Children's Hospital is part of the UPMC family.
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).
Nelson R (2006). Non-surgical therapy for anal fissure. Cochrane Database of Systematic Reviews (4).
ByHealthwise Staff Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine Adam Husney, MD - Family Medicine Specialist Medical Reviewer C. Dale Mercer, MD, FRCSC, FACS - General Surgery
Current as ofMay 5, 2017
Current as of:
May 5, 2017
Anne C. Poinier, MD - Internal Medicine & Adam Husney, MD - Family Medicine & C. Dale Mercer, MD, FRCSC, FACS - General Surgery
To learn more about Healthwise, visit Healthwise.org.
© 1995-2017 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
Children's Hospital's main campus is located in the Lawrenceville neighborhood. Our main hospital address is:
Children’s Hospital of Pittsburgh of UPMC
One Children’s Hospital Way
4401 Penn Ave.
Pittsburgh, PA 15224
In addition to the main hospital, Children's has many convenient locations in other neighborhoods throughout the greater Pittsburgh region.
With myCHP, you can request appointments, review test results, and more.
For questions about a hospital bill call:
To pay your bill online, please visit UPMC's online bill payment system.
Interested in giving to Children's Hospital? Visit Children's Hospital of Pittsburgh Foundation's website to: