WellSpan Home

Anal Fissures: Nitroglycerin Ointment

Topic Overview

Application of a 0.2% nitroglycerin ointment may help heal a long-term (chronic) tear, or fissure, in the anus. You rub a pea-sized dot of cream on the fissure twice a day. It is a good idea to either wear gloves when applying the nitroglycerin cream or wash your hands right after. The skin on your fingers can absorb the medicine and increase your chance of side effects.

An increase in muscle tension, also called resting pressure, in the internal anal sphincter can lead to fissures. Spasms and reduced blood flow to the anus may occur along with the rise in pressure, causing fissures or keeping existing fissures from healing.

Nitroglycerin is usually the first medicine used to treat a chronic anal fissure. Many studies have shown that it works better than conservative treatment (eating more fiber and taking sitz baths).footnote 1

Headaches are the main side effect of nitroglycerin ointment. The risk of headaches and lightheadedness from low blood pressure is especially high if you use too much ointment at one time.

Some people also may experience itching or burning in the anal area. In some cases, people may develop tolerance to nitroglycerin, meaning that after a while the ointment no longer works to reduce muscle tension.

People using nitroglycerin ointment have increased chances of having low blood pressure. So you should not use nitroglycerin ointment within 24 hours of taking sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra).

Related Information

References

Citations

  1. Nelson R (2006). Non-surgical therapy for anal fissure. Cochrane Database of Systematic Reviews (4).

Credits

ByHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Specialist Medical ReviewerC. Dale Mercer, MD, FRCSC, FACS - General Surgery

Current as ofMay 5, 2017


Are you sure you would like to cancel?

All information will be lost.

Yes No ×

About the provider search

This search will provide you with WellSpan Medical Group and Northern Lancaster County (Ephrata) Medical Group primary care physicians and specialists. If we don’t have a WellSpan Medical Group physician to meet your criteria, the search will expand to include community physicians who partner with WellSpan Medical Group physicians through the WellSpan Provider Network or provide care to patients on the Medical Staffs of WellSpan’s Hospitals.

×

Schedule Your Next Appointment Online with MyWellSpan

Use your MyWellSpan patient portal any time to view available appointments, and pick the date and time that best suits your schedule.

Go to MyWellSpan

New to this practice?

If you don't have a WellSpan primary care provider and would like to schedule a new patient appointment with a provider who is accepting patients, just log into your MyWellSpan account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to see the offices that are accepting new patients in relation to your zip code. If you are not enrolled in MyWellSpan, go to https://my.wellspan.org, call 1-866-638-1842 or speak with a member of the staff at a participating facility to sign up. New patient scheduling not available at all practices/programs.

Already a patient at this practice?

If you already have a relationship with a WellSpan practice, simply log into your account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to schedule an appointment with any provider or practice that already counts you as a patient. Online scheduling varies by practice/program.

×