Our Pick: Preparation H
Check price on Amazon →Preparation H vs Calmol 4: Vasoconstrictor or Protectant Only?
One difference decides this. Preparation H suppositories combine cocoa butter with phenylephrine HCl, a vasoconstrictor, and its Drug Facts panel carries an ask-a-doctor list that comes with it. Calmol 4 is cocoa butter and zinc oxide, both protectants, with no vasoconstrictor at all. Preparation H is 24 for $17.96, about 75 cents each; Calmol 4 is 24 for $24.12, about $1.01 each. Prices verified via the Amazon Creators API on September 5, 2026.
By The Pharmacy Desk2026-09-05~9 min read Ranked on verified label facts, never box claimsHow we research
For most adults, buy Preparation H Hemorrhoid Suppositories, 12 count in a 2-pack, at $17.96 (verified via the Amazon Creators API on September 5, 2026), which is 24 suppositories at about 75 cents each. Its Drug Facts panel lists cocoa butter as a protectant and phenylephrine HCl as a vasoconstrictor, and the directions allow up to 4 times daily, especially at night, in the morning, and after each bowel movement. If phenylephrine is not appropriate for you, buy Calmol 4 Hemorrhoidal Suppositories, 24 count, at $24.12, about $1.01 each, whose panel lists cocoa butter and zinc oxide, both protectants, and allows up to 6 times daily or after each bowel movement.
That is the whole comparison, and it is a genuinely useful one because the two boxes look identical on a shelf. A vasoconstrictor narrows blood vessels, which is the ingredient behind the temporary shrinking language on the Preparation H box, and it is also the ingredient that brings an ask-a-doctor list with it: heart disease, high blood pressure, thyroid disease, diabetes, or trouble urinating due to an enlarged prostate. A protectant-only product does none of that work and carries none of that list. Neither approach is better in the abstract; one of them may be better for you.
Both are over-the-counter drugs and we quote their Drug Facts panels rather than improvising around them. Both carry the stop line every hemorrhoidal product shares: stop use and ask a doctor if bleeding occurs, or if the condition worsens or does not improve within 7 days. Both send children under 12 to a doctor. Prices and counts were verified live through the Amazon Creators API on September 5, 2026, and cost per suppository is computed only where the listing title states the count. We are a research and verification desk, not clinicians, nothing here is medical advice, no brand paid for a placement, and if you buy through a link we may earn an Amazon commission at no cost to you.
The short version
- Preparation H suppositories: cocoa butter (protectant) plus phenylephrine HCl (vasoconstrictor), 24 for $17.96, about 75 cents each, up to 4 times daily per the panel.
- Calmol 4: cocoa butter and zinc oxide, both protectants, no vasoconstrictor, 24 for $24.12, about $1.01 each, up to 6 times daily or after each bowel movement per the panel.
- Phenylephrine brings its own ask-a-doctor list: heart disease, high blood pressure, thyroid disease, diabetes, or trouble urinating due to an enlarged prostate. Pregnancy is an ask-a-doctor line too.
- Preparation H is about 26 cents cheaper per suppository, and it is the cheaper box overall at the same count.
- Both stop at the same place: bleeding, or a condition that worsens or does not improve within 7 days, means stop and see a doctor. Children under 12, ask a doctor.
At a glance
| Product | Actives | Vasoconstrictor | Directions per panel | Count | Cost per suppository | Price (9/5/26) | Check price |
|---|---|---|---|---|---|---|---|
| Preparation H Suppositories, 12 ct x 2 | Cocoa butter, phenylephrine HCl | Yes | Up to 4 times daily | 24 | $0.75 | $17.96 | Check price on Amazon |
| Calmol 4 Hemorrhoidal Suppositories, 24 ct | Cocoa butter, zinc oxide | No | Up to 6 times daily or after each bowel movement | 24 | $1.01 | $24.12 | Check price on Amazon |
| NeilMed Hemorrhoidal Suppositories | See the Drug Facts panel | See the panel | Per the panel | Not published | Not computed | $10.99 | Check price on Amazon |
The two subjects and a third protectant option. Actives and directions come from each product's Drug Facts panel; counts and prices are as published on September 5, 2026 and verified via the Amazon Creators API. Where a listing title does not publish a count we compute nothing.
