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RECTOGESIC 4 mg/g RECTAL OINTMENT

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About the medicine

How to use RECTOGESIC 4 mg/g RECTAL OINTMENT

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

PACKAGE LEAFLET: INFORMATION FOR THE USER

Rectogesic 4 mg/g Rectal Ointment

Glyceryl trinitrate

Read all of this leaflet carefully before you start using this medicine because it contains important information for you.

  • Keep this leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor or pharmacist.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
  • If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the pack:

  1. What Rectogesic is and what it is used for
  2. What you need to know before you use Rectogesic
  3. How to use Rectogesic
  4. Possible side effects
  5. Storage of Rectogesic
  6. Contents of the pack and other information

1. What Rectogesic is and what it is used for

Rectogesic is a rectal ointment that contains glyceryl trinitrate as the active ingredient. Glyceryl trinitrate belongs to a group of medicines called organic nitrates.

The ointment will help to relieve the painful symptoms caused by chronic anal fissures. An anal fissure is a tear in the skin that lines the anal canal. Topical application of glyceryl trinitrate to the anal canal reduces anal pressure and increases blood flow, which reduces the sensation of pain.

Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

2. What you need to know before you use Rectogesic

Do not use Rectogesic:

  • if you are allergic to glyceryl trinitrate or other similar medicines
  • if you are allergic to any of the other ingredients of this medicine (listed in section 6)
  • if you have low blood pressure
  • if you have heart or blood vessel disorders
  • if you have closed-angle glaucoma, a condition where the pressure inside the eyes increases rapidly and causes loss of vision
  • if you have migraine or recurrent headaches
  • if you have increased intracranial pressure or high cranial pressure (e.g. head trauma or cerebral hemorrhage; a hemorrhage caused by the rupture of a blood vessel in the brain that can be fatal without immediate medical treatment. It is usually considered as a type of stroke) or inadequate cerebral circulation (low blood flow in the brain)
  • if you have anemia (low iron content in the blood)
  • if you are taking any of the following medicines: medicines for erectile dysfunction such as sildenafil citrate, tadalafil, vardenafil; medicines for angina or heart pain, such as glyceryl trinitrate (NTG), isosorbide dinitrate, amyl nitrite or butyl nitrite; medicines for high blood pressure or depression (tricyclic antidepressants), acetylcysteine or alteplase

Be careful with Rectogesic:

  • if you have any liver or kidney disease
  • if you are going to be administered heparin, your blood parameters should be closely monitored as it may be necessary to modify the heparin dose. Talk to your doctor before stopping treatment with Rectogesic
  • if you also have hemorrhoids (piles) and you notice more bleeding than usual, you should stop treatment with Rectogesic. Talk to your doctor about this
  • if you experience severe headaches when using Rectogesic, inform your doctor. The doctor will decide if you need a different amount of Rectogesic, or if it is necessary to stop treatment altogether

Rectogesic can lower blood pressure. When getting up from a lying or sitting position, you should do so slowly to avoid dizziness. It is more likely that blood pressure will drop if you drink alcohol during treatment with Rectogesic.

Children and adolescents

Rectogesic is not suitable for children and adolescents under 18 years of age as it has not been evaluated in patients in this age group.

Taking Rectogesic with other medicines

Tell your doctor or pharmacist if you are using or have recently used any other medicines, including those obtained without a prescription.

The following medicines may increase the effect of lowering blood pressure of Rectogesic.

  • Medicines for depression (tricyclic antidepressants)
  • Medicines for the treatment of erectile dysfunction (male impotence) (sildenafil citrate, tadalafil, vardenafil)
  • Medicines for high blood pressure
  • Diuretics
  • Common sedatives
  • Medicines used for the treatment of heart problems (isosorbide dinitrate and amyl nitrite or butyl nitrite)

Other medicines

  • Acetylcysteine may increase the effects of Rectogesic on blood flow
  • May decrease the effects of heparin (used to control blood clots) when used with Rectogesic
  • May decrease the effects of alteplase (used for the treatment of heart problems) when used simultaneously with Rectogesic
  • The use of Rectogesic with dihydroergotamine (used to treat migraine) may increase the effects of dihydroergotamine and cause coronary vasoconstriction (a narrowing of the blood vessels of the heart that causes slower blood circulation)
  • Aspirin and non-steroidal anti-inflammatory drugs (certain types of painkillers) may alter the therapeutic effect of Rectogesic

Using Rectogesic with alcohol

Be careful with alcohol consumption as the ointment may have a greater effect than usual.

Pregnancy and breastfeeding

Do not use Rectogesic during pregnancy or breastfeeding.

Consult your doctor or pharmacist before using a medicine during pregnancy or breastfeeding.

Driving and using machines

No studies have been conducted on the ability to drive and use machines with Rectogesic 4 mg/g Rectal Ointment. If you start to feel dizzy or sleepy or have blurred vision when you start using the ointment, do not drive or operate machinery until these effects have disappeared.

