Skip the wait. Get a Nitroglycerin rectal ointment prescription within 5 minutes
Chronic anal fissure pain hits hardest with every bowel movement, and waiting two weeks for a colorectal appointment makes each one worse. A board-certified doctor can review your symptoms online in minutes and send a Nitroglycerin 0.4% rectal ointment (Rectiv®) prescription to your pharmacy for same-day pickup, so the next bowel movement isn't dictated by your clinic's schedule.
- For adults 18+ with chronic anal fissures
- Start a consultation at any time of the day
- Headache-coaching and dose check-ins are included in your visit
Subscription starting from $20/month.
Includes unlimited consultations, prescriptions, and a doctor’s note
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Why patients choose Your Doctors Online for a Nitroglycerin Ointment online prescription
Choosing telehealth for your Nitroglycerin (Rectiv) prescription means faster care, fewer awkward conversations, and a doctor who treats fissure pain like the time-sensitive problem it is.
24/7 access. Fissure pain doesn't wait for clinic hours
Anal fissures hurt most with bowel movements, which don't respect business hours. Our doctors are on chat, video, or audio nights, weekends, and holidays.
Coaching through the headache phase
64% of patients get a headache when starting Nitroglycerin. We walk you through Tylenol use, hydration, and the 1–2 week timeline so you don't quit on day 3 and lose the chance for the fissure to heal.
Privacy that matches the topic
Fissures aren't easy to talk about face-to-face. Our HIPAA-compliant chat lets you describe symptoms, share photos if needed, and get a prescription without sitting in a waiting room.
Pick the local pharmacy
Your Nitroglycerin online prescription is sent to the pharmacy you choose: CVS, Walgreens, Costco, Walmart, Kroger, or whichever is located near you. Most patients pick up the tube the same day, so the next bowel movement does not re-tear the fissure.
How to get Nitroglycerin ointment online for an anal fissure?
Our telehealth service connects you with a licensed doctor in about 5 minutes, so you can start treating chronic anal fissure pain without leaving home.
Begin your virtual consultation
Create an account and share your fissure symptoms, bowel-movement history, any conservative measures you've already tried (sitz baths, stool softeners, fiber), and your current medications.
Connect with a licensed provider
Choose chat, audio, or video. Your doctor will assess whether Nitroglycerin 0.4% rectal cream is appropriate, screen for drug interactions, and confirm your pharmacy preference.
Receive your online Nitroglycerin prescription
If you qualify, your Nitroglycerin (or generic) e-script is sent to your chosen pharmacy. You can pick up your ointment the same day from the pharmacy.
What is Nitroglycerin (Rectiv) for anal fissures?
Nitroglycerin 0.4% is a topical nitrate vasodilator (brand name Rectiv® and available as a generic) that is used to treat moderate to severe pain from chronic anal fissures, which is a tear in the lining of the anal canal that hasn't healed after 6 weeks.
The pain comes from the internal anal sphincter going into spasm, which cuts off blood flow to the tear and prevents it from healing. The ointment works by relaxing that sphincter muscle. Nitroglycerin for anal fissure works on a simple principle: when the sphincter relaxes, blood flow improves, pain eases, and the fissure gets a better chance to heal.
Get Nitroglycerin prescriptionNitroglycerin
Generic · Rectiv® (brand)Who is eligible for an online Nitroglycerin ointment prescription?
Nitroglycerin 0.4% rectal ointment is prescription-only because, even when applied to the anal canal, it can be absorbed into the bloodstream and lower blood pressure. Your doctor will screen you against the criteria below during your visit before sending the prescription to your pharmacy.
You are eligible if
You have a chronic anal fissure
You are eligible if
You have a chronic anal fissure
You are not eligible if
Discuss alternatives with a doctor
You are not eligible if
Discuss alternatives with a doctor
What does a Nitroglycerin ointment consultation cost?
The cost of the Nitroglycerin cream at the pharmacy is separate from the consultation cost and depends on your insurance and whether you're filling the brand (Rectiv) or the generic.
Cost with insurance
Cost with insurance
| Plan Type | Generic 0.4% | Rectiv® |
|---|---|---|
| Medicare Part D | $10 – $50 | Often non-formulary |
| Medicaid | $0 – $10 | Varies, prior auth common |
| Commercial HMO / PPO | $20 – $80 | $100 – $300+ |
| ACA Plans | $20 – $80 | $100 – $300+ |
Cost without insurance
Cost without insurance
Strengths and forms of Nitroglycerin ointment your doctor may prescribe for an anal fissure
Your doctor will prescribe a 30g tube of Nitroglycerin 0.4% rectal ointment for a 3-week course. The standard adult dose is a 1-inch ribbon (measured against the dosing line on the side of the tube box), applied inside the anal canal every 12 hours. The tube must be discarded 8 weeks after opening.
| Dose | Form | Frequency | Max daily |
|---|---|---|---|
| 1-inch ribbon (~375 mg ointment) | Rectiv® 0.4% rectal ointment (brand) | Every 12 hours | 2 applications/day |
| 1-inch ribbon | Generic Nitroglycerin 0.4% rectal ointment | Every 12 hours | 2 applications/day |
How to apply Nitroglycerin ointment
Keep the tube tightly closed, at room temperature, away from heat. Discard any unused ointment 8 weeks after opening the tube.
- Wash your hands before each application.
- Cover your index finger with a finger cot, disposable surgical glove, or a piece of plastic wrap.
- Line up your covered finger with the 1-inch dosing line printed on the box.
