Rectogesic

Rectogesic

Rectogesic is a medicine used for the treatment of tears in the anus or back passage called anal fissures. These tears are typically caused when someone attempts to pass a hard stool when they are suffering from constipation. More information

A doctor will review your order and write you a prescription, if appropriate. This prescription is then forwarded to a pharmacy. The pharmacy will have your medicine delivered to you within one to three working days. Read more about this process here.

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Patient Leaflet(s)

Rectogesic is the name of an ointment containing the active ingredient Glyceryl Trinitrate. This substance is typically used for the treatment of pain associated with ripping or tearing in the lining of the anus, otherwise known as an anal fissure. Rectogesic belongs to a class of medicine called nitrates.  

What is Rectogesic? 

Rectogesic is a medicine used for the treatment of tears in the anus or back passage called anal fissures. These tears are typically caused when someone attempts to pass a hard stool when they are suffering from constipation. Usually, the tear can be quite painful, and may also bleed which leads to further discomfort for the patient.  

The tear in some cases can be caused by a tightening in the muscles around the anus. These spasms can happen because of pain and other issues. When the spasms happen, the blood supply to the anus is restricted, which might slow the healing process and prevent the anus from healing properly. In most cases, when a doctor attempts to treat anal fissures, they will provide you with solutions that are intended to resolve or prevent constipation. This is because there are many problems that can occur as a result of attempting to pass large and hard stools. In most cases, like any cut or injury, an anal fissure will actually heal by itself within a few weeks. However, in some cases, the issue can be ongoing. This can lead to chronic conditions.  

When is Rectogesic used? 

Rectogesic is most commonly used as a treatment for acute and chronic anal fissures or tears. The active ingredient Glyceryl Trinitrate helps to reduce the pain experienced when you suffer from these tears, and also helps the injury to heal. The ointment can be applied within the anus and will release a chemical known as nitric oxide. Rectogesic belongs to the group of medicines known as nitrates. The nitric oxide created will dilate blood vessels and relax the internal muscles in the anus, which helps to improve blood flow to the anus and accelerate healing. A different kind of ointment that contains the same active ingredient may also be used to treat angina pain. However, this medicine is not the same as Rectogesic.  

How do you use Rectogesic? 

Rectogesic is an ointment that needs to be applied to the skin inside of the anus using your finger. Some people will prefer to use a glove of finger covering such as a finger cot available from most pharmacies to apply their ointment. Your doctor will provide you with full instructions on how to use Rectogesic, and it is important to follow their directions carefully. If you're unsure about anything, check the patient leaflet supplied with your medication or speak to a pharmacist. 

Squeeze a small amount of the ointment onto the tip of your finger and apply the ointment directly to the inside of your anus, up to the first finger joint. You will need to turn your finger slightly to spread the ointment across the inside of the anus. Make sure that you wash your hands thoroughly before and after applying the ointment each day. In most conditions it will be necessary to apply Rectogesic twice a day to the affected to tear. Make sure that if you miss a dose, you simply apply the ointment as usual when it is due next. You do not need to apply a double dose to make up for any missing doses. Make sure that you continue using this medication for as long as your doctor tells you to. This will usually be until the pain has been eliminated and the anus has begun to heal.  

What dosages are available? 

Rectogesic usually comes in a 30g tube, although your doctor will decide how much you need to cover the length of your treatment. Unless your doctor directs otherwise, the typical dose for an adult is 2.5 cm of ointment inserted twice per day into the anus; often every twelve hours.  

It is not appropriate to provide this medication to children under the age of 18. You will need to read the label in the package carefully before use.  

What are the side effects of Rectogesic? 

All medications are subject to side effects, as the body can respond in many different ways when exposed to a new substance. It's important that you're aware of the various side effects that can occur when taking this medication. Keep in mind that there may be other side effects associated with Rectogesic that are not listed here. If you notice anything unusual about your health or wellness when using Rectogesic, contact a doctor.  

Some of the most common side effects of Rectogesic include headaches which can be treated with painkillers like paracetamol. If your headaches persist constantly, then you will need to speak to your doctor about stopping the medication. Other common side effects may include feelings of tiredness or exhaustion, blurred vision, feeling sick, and dizziness.  

