Glyceryl trinitrate belongs to a group of medicines called organic nitrates. Topical application of glyceryl trinitrate to the anal canal reduces the anal pressure and increases the blood flow, thereby reducing pain.

The ointment will help to relieve the symptom of pain caused by chronic anal fissures.

The usual dose is approximately 375 mg of ointment (approximately 1.5 mg glyceryl trinitrate) applied to the anal canal every 12 hours.
A finger covering, such as a cling film or a finger cot, may be placed on the finger to be used to apply the ointment. The covered finger is placed along side the 1.75 cm dosing line, which is provided on the outside carton, and a strip of ointment the length of the line is expressed onto the end of finger by gently squeezing the tube.
Gently insert the ointment into the anal canal using the finger. The finger with the ointment must be inserted to the first finger joint (approximately 1 cm) into the anus. Treatment may be continued until the pain goes away, or for up to a maximum 8 weeks.

Headache is the most common side-effect when glyceryl trinitrate 0.4% ointment is used. Other side-effects include dizziness, faintness on standing, light-headedness, blurred vision and tiredness & nausea.

Take special care with Glyceryl Trinitrate 0.4% ointment if patient has:
liver or kidney disease
to be given heparin
haemorrhoids (piles) and notice more bleeding than usual,
severe headaches when using ointment,
The ointment may lower blood pressure. Blood pressure is more likely to be lowered if drink alcohol whilst you are using ointment.
Ointment is not indicated for patients under the age of 18 years.

Do not use Glyceryl Trinitrate 0.4% ointment if the patients:
are allergic to glyceryl trinitrate or to similar medicines
suffer from low blood pressure
suffer from heart or blood vessel disorders
suffer from closed-angle glaucoma
suffer from migraine or recurrent headaches
suffer from increased intracranial pressure or high pressure within your skull
suffer from anaemia
are taking any of the following medicines: sildenafil citrate, tadalafil, vardenafil, medicines for angina or heart pain such as glyceryl trinitrate (GTN), isosorbide dinitrate, amyl or butyl nitrite, medicines for high blood pressure or depression (tricyclic anti-depressants), acetyl cysteine or alteplase

Ointment should not be used during pregnancy or when breast-feeding.

The following medicines may increase the blood pressure lowering effect of glyceryl trinitrate ointment-
Medicines for depression
Medicines for erectile dysfunction
Medicines for high blood pressure
Diuretics
Commonly used tranquillizers
Medicines used to treat heart problems

Overdose may cause dizzy and light-headed. Patient may also have fast heart beats or palpitations. If patient feels these symptoms wipe away any extra ointment and then talk to the doctor immediately.

Repane Ointment: Each box contains 1 tube of 30 gm ointment.