nitroglycerin 0.4 % (w/w) rectal ointment

Generic name:
Nitroglycerin ointment - rectal

Pronunciation
(NYE-troe-GLIS-er-in)

Brand name(s)
Rectiv

Nitroglycerin ointment is used to treat moderate to severe pain caused by long-term tears in the lining of the anus (anal fissures). This medication works by relaxing the muscles around the blood vessels which reduces pressure inside the anus and relieves pain. Nitroglycerin belongs to a class of drugs known as nitrates.

Read the Patient Information Leaflet if available from your pharmacist before you start using nitroglycerin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Cover your finger with plastic wrap, a disposable medical glove, or a finger cot. Using the measuring guide that comes with your product, squeeze out the prescribed amount of ointment onto your finger. Gently insert your finger inside the anus, up to the first finger joint. Spread the ointment around the inside of the anus. If you cannot do this because it is too painful, you may apply the ointment to the outside of the anus.

Throw away the finger covering and wash your hands after each dose. Apply this medication as directed by your doctor, usually every 12 hours for up to 3 weeks. Do not apply this medication in the eyes, mouth, or vagina.

Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day.

Tell your doctor if your pain does not get better.

Headache may occur, but usually lasts a short time after each dose. With continued use of this medication, some people may not be bothered as much by the headaches. Your doctor may recommend treating headaches with a nonprescription pain reliever (such as acetaminophen).

Nitroglycerin can also cause a drop in your blood pressure, which can lead to dizziness and lightheadedness. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before using this medication, tell your doctor or pharmacist if you are allergic to nitroglycerin; or to nitrates, nitrites, or isosorbide; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• anemia
• low blood pressure
• dehydration
• increased pressure inside your head (such as due to head/brain injury)
• heart/blood vessel problems (such as heart failure, recent heart attack)

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages because they can also cause a drop in your blood pressure. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this medication, especially dizziness and lightheadedness.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before breastfeeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include:

• drugs to treat erectile dysfunction-ED or pulmonary hypertension (such as sildenafil, tadalafil)
• riociguat
• vericiguat

This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: pale/gray/blue colored skin/lips/nails, severe headache, fainting, shortness of breath, fast heartbeat, confusion, unusual tiredness.

Do not share this medication with others.

If you miss a dose, apply it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature. Once the tube is opened, this medication expires after 8 weeks. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.