- Squeeze a ribbon of ointment onto your finger to match that length.
- Gently insert your finger into the anal canal, no further than the first knuckle, and spread the ointment along the inner wall of the canal.
- If the canal is too painful to enter, apply the ointment directly to the skin around the anus instead.
- Discard the finger covering in the trash and wash your hands again.
Because your blood pressure can drop slightly after application, avoid standing up quickly from a sitting or lying position for at least 10–15 minutes to prevent dizziness or fainting.
Nitroglycerin ointment side effects (headache, dizziness)
The most common side effect of Nitroglycerin rectal ointment is headache, which the FDA Rectiv label reports in 64% of patients. Other common side effects include:
Common, mild effects
Common, mild effects
Less common but serious. Call your doctor right away
Less common but serious. Call your doctor right away
Alternatives to Nitroglycerin ointment for anal fissures
Topical Diltiazem 2% ointment
Topical Nifedipine 0.2%–0.5% ointment
Topical Lidocaine 2% jelly
Botulinum toxin (Botox) injection
Meet our online doctors in the United States
Dr. Richard Honaker is a board-certified physician with more than 40 years of experience in family and emergency medicine. He serves as Chief Medical Advisor at Your Doctors Online and is affiliated with Medical City Plano in Texas. Recognized multiple times by D Magazine and Texas Monthly, Dr. Honaker provides evidence-based care across a wide range of conditions including diabetes, hypertension, and injury care.
Dr. Monique Rainford is an OB/GYN expert and Assistant Clinical Professor at Yale School of Medicine. With 25+ years of experience, she’s led OB/GYN departments at Yale Health and Baltimore Medical System. Her clinical interests include pregnancy, menstrual health, chronic pelvic conditions, and lifestyle medicine. Dr. Rainford advocates for maternal health equity, especially in underserved communities.
Dr. Candice Fraser is an OB/GYN practitioner and founder of Trinity Medical Care. With over a decade of experience, she focuses on reproductive care, menstrual health, and menopause management. Along with medical training and residency, she also holds an MBA in healthcare management, blending business insight with clinical excellence.
Frequently asked questions
Is Nitroglycerin ointment available over the counter?
No, Nitroglycerin rectal ointment (0.4%, Rectiv®) is a prescription-only medication. It's not stocked over the counter at CVS or any other major pharmacy chain. Any website claiming to sell Nitroglycerin ointment without a prescription is operating in violation of FDA regulations. The legal route is a telehealth consultation. A licensed doctor can prescribe Nitroglycerin ointment online after a proper evaluation, and your e-prescription is sent to your pharmacy of choice for same-day pickup.
Can you buy Nitroglycerin ointment online without a prescription?
No. Sites that ship Nitroglycerin cream without requiring a prescription are operating illegally and are not safe to use. Nitroglycerin is a vasodilator that, even when applied to the anal canal, can be absorbed into the bloodstream and sharply lower blood pressure. That risk is the reason for the prescription requirement. What you can do online is get the prescription itself. A telehealth visit with our board-certified doctor takes about 5 minutes. The doctor reviews your symptoms of a fissure, screens for contraindications, and sends the online prescription to a licensed pharmacy. From there, you can fill at any retail pharmacy.
How long does it take Nitroglycerin cream to heal a fissure?
Pain relief usually begins within 3–4 days of starting Nitroglycerin cream. Full healing varies. Some fissures close within the 3-week treatment course, while others need a second course or escalation to Diltiazem, botulinum toxin, or sphincterotomy. The maximum recommended course can be anywhere from 3 weeks to 2 months, based on your symptoms. Using it for longer doesn't provide additional benefit and may cause tolerance.
Can a telehealth doctor prescribe Nitroglycerin ointment?
Yes. Nitroglycerin is not a controlled substance, so a licensed doctor can prescribe it after a virtual evaluation. Start a telehealth visit with Your Doctors Online and get your e-script to the pharmacy of your choice in minutes.
Why does Nitroglycerin ointment cause headaches?
Nitroglycerin dilates blood vessels throughout the body, including in the brain. That vasodilation is what causes the headache. Headaches are usually worst in the first few days and fade within 1–2 weeks.
Can I use Nitroglycerin ointment for hemorrhoids?
Nitroglycerin 0.4% rectal ointment is not FDA-approved for hemorrhoids. It's approved only for chronic anal fissure pain. However, some compounding pharmacies prepare a Nitroglycerin + Lidocaine ointment that doctors prescribe off-label for thrombosed external hemorrhoids, but evidence is limited. For hemorrhoids specifically, lidocaine + hydrocortisone is more commonly prescribed.
What if the Nitroglycerin ointment doesn't work?
If the 3-week course of Nitroglycerin ointment doesn't heal the fissure, the next options are topical Diltiazem 2% ointment, botulinum toxin injection at a colorectal clinic, or lateral internal sphincterotomy. Your doctor will discuss the escalation path during your follow-up.
Can I drink alcohol with Nitroglycerin ointment?
Avoid alcohol during the 3-week course. Both Nitroglycerin and alcohol lower blood pressure. Taking them together can cause severe dizziness, fainting, and falls.
Is generic Nitroglycerin ointment the same as Rectiv?
Yes. Generic 0.4% Nitroglycerin rectal ointment contains the same active ingredient, the same strength, and is FDA-approved as therapeutically equivalent to Rectiv. The main difference is cost. Generic with a GoodRx coupon runs about $158, whereas brand Rectiv retails for $449.
Get your prescription now
Talk to a licensed doctor about your Nitroglycerin prescription