Generic
Nitroglycerin (Ointment)
2 brands available in the market
At a glance
Nitroglycerin 0.4% Ointment is used for relief of pain caused by chronic anal fissures. It relaxes the internal anal sphincter to reduce fissure pain.
Description
The principal pharmacologic action of glyceryl trinitrate is mediated via the release of nitric oxide. When glyceryl trinitrate ointment is applied by the intra-anal route, the internal anal sphincter becomes relaxed. Hypertonicity of the internal but not the external anal sphincter is a predisposing factor in the formation of anal fissures.
Indications
- Relief of pain caused by chronic anal fissures
Therapeutic class
Drugs used in Ano-rectal Region
Pharmacological class
Organic Nitrate
Pharmacology
Glyceryl trinitrate releases nitric oxide which relaxes smooth muscle of the internal anal sphincter, reducing hypertonicity and relieving fissure pain.
Mechanism of action
Relieves anal fissure pain by relaxing the internal anal sphincter.
Dosage
Adult Dose (Ointment):
- Insert into anal cavity with applicator at least 1 cm into anus
- Apply every 12 hours
- Continue until pain abates, up to maximum 8 weeks
Administration
- Use applicator to insert into anal cavity
- Insert at least 1 cm deep
- Apply at bedtime and morning
Missed dose
If you miss a dose, apply it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Headache
- Dizziness
- Reduced control over bowel movements and leaking (rare)
Precautions & warnings
- Caution in severe hepatic or renal disease
- Do not use if patient suffers from severe anemia, glaucoma, hypotension, increased intracranial pressure
Contraindications
- Severe anemia
- Glaucoma
- Hypotension
- Increased intracranial pressure
- Hypersensitivity
Drug interactions
- Medicines for depression
- Medicines for erectile dysfunction
- Medicines for high blood pressure
- Diuretics
- Commonly used tranquilizers
- Medicines for heart problems (may increase blood pressure lowering effect)
Food interactions
No food interactions (topical use).
Use in pregnancy
Use in Pregnancy: No adequate data; should not be used during pregnancy.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Not recommended during breastfeeding.
Pediatric use
Not recommended for children and adolescents below 18 years (lack of data on safety and efficacy).
Geriatric use
Elderly may require dose adjustment.
Renal / hepatic impairment
Renal Impairment: Caution in severe renal disease; dose adjustment may be needed.
Hepatic Impairment: Caution in severe hepatic disease; dose adjustment may be needed.
Overdose effects
Overdose: Hypotension and reflex tachycardia; prudent therapy directed toward increasing central fluid volume; methemoglobinemia treated with methylene blue infusion.
Storage conditions
Store below 25°C; do not freeze; keep out of reach of children.
Chemical structure
Nitroglycerin 0.4% Ointment