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RECTOGESIC 4 mg/g RECTAL OINTMENT

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5.0 (100)
Doctor

Tarek Agami

General medicine 11 years exp.

Dr. Tarek Agami is a general practitioner registered in both Portugal and Israel, with broad experience in family and preventive medicine. He offers online consultations for adults and children, providing personalised support for primary care needs, chronic disease management, and everyday health concerns.

Dr. Agami received clinical training and worked in leading medical institutions in Israel (Kaplan Medical Center, Barzilai Medical Center, Wolfson Medical Center) and Portugal (European Healthcare City, Viscura Internacional, Hospital Dr. José Maria Grande, Hospital Vila Franca de Xira). His approach combines international medical standards with individualised attention to each patient.

Main areas of consultation:

  • Diagnosis and treatment of acute and chronic conditions (high blood pressure, diabetes, respiratory infections, cardiovascular symptoms)
  • Evaluation of symptoms and guidance on further diagnostic testing
  • Preventive check-ups and regular health monitoring
  • Medical support during travel or after relocation
  • Treatment adjustments and lifestyle recommendations based on your personal history
Dr. Agami provides medical support for patients using GLP-1 medications (such as Ozempic or Mounjaro) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Portugal and Israel.

Dr. Agami is committed to evidence-based, patient-centred care, ensuring that each person receives trusted medical support tailored to their health goals.

This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use RECTOGESIC 4 mg/g RECTAL OINTMENT

Translated with AI

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.

Show original

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.

5.0 (100)
Doctor

Tarek Agami

General medicine 11 years exp.

Dr. Tarek Agami is a general practitioner registered in both Portugal and Israel, with broad experience in family and preventive medicine. He offers online consultations for adults and children, providing personalised support for primary care needs, chronic disease management, and everyday health concerns.

Dr. Agami received clinical training and worked in leading medical institutions in Israel (Kaplan Medical Center, Barzilai Medical Center, Wolfson Medical Center) and Portugal (European Healthcare City, Viscura Internacional, Hospital Dr. José Maria Grande, Hospital Vila Franca de Xira). His approach combines international medical standards with individualised attention to each patient.

Main areas of consultation:

  • Diagnosis and treatment of acute and chronic conditions (high blood pressure, diabetes, respiratory infections, cardiovascular symptoms)
  • Evaluation of symptoms and guidance on further diagnostic testing
  • Preventive check-ups and regular health monitoring
  • Medical support during travel or after relocation
  • Treatment adjustments and lifestyle recommendations based on your personal history
Dr. Agami provides medical support for patients using GLP-1 medications (such as Ozempic or Mounjaro) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Portugal and Israel.

Dr. Agami is committed to evidence-based, patient-centred care, ensuring that each person receives trusted medical support tailored to their health goals.

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Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Nuno Tavares Lopes provides medical support for patients using GLP-1 medications (Mounjaro, Wegovy, Ozempic, Rybelsus) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Europe.

Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.

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Rita Isabel Calero Garcia

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Dr. Rita Isabel Calero Garcia is a physician with extensive experience in emergency medical care, general medicine, and healthcare assistance in various clinical and out-of-hospital settings.

She currently works as a physician at the Canary Islands Emergency Service (Servicio de Urgencias Canario – SUC), where she is responsible for the assessment and care of patients in medical emergency situations, performing the initial diagnosis, patient stabilization, and coordination with hospital services when necessary.

She has also developed her professional activity within the Primary Care Management Service, providing consultations in general medicine. In this setting she is responsible for patient follow-up, management of acute and chronic conditions, as well as health promotion and disease prevention.

She has also worked as a physician in a mobile ICU unit, providing medical assistance in out-of-hospital emergencies, treating critical patients and participating in medicalized patient transport.

In addition, she has collaborated with the Red Cross, participating in healthcare support units, providing medical assistance at events and supporting emergency interventions.

Furthermore, she has provided medical services in the private sector with Salvaser, conducting clinical assessments of patients and providing healthcare services within private medical services.

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Jorge Correa Bellido

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Dr. Jorge Correa Bellido is a Spanish physician who offers online consultations in Spanish and English. He graduated from the University of La Laguna and has a solid background in clinical practice and international research.

Throughout his career, he has participated in various medical and academic projects, including a research fellowship in Spain, where he contributed to evidence-based studies in the field of family medicine. This experience allowed him to broaden his global perspective on healthcare and comprehensive patient care.

Dr. Correa Bellido has worked with several healthcare providers in Spain, focusing particularly on patient-centered care and public health initiatives aimed at communities with limited access to healthcare services.

In addition, he actively participates in international medical conferences and workshops, which allows him to stay up to date with the latest medical advances and collaborate with healthcare professionals from different countries.

