Rectogesic

What is Rectogesic?

Rectogesic is a prescription rectal ointment used to treat chronic anal fissures.

An anal fissure is a small tear in the lining of the anus. It can cause:

• Sharp pain during or after bowel movements
• Burning sensation
• Bleeding when passing stool
• Spasm of the anal muscle

Fissures often occur due to constipation, hard stools, or straining. When the muscle around the anus (the internal anal sphincter) becomes tight, it reduces blood flow to the area. Poor blood flow slows down healing.

Rectogesic contains glyceryl trinitrate (GTN), which helps relax the anal muscle and increase blood flow. This reduces pain and supports natural healing.

Rectogesic is specifically used for chronic fissures, meaning fissures that have not healed after several weeks.

What is it used for?

Rectogesic is used to treat:

• Chronic anal fissures
• Pain associated with anal fissures
• Anal muscle spasm that delays healing

It is not a general haemorrhoid cream and should not be used for other anal conditions unless prescribed.

By reducing muscle tension and improving circulation, Rectogesic helps:

• Decrease pain during bowel movements
• Reduce anal muscle spasm
• Improve blood supply to the fissure
• Promote healing

It is typically prescribed when simple measures such as dietary fibre, stool softeners and sitz baths have not been enough.

How does the product work?

Rectogesic contains glyceryl trinitrate (GTN), a medicine that relaxes smooth muscle tissue.

In an anal fissure:

• The internal anal sphincter muscle becomes overly tight
• Blood flow to the fissure decreases
• Healing is delayed
• Pain increases due to muscle spasm

Glyceryl trinitrate works by:

• Relaxing the internal anal sphincter
• Reducing pressure inside the anal canal
• Increasing blood flow to the fissure
• Helping the tear heal naturally

This mechanism directly targets the cause of chronic fissure pain rather than just masking symptoms.

Who should not use the product?

You should not use Rectogesic if:

• You are allergic to glyceryl trinitrate
• You are using medicines for erectile dysfunction (such as sildenafil, tadalafil or vardenafil)
• You have severe anaemia
• You have increased pressure inside the skull
• You have very low blood pressure
• You have certain heart conditions

Rectogesic can interact with medicines that also lower blood pressure.

Always inform your doctor about all medications you are taking before starting treatment.

Pregnancy and breastfeeding

If you are pregnant or planning to become pregnant, consult a doctor before using Rectogesic.

There is limited data on the use of glyceryl trinitrate in pregnancy for anal fissures.

If you are breastfeeding, discuss the risks and benefits with your doctor before using Rectogesic.

How to use and dosage

Always use Rectogesic exactly as prescribed.

The usual adult dose is:

• Apply approximately 1 inch (2.5 cm) of ointment inside the anal canal
• Use every 12 hours (twice daily)

Wash your hands before and after application.

You may use a finger covered with a finger cot or disposable glove to apply the ointment just inside the anus.

Treatment usually continues for up to 8 weeks, depending on healing progress.

Do not exceed the recommended dose, as higher amounts increase the risk of side effects such as headache.

Possible side effects

Like all medicines, Rectogesic may cause side effects, although not everyone experiences them.

The most common side effect is:

• Headache

Headaches can occur because glyceryl trinitrate widens blood vessels. These headaches are often strongest when starting treatment and may improve over time.

Other possible side effects include:

• Dizziness
• Lightheadedness
• Low blood pressure
• Flushing
• Mild irritation at the application site

Because Rectogesic can lower blood pressure, you may feel dizzy when standing up quickly.

If severe headaches or fainting occur, seek medical advice.

Important safety information

Before using Rectogesic, tell your doctor if you:

• Have low blood pressure
• Have heart disease
• Have migraine
• Are taking medicines that affect blood pressure
• Are using erectile dysfunction medicines

Do not use Rectogesic together with:

• Sildenafil (Viagra)
• Tadalafil (Cialis)
• Vardenafil
• Other nitrate medicines

Combining these can cause a dangerous drop in blood pressure.

To support healing:

• Maintain a high-fibre diet
• Stay well hydrated
• Avoid straining during bowel movements
• Consider stool softeners if recommended

Rectogesic works best as part of a comprehensive fissure management plan.

When to seek medical help

Seek urgent medical attention if you experience:

• Severe dizziness or fainting
• Chest pain
• Severe allergic reaction
• Persistent severe headache

Contact your doctor if:

• Pain does not improve after several weeks
• Bleeding worsens
• Symptoms become more severe
• You develop new rectal symptoms

If you are unsure whether your symptoms are caused by an anal fissure or another condition, you can book a secure video consultation with a licensed doctor via Transtoyou for personalised advice. If symptoms are severe or sudden, seek urgent medical care immediately.