Published: August 2009

Glyceryl trinitrate for rectal use now pharmacist-only

Prescriber Update 30(3): 21
August 2009

Healthcare professionals are reminded that glyceryl trinitrate for rectal use has been reclassified from a pharmacy to a pharmacist-only medicine.

Glyceryl trinitrate for rectal use is indicated in New Zealand for treatment of anal fissure and to relieve the pain and discomfort associated with haemorrhoids. Rectogesic is currently the only glyceryl trinitrate product for rectal use approved in New Zealand.

The reclassifi cation is due to concerns about the potentially serious adverse effects associated with the concomitant use of erectile dysfunction (ED) medications such as sildenafil, tadalifil and vardenafil. Specifically, the interaction may potentiate the hypotensive effects of organic nitrates.

The reclassification enables pharmacists to provideadvice about this interaction at the point of sale. Healthcare professionals are reminded to ask about other medicines being used by the patient prior to prescribing, dispensing or selling Rectogesic. An alternative treatment should be offered to patients who are also being prescribed an ED medicine.

Further information on the use of glyceryl trinitrate for rectal use can be found in the Rectogesic data sheet at