Preparation H Hemorrhoid Suppositories, 12 count, 2-Pack
Preparation H
Cocoa butter plus phenylephrine, 24 suppositories at about 75 cents each.
Our verdict: The default for an adult with no reason to avoid a vasoconstrictor. Preparation H pairs a cocoa butter protectant with phenylephrine HCl, which is the ingredient behind the box's temporary shrinking language, and it is both the cheaper box and the cheaper suppository of the two subjects. Read the ask-a-doctor list before you buy it, because it is longer than most people expect.
Verified: Labeled actives: cocoa butter (protectant) and phenylephrine HCl (vasoconstrictor) per the Drug Facts panel. Directions allow up to 4 times daily, especially at night, in the morning, and after each bowel movement; children under 12, ask a doctor. Two cartons of 12 for 24 total per the listing title. Live at $17.96 on Amazon, verified via the Creators API on September 5, 2026, about 75 cents per suppository.
What the panel lists. Preparation H Hemorrhoid Suppositories carry cocoa butter as a protectant and phenylephrine HCl as a vasoconstrictor. The directions allow use up to 4 times daily, especially at night, in the morning, and after each bowel movement, and send children under 12 to a doctor. Twenty-four suppositories at $17.96 is about 75 cents each.
Preparation H sells the same suppository in a 48 count box at $35.92, which is about 75 cents each as well, so at our September 5, 2026 check there was no volume discount to chase. If you want the same active pairing in a cream instead, the 0.9 oz tube is $7.78. The full write-up is the Preparation H suppositories review, and the other head to head readers ask for is Preparation H vs Anusol.
Who should buy it
Buy Preparation H if you are an adult with none of the conditions on its ask-a-doctor list and you want the standard hemorrhoidal suppository at the lowest cost per use of the two subjects here. It is the box most people are picturing when they think of this category.
What we don't like
The phenylephrine ask-a-doctor list rules it out for a meaningful number of people, and the panel allows fewer uses per day than Calmol 4 does, at up to 4 against up to 6. The 48 count box offered no per-suppository saving at our check.
- Active ingredients
- Cocoa butter (protectant), phenylephrine HCl (vasoconstrictor)
- Directions per panel
- Up to 4 times daily, especially at night, in the morning, and after each bowel movement
- Count
- 24 (two cartons of 12)
- Form
- Rectal suppository
- Label ages
- Adults; children under 12, ask a doctor
- Cost per suppository
- $0.75 ($17.96 divided by 24)
- Packaging
- Two cartons of individually wrapped suppositories
What we like
- About 75 cents per suppository, the cheapest of the two subjects
- Cocoa butter protectant plus phenylephrine HCl, the standard pairing on this shelf
- Two cartons, so one can live in a second bathroom
- The most widely stocked hemorrhoidal suppository there is
Worth noting
- Phenylephrine brings an ask-a-doctor list that rules it out for some buyers
- Panel allows up to 4 times daily, fewer than Calmol 4's up to 6
- No volume saving on the 48 count box at our check
Calmol 4 Hemorrhoidal Suppositories, 24 count
Calmol 4
Cocoa butter and zinc oxide, no vasoconstrictor, about $1.01 each.
Our verdict: The box for anyone the phenylephrine list applies to, and for anyone who simply wants a protectant rather than an active vasoconstrictor. Cocoa butter and zinc oxide both work by coating and shielding irritated tissue, the panel allows more uses per day than Preparation H does, and it costs about 26 cents more per suppository.
Verified: Labeled actives: cocoa butter and zinc oxide, both protectants, per the Drug Facts panel, with no vasoconstrictor. Directions allow up to 6 times daily or after each bowel movement; children under 12, ask a doctor. 24 count per the listing title. Live at $24.12 on Amazon, verified via the Creators API on September 5, 2026, about $1.01 per suppository.
What the panel lists. Calmol 4 Hemorrhoidal Suppositories carry cocoa butter and zinc oxide, both classified as protectants, with no vasoconstrictor. The directions allow use up to 6 times daily or after each bowel movement, and send children under 12 to a doctor. Twenty-four for $24.12 is about $1.01 each.
Calmol 4 also appears in a second listing, titled with the cocoa butter and zinc oxide wording, at $26.63 for the same 24 count, and a 3-pack at $71.11, about 99 cents each. Compare the listings before ordering, because the cheapest is not always the one at the top of the search. Our brand write-up is the Calmol 4 review.
