Glyceryl trinitrate is used to relieve pain caused by chronic (long-term) anal fissures (tears or sores in the skin lining of the anus).
Apply Glyceryl trinitrate ointment exactly as directed by your doctor or according to the instructions on the label. Do not use more often or over a larger area than instructed by your doctor.
To use the ointment, follow these steps:
- Wash your hands thoroughly.
- Place your finger alongside the dosing line printed on the outside carton of the ointment tube.
- Squeeze the tube to release the length of ointment onto your finger corresponding to the line indicated on the carton.
- Gently insert your finger into the anal canal. Apply the ointment around the area in a gentle, circular motion. The finger must be inserted up to the first finger joint (about 1 cm) into the anus.
- Wash your hands after applying the ointment. You may use a finger cot to apply the ointment instead of your bare finger.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of treatment depending on the severity of your condition and your response to the medication.
Apply the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose to make up for a missed dose.
If you often forget to apply your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- hypertrophic obstructive cardiomyopathy (abnormally thick heart muscle that results in blockage of blood flow)
- low volume of circulating fluids in the body which have not been treated
- severe low blood pressure
- increased pressure in the brain e.g. head trauma or injury, bleeding in the brain
- severe anaemia (low red blood cell count in the body)
- constrictive pericarditis (inflammation of the sac-like membrane surrounding the heart)
- pericardial tamponade (a condition where fluid builds up in the sac around the heart that prevents it from pumping enough blood)
- acute circulatory failure (a serious sudden condition when the heart and blood vessels cannot supply enough oxygen-rich blood to the organs and tissues)
- narrowing of the heart valves
as Glyceryl trinitrate may not be suitable for you.
Do not use Glyceryl trinitrate with medicines used to treat impotence and certain medicine used to treat high blood pressure in the lungs. Please see the section "Can I use this with other medicines?" below for more information.
Inform your doctor if you have the following conditions:
- recent history of heart attack
- severe liver disease
- severe kidney disease
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving Glyceryl trinitrate to the elderly. Elderly people may be more sensitive to the side effects.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
Glyceryl trinitrate may cause dizziness. If affected, do not drive or take part in any activity in which you need to be alert.
This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.
Other side effects include any of the following: headache, dizziness with sensations of spinning, generalised weakness or lack of energy, drowsiness, nausea, vomiting, and flushing.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- severe dizziness, passing out
- worsening of chest pain, fast heartbeat
- bluish skin, shortness of breath, tiredness
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not use Glyceryl trinitrate with the following medicines:
- medicines used to treat impotence e.g. sildenafil, vardenafil, tadalafil
- riociguat (medicine used to treat high blood pressure in the blood vessels leading to the lungs)
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines for high blood pressure e.g. amlodipine, captopril
- medicines to treat depression e.g. amitriptyline
- medicines for migraine (severe throbbing pain or pulsating sensation usually affecting one side of the head that is often accompanied by nausea, vomiting, and sensitivity to light and sound) e.g. ergotamine
- heparin (blood-thinning medicine)
- acetylcysteine (medicine used to treat lung disorders associated with abnormal, thick, and viscous mucus secretions [phlegm])
This list does not include all medicines that may interact with Glyceryl trinitrate.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol. Alcohol intake may worsen the side effects caused by Glyceryl trinitrate.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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