nitroglycerin
Nitroglycerin (Rectiv) is a rectal ointment that's used to treat anal fissure pain in adults. It's a nitrate that works by relaxing the sphincter muscle in the anus to improve blood flow and help relieve pain. The carton provides instructions on how to measure the correct dose of ointment, which should then be applied to the anus every 12 hours. Common side effects include headache and dizziness. Nitroglycerin (Rectiv) isn't available over the counter; it requires a prescription from your healthcare professional (HCP).
What is Nitroglycerin (Rectiv)?
What is Nitroglycerin (Rectiv) used for?
- Anal fissure pain (moderate to severe)
How Nitroglycerin (Rectiv) works
Nitroglycerin (Rectiv) is a nitrate. When it's applied inside the anus, this medication mainly works to relax the muscles around the area. This lowers the pressure inside the anus which helps with pain and allows the fissures (small skin tears) to heal faster.
Drug facts
Side effects of Nitroglycerin (Rectiv)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache (64%)
- Dizziness (5%)
Less Common Side Effects
- Lightheadedness due to low blood pressure
The following Nitroglycerin (Rectiv) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Bloating or swelling of the face, arms, hands, lower legs, or feet
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
difficult or labored breathing
feeling faint, dizzy, or lightheadedness
feeling of warmth or heat
flushing or redness of the skin, especially on the face and neck
headache
rapid weight gain
sweating
tightness in the chest
tingling of the hands or feet
unusual weight gain or loss
Rare
Bluish-colored lips, fingernails, or palms
dark urine
pale skin
rapid heart rate
unusual bleeding or bruising
unusual tiredness or weakness
Incidence not known
Arm, back, or jaw pain
blurred vision
chest pain or discomfort
chest tightness or heaviness
confusion
cracks in the skin
difficulty with swallowing
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fainting
fast, irregular, pounding, or racing heartbeat or pulse
feeling of constant movement of self or surroundings
feeling of warmth
increased sweating
loss of heat from the body
nausea or vomiting
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red, swollen skin
redness of the face, neck, arms, and occasionally, upper chest
sensation of spinning
weakness
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Bluish-colored lips, fingernails, or palms
blurred or loss of vision
bulging soft spot on the head of an infant
change in consciousness
change in the ability to see colors, especially blue or yellow
cold, clammy skin
dark urine
difficulty breathing
disturbed color perception
dizziness or lightheadedness
double vision
flushed skin
halos around lights
headache, severe and throbbing
increased sweating
loss of appetite
loss of consciousness
night blindness
overbright appearance of lights
pale skin
paralysis
slow or irregular heartbeat
tunnel vision
unusual bleeding or bruising
unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Nitroglycerin (Rectiv)
Pros
- Works to lessen pain due to anal fissures
- Stored at room temperature
- Applied directly to the location of the injury
Cons
- Headaches are a very common side effect
- Not a good option for people with certain heart problems
- Can cause dizziness
Pharmacist tips for Nitroglycerin (Rectiv)
- Use nitroglycerin (Rectiv) for no longer than 3 weeks. If your pain hasn't improved after that time, talk to your prescriber.
- After you open a tube of nitroglycerin (Rectiv), it's only good for 8 weeks. After that time period, you'll need a refill if you continue to need the medication.
- You might get a headache, especially after the first few times taking nitroglycerin (Rectiv). This is a known side effect and usually goes away with time. If it becomes bothersome, ask your prescriber if you can use certain medications like acetaminophen (Tylenol) to treat the headache.
- Nitroglycerin (Rectiv) can cause low blood pressure, which can lead to dizziness or lightheadedness. Change positions slowly until you know how your body reacts to this medication. And don't drive until you know how this medication affects you.
- Erectile dysfunction medications (e.g., sildenafil (Viagra), tadalafil (Cialis)) can't be taken while you're taking nitroglycerin (Rectiv). Taking them together can cause your blood pressure to become dangerously low.
- Nitroglycerin (Rectiv) should only be applied inside the anus. Don't use it on other parts of the body.