Who should buy it
Buy Calmol 4 if the phenylephrine ask-a-doctor list applies to you, if a clinician has told you to avoid a vasoconstrictor, or if you simply prefer a protectant-only product. Its panel also allows more uses per day, which suits a bad flare.
What we don't like
About $1.01 per suppository is roughly a third more than Preparation H, it is sold under two near-identical listings at two prices, and a protectant does not do the vessel-narrowing work some buyers are specifically looking for.
- Active ingredients
- Cocoa butter and zinc oxide, both protectants
- Directions per panel
- Up to 6 times daily or after each bowel movement
- Count
- 24
- Form
- Rectal suppository
- Label ages
- Adults; children under 12, ask a doctor
- Cost per suppository
- $1.01 ($24.12 divided by 24)
- Packaging
- Carton of individually wrapped suppositories
What we like
- No vasoconstrictor, so none of the phenylephrine ask-a-doctor list applies
- Panel allows up to 6 times daily or after each bowel movement
- Two protectants, cocoa butter and zinc oxide, working the same way
Worth noting
- About $1.01 per suppository, roughly a third more than Preparation H
- Sold under two near-identical listings at two different prices
- No vessel-narrowing action, which is what some buyers actually want
NeilMed Hemorrhoidal Suppositories
NeilMed
The cheapest box of the three at $10.99, with its count not published.
Our verdict: The third option worth knowing about, from a brand better known for its saline products but with a credible pharmacy presence. At $10.99 it is the lowest outlay here, and it is also the listing that publishes the least: no count and no actives in the title, so cost per suppository cannot be computed and the panel is the only source.
Verified: NeilMed hemorrhoidal suppositories, described in the listing title as shrinking swollen tissue and relieving burning, itching and discomfort. The listing title does not publish a count or the active ingredients, so read the Drug Facts panel on the carton. Live at $10.99 on Amazon, verified via the Creators API on September 5, 2026.
What the listing does and does not publish. NeilMed Hemorrhoidal Suppositories are $10.99, and the title describes shrinking swollen tissue and relief from burning, itching and discomfort. It does not print a count and it does not print the active ingredients, so we print neither and compute no cost per suppository.
NeilMed also sells a larger pack at $29.08. The wider field is ranked in best hemorrhoid suppositories, the brand write-up is the NeilMed suppositories review, and if a cream would suit better, suppository vs cream for hemorrhoids covers that choice.
Who should buy it
Consider it if you want the lowest outlay and you are willing to read the Drug Facts panel on the listing page to confirm the actives and the count before ordering. NeilMed is a credible pharmacy brand.
What we don't like
Neither the count nor the active ingredients are published in the listing title, so no cost per suppository can be computed and the vasoconstrictor question, the whole subject of this page, cannot be answered from the listing alone.
- Active ingredients
- Not published in the listing title; see the Drug Facts panel
- Directions per panel
- Per the Drug Facts panel on the carton
- Count
- Not published in the listing title
- Form
- Rectal suppository
- Label ages
- Adults; children under 12, ask a doctor per the category
- Cost per suppository
- Not computed, count not published
- Packaging
- Carton
What we like
- $10.99, the lowest outlay of the three
- NeilMed is an established pharmacy brand
- A larger pack is available from the same line
Worth noting
- Count not published, so cost per suppository cannot be computed
- Actives not published in the listing title
- Cannot be placed on either side of this comparison from the listing alone
What you'll need
The six things that go in the same cart as a suppository: the pharmacy-standard glycerin, a daily stool softener, an enema for the nights nothing else works, witch hazel wipes, sitz salts, and a barrier ointment. Prices are approximate at time of writing.
Vasoconstrictor or protectant: the one real difference
Hemorrhoidal suppositories do their work in one or both of two ways. A protectant forms a physical barrier over irritated tissue: cocoa butter and zinc oxide are both protectants, and they relieve discomfort by shielding rather than by changing anything in the tissue. A vasoconstrictor narrows blood vessels, and phenylephrine HCl is the one used on this shelf. It is the ingredient behind the temporary shrinking language on a box.
Preparation H does both: cocoa butter and phenylephrine. Calmol 4 does only the first: cocoa butter and zinc oxide, no vasoconstrictor.