Rectogesic contains lanolin and propylene glycol

This medicine contains lanolin (wool fat), which may cause local skin reactions (such as contact dermatitis). This medicine also contains propylene glycol, which may cause skin irritation.

3. How to use Rectogesic

Method of administration

Rectogesic 4 mg/g Rectal Ointment is for rectal use.

Follow exactly the administration instructions of this medicine indicated by your doctor. In case of doubt, consult your doctor or pharmacist again. The recommended dose is approximately 375 mg of ointment (approximately 1.5 mg of glyceryl trinitrate) applied to the anal canal every 12 hours.

The finger can be covered with a plastic film or a finger stall before applying the ointment. Finger stalls can be obtained at your local pharmacy or a surgical supply provider, and plastic film at a local store. The covered finger is placed next to the 2.5 cm dosing line, which appears on the outer packaging, and a amount of ointment equivalent to the length of the line is extracted over the end of the finger with gentle pressure on the tube. Insert the ointment gently into the anal canal with your finger. The finger with ointment should be inserted up to the first knuckle (approximately 1 cm) inside the anus.

Apply the ointment every twelve hours as instructed by your doctor and do not exceed the indicated dose. Wash your hands after each use and dispose of the finger stall or plastic film (not down the toilet drain).

Treatment may continue until the pain disappears, or for a maximum of 8 weeks. If the pain is not relieved after using Rectogesic, you should consult your doctor again to rule out another cause of the pain.

If you use more Rectogesic than you should

If you use a larger amount of ointment than indicated, you may feel dizzy or lightheaded. You may also feel a rapid heartbeat or palpitations. If you experience these symptoms, clean the excess and talk to your doctor or pharmacist immediately.

If you forget to use Rectogesic

Do not apply a double dose to make up for forgotten doses. Apply the next dose at the usual time.

If you have any other questions about the use of this medicine, ask your doctor or pharmacist.

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Serious side effects:

  • Anaphylactoid reaction (potentially life-threatening allergic reaction with swelling of the face, lips, tongue or throat, difficulty breathing, shortness of breath or fainting). If you experience any of these symptoms, stop using the ointment and consult a doctor immediately.
  • Severe skin allergic reactions (potentially serious). If you experience any skin allergic reaction, stop using the ointment and consult a doctor immediately.

Other side effects:

Very common (may affect more than 1 in 10 people)

  • Headaches, which can be severe. If you start to suffer from a headache as a side effect, clean any remaining ointment. If the headaches become bothersome, consult your doctor if you should stop using the medicine.

Common (may affect up to 1 in 10 people)

  • Dizziness
  • Nausea

Uncommon (may affect up to 1 in 100 people)

  • Diarrhea
  • Vomiting
  • Rectal bleeding, rectal disorder
  • Anal discomfort, itching or burning in the anal canal
  • Rapid heartbeat or palpitations

Rare (may affect up to 1 in 1000 people)

  • Dizziness when standing up

Side effects of unknown frequency (frequency cannot be estimated from the available data)

  • Dizziness, fainting
  • Low blood pressure
  • Irritation, rash or pain at the application site

Other side effects known to be associated with glyceryl trinitrate products (frequency unknown)

  • Flushing
  • Unstable angina (chest pain)
  • High blood pressure when stopping treatment
  • Methemoglobinemia (symptoms are bluish discoloration of the skin and shortness of breath)

Reporting of side effects

If you experience any side effects, talk to your doctor or pharmacist, even if it is possible side effects not listed in this leaflet. You can also report them directly through the Spanish Medicines and Health Products Agency's website: https://www.notificaRAM.es.

By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Rectogesic

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the tube and carton after EXP. The expiry date is the last day of the month stated.

  • Do not store above 25°C.
  • Do not freeze.
  • Keep the tube tightly closed.

Once opened, use the ointment within the next 8 weeks.

6. Contents of the pack and other information

Composition of Rectogesic

The active ingredient is glyceryl trinitrate. One gram of rectal ointment contains 4 mg of glyceryl trinitrate. The normal dose of 375 mg of Rectogesic contains approximately 1.5 mg of glyceryl trinitrate.

The other ingredients (excipients) are: propylene glycol, lanolin, sorbitan sesquioleate, hard paraffin and white soft paraffin.

Appearance of Rectogesic and pack size

Rectogesic is a white, smooth and opaque rectal ointment that is supplied in 30 g aluminum tubes.

Marketing authorization holder and manufacturer

Marketing authorization holder

Grünenthal Pharma, S.A.

Doctor Zamenhof, 36

28027 Madrid

Spain

Manufacturer

PHARBIL Waltrop GmbH

Im Wirrigen 25

45731 Waltrop

Germany

Date of last revision of this leaflet:May 2015

Detailed and up-to-date information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/

Online doctors for RECTOGESIC 4 mg/g RECTAL OINTMENT

Discuss questions about RECTOGESIC 4 mg/g RECTAL OINTMENT, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

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Doctor

Hocine Lokchiri

General medicine 21 years exp.

