Indications for RECTIV:
Treatment of moderate-to-severe pain associated with chronic anal fissure.
Apply using finger covering (eg, plastic-wrap, disposable surgical glove, finger cot). ≥18yrs: 1 inch of ointment intra-anally every 12 hours for up to 3 weeks. Not for oral, ophthalmic, or intravaginal use.
<18yrs: not recommended.
Concomitant PDE5 inhibitors (eg, sildenafil, vardenafil, tadalafil). Severe anemia. Increased intracranial pressure.
Volume depleted. Hypotension. Cardiomyopathy. CHF. Acute MI. Poor cardiac function. Elderly. Pregnancy (Cat.C). Nursing mothers.
See Contraindications. Hypotension with PDE5 inhibitors, antihypertensive drugs (eg, calcium channel blockers, beta-adrenergic blockers, other nitrates). Potentiated by aspirin. Antagonizes tissue-type plasminogen activator (t-PA); caution. Anticoagulant effect of heparin may be reduced; monitor APTT. Potentiates ergotamine; possible ergotism. Additive vasodilating effects with alcohol; avoid use.
Headache, dizziness, hypotension (including orthostatic hypotension); rare: flushing, allergic reactions, application site reactions (eg, drug rash, exfoliative dermatitis), methemoglobinemia.