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Nitrovas 0.4% Rectal Ointment 30g
Nitrovas (glyceryl trinitrate) is used for the treatment and prevention of angina pectoris, which results from insufficient blood flow to the heart. The medication works by relaxing and dilating blood vessels, enhancing blood flow to the heart muscle. The injectable form is short-acting and must be administered intravenously under strict medical supervision, typically as a continuous infusion, and should not be stopped abruptly.
⚠️ Do not mix Nitrovas with any other medication.
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✅ Description:
Glyceryl trinitrate activates guanylate cyclase via nitric oxide in vascular smooth muscles, leading to vasodilation. It lowers preload by reducing venous return, improves coronary blood flow, and decreases afterload through arterial dilation. These effects alleviate and prevent anginal pain and relieve vasospasms.
Safety Advices
Alcohol
UNSAFE
Alcohol Use – Unsafe:
Consuming alcohol during Nitrovas treatment may trigger symptoms such as facial flushing, rapid heartbeat, nausea, excessive thirst, chest discomfort, and a significant drop in blood pressure—similar to a disulfiram-like reaction.
Pregnancy
CONSULT YOUR DOCTOR
Nitrovas is generally regarded as safe for use during pregnancy. Animal research has shown minimal to no harm to the developing fetus; however, there is limited clinical data in humans. Use only if advised by a healthcare professional.
Breastfeeding
CONSULT YOUR DOCTOR
Available evidence suggests Nitrovas poses no significant risk to nursing infants, but it should still be used under medical guidance.
Driving
CAUTION
Nitrovas may impair alertness, vision, or coordination. Do not drive or operate heavy machinery if you feel dizzy, drowsy, or experience blurred vision.
Kidney
CAUTION
Patients with kidney disease can generally use Nitrovas without dose adjustment, though they should still consult a physician for personalized advice.
Liver
CAUTION
There is not enough evidence on its safety in patients with liver dysfunction. Physician guidance is strongly advised.
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✔️ How to Use Nitrovas (Ointment)
For chronic anal fissures, apply a small amount of the 0.4% ointment (1.5 mg) into the anal canal up to the first finger joint (approximately 1 cm) using the fingertip. Use twice daily for up to 8 weeks, or until symptoms resolve.
✔️ Dosage (Adult – Anal Fissure)
Rectal Application: 1.5 mg of 0.4% ointment, applied every 12 hours
Duration: Maximum of 8 weeks, or until pain is relieved
✔️ Do not use Nitrovas (ointment or injectable) if the patient:
- Is allergic to glyceryl trinitrate or similar drugs
- Has low blood pressure
- Suffers from heart or blood vessel disorders
- Has closed-angle glaucoma
- Experiences frequent migraines or increased intracranial pressure
- Has anemia
- Is taking any of the following:
- Medications for erectile dysfunction (e.g., sildenafil, tadalafil, vardenafil)
- Other nitrate-based medicines
- Certain antidepressants (TCAs) or drugs like acetylcysteine or alteplase
✔️ Drug Interactions
- Increased effects of dihydroergotamine (ergot alkaloids)
- May prolong neuromuscular blockade with pancuronium
- May weaken the effects of heparin, alteplase, and noradrenaline
- Buccal or sublingual nitrate formulations may have reduced efficacy when taken with drugs causing dry mouth
- NSAIDs (e.g., aspirin) may diminish Nitrovas efficacy
✔️ Serious hypotension can occur when used with:
- Calcium channel blockers
- Antihypertensives
- Tricyclic antidepressants (TCAs)
- Phenothiazines
- Alcohol
✔️ Special caution is advised in patients with:
- Liver or kidney disease
- Hemorrhoids (monitor for increased bleeding)
- Severe headaches or migraines
- Low blood pressure (especially when using alcohol concurrently)
- Not recommended for patients under 18 years of age.
✔️ Storage Condition
Store in a cool & dry place, away from light & moisture. Keep out of reach of children.
⚠️Disclaimer:
At ePharma, we’re committed to providing accurate and accessible health information. However, all content is intended for informational purposes only and should not replace medical advice from a qualified physician. Please consult your healthcare provider for personalized guidance. We aim to support, not substitute, the doctor-patient relationship.
