Nitrogesic 0.20% Ointment 30gm

Introduction About NITROGESIC 0.20% OINTMENT

NITROGESIC 0.20% OINTMENT contains Nitroglycerin (Glyceryl trinitrate) which belongs to the group of medicines called Vasodilators. It is used in adults to relieve and manage symptoms of anal fissures. Anal fissure is a tear or crack in the anus and anal canal caused by passing hard or constipated bowel movements. The symptoms include sharp pain, spasms, and bleeding during and after passing stool, itching, and burning in the anal area.

NITROGESIC 0.20% OINTMENT is also used to relieve pain and discomfort due to haemorrhoids (swelling of veins in anus, rectum) and haemorrhoidectomy (operation to remove haemorrhoids).

It’s advisable to drink plenty of water and add a fibre rich diet to enhance proper digestion and to reduce chances of getting constipation.

NITROGESIC 0.20% OINTMENT is not recommended for use in patients having severe anaemia (low red blood cells count), glaucoma (increased pressure in eyes), low blood pressure, increased pressure inside your head. NITROGESIC 0.20% OINTMENT is not recommended to use in children, in pregnant and breastfeeding women.

Most common side effects of using NITROGESIC 0.20% OINTMENT includes headache, nausea and dizziness. Consult your doctor if any of these symptoms doesn’t improve or worsen.

Uses Of NITROGESIC 0.20% OINTMENT

It is used in adults to:

• relieve and manage symptoms of anal fissures
• relieve pain and discomfort due to haemorrhoids (swelling of veins in anus, rectum) and haemorrhoidectomy (operation to remove haemorrhoids).

How NITROGESIC 0.20% OINTMENT Works

NITROGESIC 0.20% OINTMENT is a vasodilator which works by relaxing the smooth muscles in the anus (back channel), which reduces pressure and muscle spasm. This helps in relieving the pain. The reduction in muscle spasm improves the blood flow which helps in wound healing.

How to use NITROGESIC 0.20% OINTMENT

Always use NITROGESIC 0.20% OINTMENT as directed by your physician. It is for rectal use only.  Wash your hands properly before applying NITROGESIC 0.20% OINTMENT. If possible, wear a finger covering or disposable gloves to apply the medicine. Apply ointment to the skin 2.5 cm (1 inch) around the anus and, if possible, a little inside. Discard gloves and wash your hands after applying the medicine. Avoid contact of this medicine in your eyes, ears, nose, mouth, or vagina. Your doctor will decide the correct dose and duration of NITROGESIC 0.20% OINTMENT for you depending upon your age, body weight and severity of disease condition.

Side Effects Of NITROGESIC 0.20% OINTMENT

How To Manage Side Effects

Nausea:

Stick to simple meals while using this medicine. Avoid eating rich or spicy food. Do not take any medication on your own. Ask for your doctor’s advice if nausea doesn’t improve.

Headache:

Drink plenty of water and stay hydrated. Take adequate rest and sleep. Try to be stress and tension free. Avoid drinking alcohol. Reduce screen time. Apply pain balm if needed. Consult doctor before taking any medicines.

Dizziness:

Sit or lie down soon after you feel dizzy. Do not drive or operate any machines. Drink enough water. Consult doctor if it is worsening.

Vomiting

Avoid eating oil rich and sweet foods. Take small meals at frequent time. Maintain a balanced diet with adequate amount of water. Consult doctor if it is not subsiding.

Warning & Precautions

Pregnancy

NITROGESIC 0.20% OINTMENT is not recommended for use in pregnant women. Consult your doctor before using.

Breastfeeding

NITROGESIC 0.20% OINTMENT is not recommended for use in breast feeding women. Consult doctor before using.

Driving and Using Machines

Do not drive or operate machines if you feel dizzy, lightheaded, tired or have blurring of vision, or headaches after using NITROGESIC 0.20% OINTMENT.

Alcohol

Avoid consumption of alcohol while using NITROGESIC 0.20% OINTMENT as it may make your blood pressure to fall, making you dizzy and faint.

Allergy

Do not use NITROGESIC 0.20% OINTMENT if you are allergic to Nitroglycerin or any other ingredients of this medicine.

Interactions

A. Drug – drug interaction:

Before using NITROGESIC 0.20% OINTMENT inform your doctor if you are taking following medicines

• medicine used to manage erectile dysfunction (Ex. sildenafil citrate, tadalafil, vardenafil)
• medicine used to manage migraine (Ex. dihydroergotamine)
• medicine used to manage heart problems (Ex. isosorbide dinitrate, amyl or butyl nitrite, enalapril)
• medicines used to manage depression (Ex. amitriptyline, amoxapine, desipramine)
• medicine used to manage liver problems (Ex. acetylcysteine)
• medicine used to manage blood clots (Ex. alteplase)

Overdosage:

If you or anyone else accidentally ingests or use too much of NITROGESIC 0.20% OINTMENT, consult your doctor or visit the nearby hospital. Symptoms of overdosage of NITROGESIC 0.20% OINTMENT include headache, fainting, dizziness.