The phenylephrine ask-a-doctor list
This is the part of the Preparation H panel most buyers skim, and it is the reason Calmol 4 exists as an alternative rather than as a competitor. Ask a doctor before use if you have:
- heart disease
- high blood pressure
- thyroid disease
- diabetes
- trouble urinating due to an enlarged prostate
Anyone pregnant or nursing should also ask a doctor before use, which is the standing line across this whole shelf and is covered in hemorrhoid treatments for pregnancy and postpartum. If any of those apply, the protectant-only box is the one to look at, and the conversation with a clinician comes first either way.
Directions: up to 4 times daily against up to 6
The two panels do not allow the same frequency, and it is worth knowing which box you own before a bad day.
Preparation H: up to 4 times daily, especially at night, in the morning, and after each bowel movement. Calmol 4: up to 6 times daily or after each bowel movement. Both send children under 12 to a doctor.
Do not read the higher number as a sign that Calmol 4 is stronger. It is the opposite: a protectant-only product is doing gentler work, and its panel reflects that. Never use either product more often than its own panel allows, and never assume one label's frequency transfers to another product just because both are hemorrhoidal suppositories.
Price, count and the duplicate listings
| Listing | Actives | Count | Cost per suppository | Price (9/5/26) |
|---|---|---|---|---|
| Preparation H, 12 ct x 2 | Cocoa butter, phenylephrine HCl | 24 | $0.75 | $17.96 |
| Preparation H, 48 ct | Cocoa butter, phenylephrine HCl | 48 | $0.75 | $35.92 |
| Calmol 4, 24 ct x 3 | Cocoa butter, zinc oxide | 72 | $0.99 | $71.11 |
| Calmol 4, 24 ct | Cocoa butter, zinc oxide | 24 | $1.01 | $24.12 |
| Calmol 4, 24 ct (second listing) | Cocoa butter, zinc oxide | 24 | $1.11 | $26.63 |
Two things to take from that table. First, Preparation H is the cheaper product per suppository by about 26 cents, and its 48 count box offered no additional saving at our September 5, 2026 check. Second, Calmol 4 appears twice at two prices for what the titles describe as the same 24 count product, a $2.51 difference for reading the search results more carefully. Prices move; the habit of dividing before buying does not.
Where both labels stop
The shared lines matter more than the differences, because they are where a product stops being the right answer.
- Stop use and ask a doctor if bleeding occurs. Rectal bleeding is not something to self-treat past, on either product.
- Stop if the condition worsens or does not improve within 7 days. Seven days is the ceiling both panels set.
- Children under 12, ask a doctor, on both.
- Pregnant or nursing, ask a doctor before use.
If a suppository is not the format you want in the first place, suppository vs cream for hemorrhoids covers the choice, and the creams, wipes and pads beside these boxes are ranked in best hemorrhoid creams and best witch hazel pads.
The verdict, by buyer
- Adult with none of the phenylephrine conditions: Preparation H, 24 for $17.96, about 75 cents each. The cheaper box and the standard pairing.
- Heart disease, high blood pressure, thyroid disease, diabetes, or trouble urinating from an enlarged prostate: ask a doctor, and look at Calmol 4, 24 for $24.12, which has no vasoconstrictor.
- Pregnant or postpartum: ask a doctor before using either, and read the pregnancy and postpartum guide first.
- Wants the most uses per day allowed by a panel: Calmol 4, at up to 6 times daily or after each bowel movement.
- Wants the lowest outlay and will read the panel: NeilMed at $10.99, with the caveat that its listing publishes neither count nor actives.
- Bleeding, or no improvement after 7 days: neither. That is the doctor.
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- Preparation H Hemorrhoid Suppositories, 12 count, 2-PackBest for Most AdultsPreparation H · $17.96Check price on Amazon
- Calmol 4 Hemorrhoidal Suppositories, 24 countBest Protectant-Only OptionCalmol 4 · $24.12Check price on Amazon
- NeilMed Hemorrhoidal SuppositoriesIf Neither: the Lower-Priced ThirdNeilMed · $10.99Check price on Amazon
How we chose
We compared these two products on their Drug Facts panels first: the active ingredients and what each is classified as, the Uses statement, the directions as printed including how often each may be used, the warnings, and the stop lines. Then on the listings: count, cost per suppository where the title states a count, and packaging. Both listings were verified live through the Amazon Creators API on September 5, 2026 and prices are hedged to that date. Owner reports were weighed only for the practical questions a panel does not answer, such as how each behaves in a warm bathroom and how the wrappers open.