How to use nitroglycerin (Rectiv):
- Cover your finger using plastic wrap, a glove, or finger cot.
- Squeeze 1 inch of ointment on the covered finger by measuring the dose with the line on the medication box.
- Place your finger inside of the anus up to the first finger joint and spread the ointment. If it hurts too much to insert a finger, you can put the ointment directly on the outside part of the anus.
- After use, throw the finger covering away and wash your hands.
Common questions about Nitroglycerin (Rectiv)
Before applying nitroglycerin (Rectiv), cover your finger with plastic wrap, a glove, or a finger cot. Align your finger with the 1-inch dosing line on the side of the medication box. Squeeze the ointment onto your finger to match the length of the dosing line. Then, gently insert your finger into the anus up to the first finger joint and spread the ointment inside. After you're done, throw the finger covering away and wash your hands with soap and water.
Nitroglycerin (Rectiv) is absorbed through the skin in your anus and can cause effects in other parts of your body. Nitrates like nitroglycerin (Rectiv) can relax and open blood vessels in other parts of the body. So when the blood vessels in your brain widen, it can cause headache symptoms.
No, nitroglycerin (Rectiv) isn't available over the counter. You'll need to get a prescription from a healthcare professional (HCP) in order to use this medication.
Headaches are a common side effect of nitroglycerin (Rectiv). If you get headaches after using it, they should get better as you continue to use the medication. In the meantime, drink plenty of fluids to stay hydrated and make sure you get enough sleep. Ask your prescriber if an over-the-counter pain reliever would be safe for you to use to treat your headache symptoms.
The amount of time it takes for an anal fissure to heal is different for everyone. While nitroglycerin (Rectiv) can help relieve pain due to anal fissures, a small study showed it didn't help anal fissures heal any faster than people taking a placebo (no active medication). So if you're still having symptoms after using nitroglycerin (Rectiv) for 3 weeks, tell your prescriber.
No, avoid drinking alcohol while you're taking nitroglycerin (Rectiv). Drinking alcohol with this medication can further lower your blood pressure, which can lead to dizziness, lightheadedness, and fainting.
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Risks and warnings for Nitroglycerin (Rectiv)
Nitroglycerin (Rectiv) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heart problems
- Risk factors: History of heart problems | Low fluids in the body | Low blood pressure
Even though it's used in the anus, nitroglycerin (Rectiv) can absorb into your bloodstream and relax blood vessels in other parts of your body. This can cause low blood pressure and make it harder for the heart to pump blood throughout the body. Talk to your prescriber if you are concerned about this potential problem.
Headache
Nitroglycerin (Rectiv) can cause headaches, especially when you first start taking this medication. Don't use more than what's prescribed, since this could make your headaches worse. The headaches can get pretty bad, but should get better after you've used nitroglycerin (Rectiv) for a few times as your body gets used to it. Consider taking a pain reliever, such as acetaminophen (Tylenol), to help relieve your headache symptoms. If the headaches are causing you too many problems, talk to your prescriber about other options.
Nitroglycerin (Rectiv) dosage
Tube of ointment| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 30g of 0.4% | 1 tube | $158.11 | $158.11 |
Typical dosage for Nitroglycerin (Rectiv)
Apply 1 inch of ointment in the anus every 12 hours for up to 3 weeks.
Interactions between Nitroglycerin (Rectiv) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Avanafil
- Riociguat
- Sildenafil
- Tadalafil
- Vardenafil
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alteplase, Recombinant
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acetylcysteine
- Apomorphine
- Aspirin
- Dihydroergotamine
- Pancuronium
How much does Nitroglycerin (Rectiv) cost?
Nitroglycerin (Rectiv) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Nitroglycerin (Rectiv) will not be safe for you to take.
- Taking a PDE5 inhibitor
- Severe low red blood cells (anemia)
- High pressure in the brain
- Allergy to nitrates or nitrites
What are alternatives to Nitroglycerin (Rectiv)?
Nitroglycerin (Rectiv) images
