Rectiv is a brand of ointment that contains 0.4% nitroglycerin, an organic nitrate. It is formulated as an ointment and is applied topically, with each gram containing 4 mg of nitroglycerin. Key inactive ingredients include propylene glycol, lanolin, sorbitan sesquioleate, paraffin wax, and white petrolatum. This medication is commonly used in tubes that allow dosing through a measuring line.

How should I use this medication?

This medication is for rectal use only. Do not take by mouth. Follow the directions on the prescription label. Use exactly as directed. Cover a finger with plastic-wrap or surgical glove. Use the dosing guide on the medication box to measure the dose. With the ointment on the covered finger, insert into anal canal up to the first finger joint. After application, throw away the finger covering. Wash hands after applying ointment.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, use it as soon as you can. If it is almost time for your next dose, use only that dose. Do not use double or extra doses.

Where should I keep my medication?

Keep out of the reach of children.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Close tightly after each use. Throw away any unused medication after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Headache, unusual weakness or fatigue, shortness of breath, nausea, vomiting, rapid heartbeat, blue skin or lips, which may be signs of methemoglobinemia
• Increased pressure around the brain—severe headache, blurry vision, change in vision, nausea, vomiting
• Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
• Slow heartbeat—dizziness, feeling faint or lightheaded, confusion, trouble breathing, unusual weakness or fatigue
• Worsening chest pain (angina)—pain, pressure, or tightness in the chest, neck, back, or arms

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Dizziness
• Flushing
• Headache

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Head injury, recent stroke, or bleeding in the brain
• Heart disease
• Low blood cell levels, such as red cells
• Low blood pressure
• Migraine or recurrent headaches
• An unusual or allergic reaction to nitroglycerin, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breastfeeding

What may interact with this medication?

Do not take this medication with any of the following:

• Medications used to treat erectile dysfunction, such as sildenafil, tadalafil, and vardenafil
• Riociguat

This medication may also interact with the following:

• Alteplase
• Aspirin
• Certain migraine medications, such as ergotamine and dihydroergotamine (DHE)
• Heparin
• Medications for blood pressure
• Other medications used to treat angina

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Tell your care team if you feel your medication is no longer working.

This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.

Do not treat yourself for coughs, colds, or pain while you are taking this medication without asking your care team for advice. Some ingredients may increase your blood pressure.