Compliance for this shelf. Hemorrhoidal suppositories are over-the-counter drugs and we quote the label's Uses and Directions and nothing beyond them. We never suggest using a product more often than its own panel allows, and the two panels here differ, so we state each separately rather than blending them. We carry every warning as printed, including the ask-a-doctor list that comes with phenylephrine, the instruction for children under 12 to ask a doctor, and the stop line both products share: stop use and ask a doctor if bleeding occurs, or if the condition worsens or does not improve within 7 days. Anyone pregnant or nursing should ask a doctor before use. Rectal bleeding is never something to self-treat past. Nothing here is medical advice.
Questions, answered
What is the difference between Preparation H and Calmol 4?
One ingredient class. Preparation H suppositories list cocoa butter as a protectant and phenylephrine HCl as a vasoconstrictor; Calmol 4 lists cocoa butter and zinc oxide, both protectants, with no vasoconstrictor. That means Preparation H carries the ask-a-doctor list that comes with phenylephrine, covering heart disease, high blood pressure, thyroid disease, diabetes, and trouble urinating due to an enlarged prostate, and Calmol 4 does not. Everything else, format, count and the 7-day stop line, is effectively the same.
Which is cheaper, Preparation H or Calmol 4?
Preparation H, by about 26 cents per suppository. On September 5, 2026 the Preparation H 12 count 2-pack was $17.96 for 24, about 75 cents each, while the Calmol 4 24 count was $24.12, about $1.01 each. Note that Calmol 4 appears in a second listing at $26.63 for the same stated count, about $1.11 each, and that the Calmol 4 3-pack at $71.11 works out to about 99 cents each, so divide before ordering.
Is Calmol 4 better if I have high blood pressure?
High blood pressure is on the ask-a-doctor list printed on the phenylephrine-containing product, so that conversation comes first regardless of which box you are considering. What we can say from the panels is that Calmol 4 contains no vasoconstrictor and therefore does not carry that list, which is precisely why a protectant-only product exists on this shelf. Take the question to a clinician or a pharmacist rather than to a comparison page.
How often can I use a hemorrhoid suppository?
Read the panel on the box you own, because these two differ. Preparation H directs up to 4 times daily, especially at night, in the morning, and after each bowel movement. Calmol 4 directs up to 6 times daily or after each bowel movement. Never exceed the frequency printed on your own product, and never assume one hemorrhoidal label's directions transfer to another, even within the same category.
Can I use these while pregnant?
Ask a doctor before use. That instruction appears on this shelf as standard and it applies to both products here. Hemorrhoids are common in pregnancy and postpartum, which is exactly why the question comes up so often, and why the decision belongs with the clinician who is already looking after you. Our hemorrhoid treatments for pregnancy and postpartum page sets out what each label states for that situation.
How long can I use a hemorrhoid suppository before seeing a doctor?
Seven days is the ceiling both panels set. Stop use and ask a doctor if the condition worsens or does not improve within 7 days, and stop immediately if bleeding occurs. Rectal bleeding in particular is not something to treat past with an over-the-counter product, because the product is treating symptoms and bleeding is information about a cause. Children under 12 should ask a doctor before use of either product.
Is a suppository better than a cream for hemorrhoids?
They address different locations rather than different severities. A suppository is placed internally; a cream or ointment is applied externally, and some products supply an applicator for both. Preparation H sells the same brand of relief across suppositories, creams, ointments and wipes, so the choice is usually about where the discomfort is rather than which product is stronger. Our suppository vs cream for hemorrhoids page walks through it.
Filed under Comparison
Part of Hemorrhoid Suppositories, Creams & Wipes · Head-to-Head Comparisons
Keep reading
Best Hemorrhoid Suppositories (2026)
The full field ranked on labeled actives and cost per suppository.
Preparation H Suppositories Review
The category standard in detail, including the phenylephrine warnings.
Calmol 4 Review
The protectant-only box, its duplicate listings, and who it is actually for.
Preparation H vs Anusol
The other head to head on this shelf, with the same panel table on both sides.