g/100gPetrolatum — 15 g/100gGlycerin — 14.4 g/100gPhenylephrine hydrochloride — .25 g/100g
- Dosage form
- Cream
- Route
- Topical
- Labeler
- Walgreens
- Product type
- Over-the-counter drug
- Marketing category
- OTC monograph drugApplication M 015
- Marketing start
- Listing expires
- Other FDA classes
- Adrenergic alpha1-Agonists (Mechanism)Allergens (Chemical structure)Amides (Chemical structure)Cell-mediated Immunity (Physiologic effect)Glycerol (Chemical structure)Increased Histamine Release (Physiologic effect)Increased IgG Production (Physiologic effect)Local Anesthesia (Physiologic effect)
- Identifiers
- Product ID 0363-1217_22905917-65b6-0c81-e063-6394a90a8571SPL ID 22905917-65b6-0c81-e063-6394a90a8571SPL set ID e79ed7ae-0d06-2f88-e053-2995a90a1e35RxCUI 2642220UNII 98PI200987, 4T6H12BN9U, PDC6A3C0OX, 04JA59TNSJUPC 0311917124773
- Pharmacologic class
- Amide Local Anesthetic; Antiarrhythmic; Non-Standardized Chemical Allergen; alpha-1 Adrenergic Agonist
Billing references
What Med-Code can say about coding this product, and where each statement comes from. Nothing here is inferred from the name alone.
- HCPCS codeNo match
No HCPCS code in Med-Code's directory. Topical products like this are usually dispensed by a pharmacy and billed by NDC.
- NDC on a medical claim
N400363121700followed by a unit qualifier and the quantityPackage 00363-1217-00. Unit qualifiers: F2 (international unit), GR (gram), ME (milligram), ML (milliliter), UN (unit (each)). The qualifier and quantity depend on what was given. About the N4 qualifier
Product label
Current FDA label (SPL), effective .
Indications (excerpt from the label)
For the temporary relief of pain, soreness, and burning. Helps relieve the local itching and discomfort associated with hemorrhoids. Temporarily shrinks hemorrhoidal tissue. Temporarily provides a coating for the relief of anorectal discomforts. Temporarily protects the inflamed, irritated anorectal surface to help make bowel movements less painful.
Excerpt only. Read the full label for complete information.
Other NDCs under M 015
Products listed under the same FDA application: other strengths and forms, and repackagers who relabel the same product.
| Product | Strength | Form · route | Labeler | Product NDC |
|---|---|---|---|---|
| Chamosynbarrier cream | Menthol 1 mg/g; Zinc oxide 200 mg/g | OintmentTopical | Links Medical Products | 51028-002 |
| Hemorrhoid Relief Creamlidocaine 5% anorectal | Lidocaine 50 mg/g | CreamTopical | ALAINA HEALTHCARE PRIVATE LIMITED | 73492-712 |
| Hemorrhoidalcocoa butter, phenylephrine hcl | Cocoa butter 2.39 g/1; Phenylephrine hydrochloride 6.75 mg/1 | SuppositoryRectal | Amerisourcebergen Drug Corporation | 46122-777 |
| Family wellnessmineral oil, petrolatum, phenylephrine hcl | Mineral oil 14 g/100g + 2 more ingredients | OintmentTopical | FRONT PHARMACEUTICAL PLC | 69571-006 |
| Kroger Medicated Wipes Hemorrhoidal Wipe With Witch Hazel And Aloewitch hazel cloth | Witch hazel .5 g/g | SwabTopical | The Kroger Co. | 30142-791 |
| TN Dickinsons Witch Hazel Hemorrhoidal Padswitch hazel | Witch hazel 1.2 g/1 | ClothTopical | Dickinson Brands Inc. | 52651-003 |
| T.N. Dickinsons Witch Hazel Medicated Cooling Pads Hemorrhoidal Reliefwitch hazel | Witch hazel .034 g/1 | ClothTopical | Dickinson Brands Inc. | 52651-010 |
| Norms Hemorrhoidphenylephrine hydrochloride, witch hazel | Witch hazel 50 g/100g; Phenylephrine hydrochloride .25 g/100g | SprayTopical | Totally Normal Company | 85996-135 |
| hemorrhoidalcocoa butter, phenylephrine hcl | Cocoa butter 2211 mg/1; Phenylephrine hydrochloride 6.5 mg/1 | SuppositoryRectal | H E B | 37808-279 |
| Dermatool Hemorrhoidalglycerin, lidocaine, petrolatum, phenylephrine hcl | Lidocaine 5 g/100g + 3 more ingredients | CreamTopical | Papalo Group LLC | 84728-413 |
| Norms Medicated Wipeswitch hazel | Witch hazel .5 g/g | ClothTopical | Totally Normal Company | 85996-001 |
| Norms Hemorrhoid Wipeswitch hazel | Witch hazel .5 g/g | ClothTopical | Totally Normal Company | 85996-002 |
| Norms Hemorrhoidglycerin, lidocaine, petrolatum, phenylephrine hcl | Lidocaine 5 g/100g + 3 more ingredients | CreamTopical | Totally Normal Company | 85996-173 |
| ReVIVOL-XRphenylephrine hydrochloride | Phenylephrine hydrochloride 6.25 mg/1 | SuppositoryRectal | Unipack LLC | 43749-432 |
| Preparation Hcocoa butter, phenylephrine hydrochloride | Cocoa butter 2211 mg/1; Phenylephrine hydrochloride 6.25 mg/1 | SuppositoryRectal | Haleon US Holdings LLC | 0573-2883 |
| FAMILY Wellness MEDICATED HEMORRHOIDAL WIPESwitch hazel | Witch hazel 50 g/100mL | ClothTopical | Family Dollar Stores, Inc | 55319-774 |
| Walgreens Hemorrhoidalhemorrhoidal rectal suppositories | Cocoa butter 2211 mg/1; Phenylephrine hydrochloride 6.25 mg/1 | SuppositoryRectal | Walgreens | 0363-0476 |
| Recticarelidocaine and glycerin | Lidocaine 50 mg/g; Glycerin 200 mg/g | ClothTopical | Ferndale Laboratories, Inc. | 0496-0980 |
| Kroger Hemorrhoidglycerin, lidocaine, petrolatum, phenylephrine hcl | Lidocaine 5 g/100g + 3 more ingredients | CreamTopical | Kroger Company | 30142-713 |
| Mayinglong Hemorrhoidalpetrolatum, zinc oxide | Petrolatum 779.9 mg/g; Zinc oxide 76 mg/g | OintmentTopical | Mayinglong Pharmaceutical Group Co., Ltd. | 68511-998 |
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