Different CRS have different approach and all that I visited (and there were 5...or more :roll: LOL) suggested OUTSIDE application for both Nitro and Nefidapine (sp.?)
Since I got headache any time I applied Nitro - it obviously did not need to be applied any other way LOL- it is a proof that it was absorbed anyway and had systemic effect. BTW, Nitro is applied as a patch on the skin for heart patients in the ER - hence, not "in the heart" to work ; ))) and it relaxes heart anyway as it should
Even if any of those creams are applied IN the anus - they are certainly not in contact with internal sphincter but anal mucosa.
My personal opinion is that the whole thing with butt creams and blood-pressure meds applied "locally" is one big charade - just the way to bypass some FDA loops since giving a blood-pressure meds orally would require WHOOOOLE new game of tests and commissions and approvals. This way they do not have to go through all of that caboodle.
I am sure that if taken orally both Nitro and Nefid. would have same effect on the butt - same way butt creams have SAME effect on blood pressure in the whole body regardless of the fact that they are applied ON the butt or IN the butt !!!!
OK - enough of my "rant " LOL