What is the indication of Nitrogesic Ointment?

Nitrogesic ointment is used for the treatment of anal fissure.This medication provides the symptomatic relief of spasm and pain by relaxing the smooth muscle of anal sphincter.

How does Nitrogesic ointment work?

This medication works by converting Nitroglycerin to nitric oxide. Nitric oxide is the active mediator compound and it activates the enzyme guanylatecyclase. This enzyme influence the production of cGMP (cyclic guanosine 3',5'-monophosphate). The cGMP initiates the activation of the protein kinase-dependent phosphorylation in the cells of smooth muscle of the anal region.This results in the dephosphorylation of the chainsof myosinsin the fibers of the smooth muscles. So thus the release of calcium ions causes the relaxation of the smooth muscle cells and it helps relieve the strain and other symptoms in the anal fissure.

What are the contraindications of Nitrogesic ointment?

This medication is not indicated in the following conditions;

• If the patient has a history of severe chest pain.
• In hypersensitivity to Glyceryltrinitrate or any other component of the ingredient.
• This medication should be avoided in pregnancy because it can cause developmental anomaly to the fetus.
• In high BP.
• In anaemia and low blood pressure.
• If you are taking any medicine containing Phosphodiesterase type-5 inhibitor.
• If you are alcoholic.
• In headache and migraine.

What are the drug interactions of Nitrogesic ointment?

Since this medication contains Glyceryltrinitrate, it shows some drug interactions in the following conditions:

• Drugs used in cardiac disesaes like angina pectoris, heart failure or stroke.
• Drugs used for the chronic treatment of oesophagitis.
• Medications of Cardiac infarction.
• Any drugs used for postoperative hypertension.

What are the side effects of Nitrogesictrinitrate?

You should always consult with your doctor if you if develop any of the following side effects,

Some common side effects:

• Rashes
• Bumps or hives
• Irritation or itching

Some of the general side effects:

• Light headedness
• Headache
• Chest pain
• Fainting
• Low blood pressure

Note: Always take medical help if you catch any other symptoms apart from the above mentioned side effects to avoid any serious complication.

What is the dosage and method for applying this medication/

Dosage: In adult, 1.5 mg of Nitrogesic 0.4% ointment should be applied intra-anally in every 12 hour. The duration of this course is up to 8 weeks.

Method: it should be applied topically (intra-anally).

How should you store this medication?

This medication should be stored at room temperature, in a cool and dry place and kept out of the reach of children and pets.

What are the precautions of Glyceryltrinitrate?

Always take some precautions while using this medication to avoid the unwanted complications. Some of the precautions are mentioned below:

• Always avoid this medication if you are allergic to Glyceryltrinitrate or any other components of this ointment.
• Caution should be taken in patients who experiences cardiac failure, low BP, cardiac attack or stroke.
• Always consult with your doctor if you are suffering from any eye problem like increased intraocular pressure or eye pain.
• You should talk to your doctor if you have anaemia and hypotension (low BP).
• This medication should be avoided in pregnancy and lactation period because safety and efficacy of glyceryltrinitrate are not confirmed in these conditions.
• Do not drive any vehicle or operate any surgical procedure after taking Nitrogesic ointment, because it can cause dizziness and blurred vision.
• This drug can cause dehydration, so always inform your doctor if you experience this.
• You should always avoid the consumption of alcohol, because it worsens the condition.