Some less common side effects may also occur, including vomiting, itching, diarrhea, discomfort and itching around the anus, rectal bleeding, and a drop-in blood pressure which may cause dizziness when standing up. You may also be more likely to faint when taking this medicine and may experience an increased heart rate or chest pain. If these conditions occur, make sure that you speak to your doctor straight away, or seek emergency help if you think this is necessary.  

An allergic reaction may occur, which causes symptoms like rash, swelling, and trouble breathing in some cases. If you have an allergic reaction, seek emergency help immediately. 

When shouldn't you use Rectogesic? 

Rectogesic will not be appropriate for all patients. If you are under the age of 18 you will not be able to take this medication. Additionally, doctors will use caution when prescribing this substance to older adults who are more likely to suffer from side effects.

People who generally shouldn't use Rectogesic include:  

  • Anyone allergic to nitrates 
  • Anyone using other medications that include nitrates 
  • People with low blood pressure issues 
  • People who suffer from sudden changes in blood pressure 
  • People with a low volume of circulating blood 
  • People with higher pressure than usual inside of the skull 
  • Anyone with limited blood flow to the brain 
  • Anyone who suffers regularly from recurring headaches or migraines 
  • People with narrowing in the main artery leaving the heart 
  • People who suffer from heart disease  
  • People with narrowing in the heart values  
  • Anyone with inflammation in the sac surrounding the heart which damages vascular function 
  • People with severe anaemia 
  • Those diagnosed with closed angle glaucoma 

Make sure that you do not take this medication if you are allergic to any of the ingredients in it. Additionally, it's worth noting that the safety of this medication is not fully established when it comes to pregnant women. The manufacturer suggests that it should not be used during pregnancy and that it may not be appropriate for use by women who are breastfeeding. If you are pregnant, nursing or trying to get pregnant, speak to your doctor before taking Rectogesic.  

Does Rectogesic interact with any other medications? 

It is always important to tell your doctor about any additional medications that you may be taking before you start using a new substance, such as Rectogesic. This includes any medications that you have obtained with a prescription, as well as over the counter drugs, and substances that are herbal or supplemental in nature. You should not start taking any new medications when using Rectogesic without the approval of your doctor.  

When you are using Rectogesic, do not use any other medications that contain nitrates, such as amyl nitrate, butyl nitrate, glyceryl nitrate, or any medications for angina or heart failure, this can lead to a huge drop in blood pressure. A loss of blood pressure can make heart attacks more likely and cause dizziness or fainting.  

Do not take Rectogesic with isosorbide mononitrate or dinitrate, avanafil, sildenafil, tadalafil, or vardenafil. Rectogesic can cause a drop-in blood pressure, and this might be enhanced by people who are taking other medications that affect blood pressure, such as benzodiazepines and certain medicines used for psychotic conditions. It can also be heightened by things like medicines to treat high blood pressure, certain antidepressants, and diuretic medications.  

Your doctor will be able to determine whether it is safe for you to take Rectogesic with any drugs that you are already taking as part of your medical assessment when you approach them about your condition. It is important that you tell your doctor about everything you are taking to avoid interactions - even if this includes illegal substances. Generally, it is not a good idea to use Rectogesic with alcohol, as this can increase the blood pressure lowering effects of the medication.  

Where can you buy Rectogesic? 

Rectogesic is available to purchase from online and offline pharmacies, although it may sometimes be sold under different brand names, or as a generic substance. Your doctor will advise you on what you should buy and provide you with a prescription to use for your purchase.  

Can you get Rectogesic without a prescription?  

Rectogesic is not currently available to buy in the UK without a prescription, as your doctor will need to make certain that they are giving you the right medication for your condition. Make sure you get a prescription before trying to get Rectogesic.  

 

 

References 

BNF NICE org, online, March 2013, Chronic anal fissure: 0.2% topical glyceryl trinitrate ointment, [Accessed on 6th of July 2019] Available at: https://www.nice.org.uk/advice/esuom7/chapter/Overview-for-healthcare-professionals 

Kyowa Kirin Ltd, online, Rectogesic 4 mg/g rectal ointment, [Accessed on 6th of July 2019] Available at: https://www.medicines.org.uk/emc/product/3933/smpc 

Michael Stewart, Sid Dajani, 11th of October 2018, The Information Standard, Patient info online, Glyceryl trinitrate rectal ointment, [Accessed on 6th of July 2019] Available at: https://patient.info/medicine/glyceryl-trinitrate-rectal-ointment-rectogesic