Dr. Hocine Lokchiri is a French consultant with over 20 years of experience in General and Emergency Medicine. He works with adults and children, helping patients with urgent symptoms, infections, sudden health changes and everyday medical concerns that require timely evaluation. His background includes clinical practice in France, Switzerland and the United Arab Emirates, which allows him to navigate different healthcare systems and manage a wide range of conditions with confidence. Patients value his calm, structured approach, clear explanations and evidence-based decision-making.

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Many patients reach out when symptoms appear suddenly and cause concern, when a child becomes unwell unexpectedly, when a rash changes or spreads, or when it’s unclear whether an in-person examination is necessary. His emergency medicine background is particularly valuable online, helping patients understand risk levels, identify warning signs and choose safe next steps.

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Даниэль Чики

Family medicine 24 years exp.

Dr Daniel Cichi is a family medicine doctor with over 20 years of clinical experience. He provides online consultations for adults, supporting patients with acute symptoms, chronic conditions, and everyday health concerns that require timely medical guidance.

His background includes work in emergency care, ambulance services, and family medicine, which allows him to assess symptoms quickly, identify warning signs, and help patients choose the safest next steps – whether that means home care, treatment adjustment, or in-person evaluation.

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Dr Cichi’s consultations are structured and practical. He focuses on clear explanations, risk assessment, and actionable recommendations, helping patients understand their symptoms and make informed decisions about their health.
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Yevgen Yakovenko

General surgery 12 years exp.

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

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Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
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Lina Travkina

Family medicine 13 years exp.

Dr. Lina Travkina is a licensed family and preventive medicine doctor based in Italy. She provides online consultations for adults and children, supporting patients across all stages of care – from acute symptom management to long-term health monitoring and prevention.

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Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

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Doctor

Alina Tsurkan

Family medicine 13 years exp.

Dr. Alina Tsurkan is a licensed family medicine physician based in Portugal, offering online consultations for adults and children. She provides professional primary care, with a focus on prevention, accurate diagnosis, and long-term management of acute and chronic conditions.

Dr. Tsurkan supports patients with a wide range of health issues, including:

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Anna Biriukova

General medicine 6 years exp.

Dr Anna Biriukova is an internal medicine doctor with clinical experience in cardiology, endocrinology, and gastroenterology. She provides online consultations for adults, offering expert medical support for heart health, hormonal balance, digestive issues, and general internal medicine.

Cardiology – Diagnosis and treatment of:

  • High blood pressure, blood pressure fluctuations, and cardiovascular risk prevention.
  • Chest pain, shortness of breath, arrhythmias (tachycardia, bradycardia, palpitations).
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  • EKG interpretation, lipid profile evaluation, cardiovascular risk assessment (heart attack, stroke).
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Endocrinology – Diabetes, thyroid, metabolism:
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  • Individual treatment plans including oral medications and insulin therapy.
  • GLP-1 therapy– modern pharmacological treatment for weight management and diabetes control, including drug selection, monitoring, and safety follow-up.
  • Thyroid disorders – hypothyroidism, hyperthyroidism, autoimmune thyroid diseases (Hashimoto’s, Graves’ disease).
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Gastroenterology – Digestive health:
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Dr Biriukova combines internal medicine with specialist insight, offering clear explanations, personalised treatment plans, and comprehensive care tailored to each patient.
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Frequently Asked Questions

Is a prescription required for RECTOGESIC 4 mg/g RECTAL OINTMENT?
RECTOGESIC 4 mg/g RECTAL OINTMENT requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in RECTOGESIC 4 mg/g RECTAL OINTMENT?
The active ingredient in RECTOGESIC 4 mg/g RECTAL OINTMENT is glyceryl trinitrate. This information helps identify medicines with the same composition but different brand names.
How much does RECTOGESIC 4 mg/g RECTAL OINTMENT cost in pharmacies?
The average pharmacy price for RECTOGESIC 4 mg/g RECTAL OINTMENT is around 64.46 EUR. Prices may vary depending on the manufacturer and dosage form.
Who manufactures RECTOGESIC 4 mg/g RECTAL OINTMENT?
RECTOGESIC 4 mg/g RECTAL OINTMENT is manufactured by Grünenthal Pharma S.A.. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of RECTOGESIC 4 mg/g RECTAL OINTMENT online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether RECTOGESIC 4 mg/g RECTAL OINTMENT is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to RECTOGESIC 4 mg/g RECTAL OINTMENT?
Other medicines with the same active substance (glyceryl trinitrate) include ABRASONE RECTAL, RECTAL CREAM, ANSO RECTAL OINTMENT, ANTIHEMORROIDAL CINFA RECTAL OINTMENT. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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