Synopsis

More Information

• Keep NITROGESIC 0.20% OINTMENT out of reach of children.
• Store NITROGESIC 0.20% OINTMENT at room temperature below 25°C

FAQs About NITROGESIC 0.20% OINTMENT

What is NITROGESIC 0.20% OINTMENT used for?

NITROGESIC 0.20% OINTMENT is used in adults to relieve and manage symptoms of anal fissures(tear or crack in the anus), haemorrhoids (swelling of veins in anus, rectum) and haemorrhoidectomy (operation to remove haemorrhoids). Consult a doctor before using.

How to use NITROGESIC 0.20% OINTMENT?

Always use NITROGESIC 0.20% OINTMENT as directed by your physician. It is for rectal use only.  Wash your hands properly before applying NITROGESIC 0.20% OINTMENT. If possible, wear a finger covering or disposable gloves to apply for the medicine. Apply ointment to the skin 2.5 cm (1 inch) around the anus and, if possible, a little inside. Discard gloves and wash your hands after applying for the medicine. Avoid contact with this medicine in your eyes, ears, nose, mouth, or vagina. Your doctor will decide the correct dose and duration for you depending on your age, body weight and severity of the disease condition.

What happens if I use too much of NITROGESIC 0.20% OINTMENT?

You may get a headache, dizziness or faint if you use too much of NITROGESIC 0.20% OINTMENT. Consult your doctor or visit the nearby hospital if it happens.

Can NITROGESIC 0.20% OINTMENT cause a headache?

Yes. Headache is the most common side effect of using NITROGESIC 0.20% OINTMENT which may occur when you start to use the medicine. Drink plenty of water and stay hydrated. Take adequate rest and sleep. Try to be stress and tension free. Avoid drinking alcohol. Reduce screen time. Apply pain balm if needed. Consult your doctor if it doesn’t improve as they might consider lowering your dose.

Which conditions I should not use NITROGESIC 0.20% OINTMENT?

NITROGESIC 0.20% OINTMENT is not recommended to use in children, in pregnant and breastfeeding women. This medicine is not also recommended for use if you have severe anaemia (low blood cell count ), glaucoma (increased pressure in eyes), low blood pressure or increased pressure inside your head.

Does NITROGESIC 0.20% OINTMENT affects my ability to drive?

Do not drive your car or operate machines if you feel dizziness, lightheadedness, blurring of vision, headaches, or tiredness after using NITROGESIC 0.20% OINTMENT. Consult a doctor before using.

Is it safe to use NITROGESIC 0.20% OINTMENT in elderly patients?

NITROGESIC 0.20% OINTMENT should be used with caution in elderly patients as it can cause some unwanted side effects like nausea, dizziness and fainting in some people. Your doctor might reduce the dose of NITROGESIC 0.20% OINTMENT for you. Consult a doctor before using.

References

1. KD Tripathi. Anti-anginal and other Anti-ischemic Drugs. Essentials of Medical Pharmacology. Eighth edition. 2019. Page – 588-89

2. M.Jonas, J N Lund, J H Scholefield. Topical 0.2% glyceryl trinitrate ointment for anal fissures: long-term efficacy in routine clinical practice. NIH National Library of Medicine, National centre for biotechnology information. Pubmed.gov. September 2002 [Accessed on 8th October 2022] https://pubmed.ncbi.nlm.nih.gov/12780574/

3. J J Tjandra, J J Y Tan, J F Lim, C Murray-Green, M L Kennedy, D Z Lubowski. Rectogesic (glyceryl trinitrate 0.2%) ointment relieves symptoms of haemorrhoids associated with high resting anal canal pressures. NIH National Library of Medicine, National centre for biotechnology information. Pubmed.gov. June 2007 [Accessed on 8th October 2022] https://pubmed.ncbi.nlm.nih.gov/17504344/

4. Do Yeon Hwang, Seo-Gue Yoon, Hyun Shig Kim, Jong Kyun Lee, Kwang Yun Kim. Effect of 0.2 Percent Glyceryl Trinitrate Ointment on Wound Healing After a Haemorrhoidectomy. Springer Link. July 2002. [Accessed on 8th October 2022] https://link.springer.com/article/10.1007/s10350-004-6692-0

5. Pharmacy Retailing (NZ) Ltd. Glyceryl trinitrate [Revised in January 2017]. [Accessed on 8th October 2022 https://www.medsafe.govt.nz/Consumers/cmi/r/rectogesic.pdf

6. MIMS. Rectogesic (Glyceryl trinitrate). [Accessed on 8th October 2022] https://www.mims.com/singapore/drug/info/rectogesic?type=full

7. Care Pharmaceuticals. Rectogesic (Glyceryl trinitrate 0.2%). [Accessed on 8th October 2022]. https://carepharmaceuticals.com.au/wp-content/uploads/2021/08/CPC_Rectogesic_GP_Factsheet2021_FINAL-PRINT.-June-21.pdf

Useful Diagnostic Tests

• Digital rectal examination
• Ultrasound scanning
• Colonoscopy
• Anoscopy

Author Details

Written By Dr. Priyanka Goel - BDS

Reviewed For Accuracy By Dr. Thamada Manikanta Praveen - MBBS, MD (General Medicine)

Last updated on 15 Oct 2022 | 04:55 PM(IST)