Rectogesic Dosage/Direction for Use

Adults: Insert a 1 to 1.5 cm strip of ointment (see measurement on box) into the anal canal, either with the finger or an applicator.
The ointment is to be applied 3 times daily or more frequently on the advice of a medical practitioner. Close the tube tightly, immediately after each use.
For anal fissure, treatment with Rectogesic should be continued for 2 - 4 weeks, with assessment by a medical practitioner after 2 weeks. For haemorrhoidectomy, treatment with Rectogesic should be continued for a minimum of 2 weeks, with assessment by a medical practitioner after the initial 2 weeks.
Adverse effects: If headache, fainting or dizziness are observed, treatment should cease for a minimum of 8 hours and then the dosage halved. Simple analgesics such as paracetamol may be helpful for headaches. If headaches are severe and persist, cease administration.
Nitrate-free period: A daily 'nitrate-free period' of 12 hours is required during treatment with Rectogesic to avoid the development of tolerance. This would normally be overnight.
Where Rectogesic is used concurrently with another nitric oxide donor, the nitrate-free period should correspond with the nitrate-free period already applying to the nitric oxide donor (e.g. this may be during the day for those angina patients who require overnight treatment with glyceryl trinitrate patches).
The frequency of use of Rectogesic may need to be reduced to twice daily when it is used in conjunction with another nitric oxide donor, to reduce the likelihood of adverse systemic effects and to allow an adequate nitrate-free period for the other nitric oxide donor product.
Use in children: Safety and effectiveness in children and adolescents under 18 years of age have not been established.