Dr. Correa Bellido provides comprehensive care for a wide variety of medical conditions, including:

  • respiratory infections
  • gastrointestinal disorders
  • cardiovascular problems
  • endocrine and metabolic diseases
  • musculoskeletal and dermatological conditions
  • as well as mental health conditions such as anxiety and depression.

He also treats infectious and allergic diseases, general health concerns, and provides guidance on prevention and healthy lifestyle habits.

His services include virtual consultations, diagnosis and management of acute and chronic diseases, prescription renewals, and personalized medical advice.

With a patient-centered approach and a strong commitment to continuous learning, Dr. Correa Bellido provides accessible and high-quality healthcare to patients both in Spain and around the world.

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His approach is clear: to listen, organize your case, and provide you with a practical roadmap based on evidence-based medicine and adapted to your medical history and personal needs.

Pain: how he can help

  • Chronic pain (more than 3 months
  • Migraine and recurrent or high-intensity headaches
  •  Neck, lower back, back and joint pain
  •  Post-traumatic pain after injuries or surgeries
  •  Pain of neurological origin: neuralgia, neuropathic pain, fibromyalgia

General medicine

  • Frequent respiratory infections (cold, flu, persistent cough)
  • Hypertension, diabetes and metabolic disorders
  • Review of laboratory tests and MRI/CT reports (explained in clear language)
  • Preventive medicine and health monitoring
  • Second opinions and treatment adjustments (when clinically appropriate)

What the consultation is like
 Each session lasts up to 30 minutes. We review symptoms, medical history, medications and any tests you provide, and you finish the consultation with a clear treatment plan, defined next steps, and criteria to understand when follow-up may be needed. If warning signs are detected, he will clearly advise whether you need in-person care or urgent medical attention.

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  • acute respiratory symptoms (cough, sore throat, runny nose, fever)
  • viral illnesses such as colds and seasonal infections
  • gastrointestinal complaints (nausea, diarrhoea, abdominal pain, gastroenteritis)
  • sudden changes in how a child or adult feels
  • questions about existing treatment and whether adjustments are needed
  • renewal of prescriptions when clinically appropriate

Dr. Shalko works specifically with urgent and short-term problems, providing practical recommendations and helping patients determine the safest next step. She explains symptoms clearly, guides patients through decision-making and offers straightforward medical advice for everyday acute issues.She does not provide long-term management of chronic conditions, ongoing follow-up or comprehensive care plans for complex long-term illnesses. Her consultations are designed for acute symptoms, sudden concerns and situations where timely medical input is important.With clinical experience in both paediatrics and general medicine, Dr. Shalko confidently supports adults and children. Her communication style is clear, simple and reassuring, helping patients feel informed and supported throughout the consultation.

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Lizaveta Trafimchuk Takhvaniuk

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Dr. Lizaveta Trafimchuk Takhvaniuk graduated in Medicine and subsequently specialized in Dermatology and Venereology. She has more than 10 years of clinical experience and is licensed to practice in Spain, where she focuses on the comprehensive diagnosis and treatment of dermatological conditions.

Throughout her education and professional career, Dr. Trafimchuk has gained extensive experience in managing diseases of the skin, hair, and nails, as well as in the diagnosis, treatment, and prevention of sexually transmitted infections (STIs). Her clinical approach is based on evidence-based medicine, combined with personalized care tailored to each patient’s needs.

In her daily practice, she treats a wide range of dermatological conditions, including chronic inflammatory dermatoses such as acne, rosacea, atopic dermatitis, psoriasis, and eczema. She also has experience in treating pigmentation disorders, including melasma, post-inflammatory hyperpigmentation, and dyschromia.

She has developed a particular interest in trichology, treating various types of alopecia, chronic hair loss, and scalp disorders. In addition, she has experience in managing infectious dermatoses of fungal, viral, and bacterial origin, as well as in evaluating benign and suspicious skin lesions, with referral to specialized care when necessary.

With a strong interest in a comprehensive approach to skin health, she also treats scars, post-procedural skin changes, and conditions related to hormonal factors and aging, including those associated with pregnancy, menopause, and age-related skin changes.

Thanks to her experience and continuous professional development, Dr. Trafimchuk provides high-quality medical care that is professional, confidential, and aligned with modern dermatology standards.

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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.

How to buy RECTOGESIC 4 mg/g RECTAL OINTMENT in Spain?

Spain has a well-developed healthcare infrastructure across major cities such as Madrid, Barcelona, Valencia, and Seville. Pharmacies are widely available and operate under strict regulations, ensuring access to prescribed medications.

You can buy RECTOGESIC 4 mg/g RECTAL OINTMENT in Madrid, Barcelona, Seville, or Valencia at any local pharmacy with a valid prescription.

To obtain a prescription, you can use Oladoctor:

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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