Rectal Nitroglycerin

Aka: Rectal Nitroglycerin, Glyceryl Trinitrate, Rectiv

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II. Indications

  1. Anal Fissure

III. Preparations

  1. Glyceryl Trinitrate ointment 0.2% to 0.4% (Compounded by pharmacies)
  2. Nitroglcycerin ointment 0.4% (Rectiv)

IV. Dosing

  1. Apply twice daily for 6 weeks

V. Mechanism

  1. Chemical sphincterotomy
    1. Reduces maximal anal resting pressure

VI. Adverse effects

  1. Severe Headache (25%)
    1. Apply with glove or finger cot to prevent absorption
    2. Start at 25-50% of typical dose and advance

VII. Drug Interactions

  1. Phosphodiesterase Inhibitors (e.g. Viagra)
    1. Contraindicated in combination

VIII. Efficacy

  1. Study of 80 patients over 8 weeks
    1. Fissures healed in 68% using glyceryl ointment
    2. Adverse effects: Headache
    3. Only 8% healed with standard delivery
  2. Lund (1997) Lancet 349-11-4 [PubMed]

IX. References

  1. (2012) Presc Lett 19(1): 3

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Related Studies

Cost: Medications

rectiv (on 2/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
RECTIV 0.4% OINTMENT $20.44 per gram
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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