Adult Dosing

Moderate to severe pain associated with chronic anal fissure

• Apply 1 inch of ointment intra-anally q12 hours x up to 3 wks

Pediatric Dosing

• Safety and effectiveness in pediatric patients < 18 years of age have not been established

• Moderate to severe pain associated with chronic anal fissure

• Hypersensitivity to any of the ingredients of the product
• Hypersensitivity to other nitatres and nitrites
• Concomitant use of PDE5 inhibitors such as sildenafil, vardenafil and tadalafil
• Increased intracranial pressure
• Severe anemia

• N/A

Renal Dose Adjustment

• Renal Impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• Use cautiously in patients with existing cardiovascular disorders; venous and arterial dilatation may occur and decrease venous blood return to the heart and reduce arterial vascular resistance and systolic pressure
• Use cautiously in patients with blood volume depletion, existing hypotension, cardiomyopathies, congestive heart failure, acute myocardial infarction, or poor cardiac function for other reasons. If patients with any of these conditions are treated, monitor cardiovascular status and clinical condition
• Nitroglycerin produces dose-related headaches which may be severe

Rectiv interacts with :

	Adcirca
	Adempas
	Avanafil
	Cialis
	Levitra
	Revatio
	Riociguat
	Sildenafil
	Staxyn
	Stendra
	Tadalafil
	Vardenafil
	Viagra

Pregnancy Category:C

Breastfeeding: Safety unknown, it is not known whether nitroglycerin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when administered to a nursing woman.

• CNS: Headache,light-headedness
• DERM: Rash, exfoliative dermatitis
• CV: Hypotension, orthostatic hypotension
• HYPERSENSITIVITY: Flushing, allergic reactions, application site reactions

• Organic nitrate, vasodilator; forms free radical nitric oxide (NO), which activates guanylate cyclase, resulting in an increase of guanosine 3’,5’-monophosphate (cyclic GMP) in smooth muscle and other tissues and thus leads to dephosphorylation of myosin light chains, which regulates the contractile state in smooth muscle and results in vasodilatation
• Bioavailability: 50%
• Metabolism by liver, extrahepatic sites include red blood cells and vascular walls; CYP450: Unknown
• Excretion: Renally excreted
• Half life: 1.5-7.5 minutes

US Trade Name(s)

• Rectiv

US Availability

Rectiv

• OINT: 0.4 %

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

Gastrointestinal

Other GI Agents