Hi Guys,
Well, I've not had a pleasant time using the Rectogesic. Not at all really! But I do find it effective at loosening things up and until I can get the LIS, I'm pretty much dependent on it, which I hate. I have developed some other health concerns during the time I've been using it and I am trying to work out whether anybody else has side effects other than the usual headache, dizziness and mild incontinence.
I don't want to poison the well by telling you what symptoms I've been getting, but it would be great if you all could chime in with any and all definite or suspected Recto side effects.
Thanks

It's not a big deal, but I definitely get a metallic taste in my mouth. I felt the headache the first day, and by the 3rd or 4th day didn't have any headache at all.

I tend to get undocumented or rare side effects with some meds, most the time these side effects are psychological ones. Having not started rectogesic yet this is of interest to me, you have me concerned that you don't want to even mention it.

Hmmm,
Soreguy, I'm really sorry, I didn't mean to worry you. I get all the undocumented and rare effects also. I can put your mind at rest on at least one side effect though ...
For about the past two months, (I've been using Rectogesic for six) I have had Vulval irritation which for months, I thought was thrush. My Gynae thinks it could be the Rectogesic. Last week I had to have a biopsy taken and let me just say that I reallly can not recommend a Vulval biopsy and a retear within a few days of one another. So SG, this is at least one thing you won't have to worry about!
I really don't want to put anyone off using it. Truth is, it works well, for me. It controls the fissure pain, and I know that BMs would not be bearable without it (I've tried!). It has definately failed to heal me though. I need LIS, but I can't get it in the near future, so I just need to try and manage things until I can.
Ok, I'll just be upfront about it, here's the list. Please don't read on if you haven't used Rectogesic yet and don't want to anticipate side effects. I AM that kind of neurotic ... maybe you're not.
Headache
Facial Spasms/Twitching
Painful Urination
Vulval Irritation
The Gynae thinks the last two are possibly due to Rectogesic use and that I need to rule the Recto out by discontinuing use. I did find mention of Painful Urination when I researched it. This from Wikipedia:
Side effects
The side effects of nitroglycerin include lack of sexual desire, headache, painful urination and increased bowel movements.[citation needed] Patients are often told to sit or lie down during and immediately after taking nitroglycerin to reduce the risk of low blood pressure. A drop in blood pressure can be accompanied by weakness or dizziness.[18]
Shortly after the invention of nitroglycerin, this substance was noticed to be capable of inducing a violent headache. Headaches are the most prominent side effect of nitrate therapy. This was due to the release of nitric oxide (NO) by nitroglycerin. Such studies have led to propose that NO may be the causative molecule in migraine pain. The importance of NO as a potential initiator of the migraine attack opens new directions for other vascular headaches and pharmacological treatment of migraines.
I also have found reference to Spasms, twitching & involuntary movements, but this really seems to be more in association with individuals who work in the production of nitro, or when it is administered via IV.
I suppose it is possible that I am just very sensitive to it and should not be using it at all, but right now, I have little choice. It's very stressful though ... It's poison to me now. I hate using it.
I'm seeing a Neurologist today to get their opinion. Personally, I don't think he's going to have a clue!
I've already seen half a dozen doctors, had many, MANY tests and endured at least one absolutely excruciating biopsy ... seriously, it was the second worst acute pain I've ever experienced. The first was having a foot and half of surgical drain pulled out of my belly after a operation. Anyway, I guess I don't want to go chasing a diagnosis for each of these things, when really, it's all being caused by the Rectogesic.
If you are the neurotic, paranoid type ... why the hell are you still reading this?
I need to have a rest, I've been speed ranting for a while now!

I remember you saying diltiazem gave you a rash, do you think that would be the lesser of the 2 evils?
I am going to make an appointment with my doctor and ask for diltiazem I am going to try that 1st before the rectogesic.
Another thing to consider would be lowering the dose of rectogesic, dosage can make a bigger difference than you would imagine.

I had a bit of a pounding heart and tinnitus (pounding in my ears) the first couple of days using it, along with the usual headache and lightheadedness. Nothing about that personally.
But don't second guess yourself -- if you think it's a side effect, it most likely is. I'm pretty neurotic too though so maybe we're all just crazy hahaha.
0.2% nifedipine or 2% diltiazem ointments may be viable alternatives to consider if nitroglycerin isn't tolerable. Over here we have to get these compounded. Not sure if they're ready made or require compounding down under.

Looking up at some studies on rectogesic and diltiazem, it seems if you use too much you will get side effects but with diltiazem there is no additional benefit to using more.
As for rectogesic I am not sure if ramping up the dose over 2-3 weeks from a match head sized amount up to a pea sized amount would be viable, as it would supposedly reduce the headache but for it to be most effective I interpreted(just assuming based on bits and pieces of info from different sources!) that pulsing the dose is most effective although with the worst side effects.
Regardless I would decrease the dose until side effects disappear and hopefully it will still be just as effective, otherwise there is possibly too much systematic absorption so if its diltiazem perhaps change the base or if its rectogesic decrease the depth/spread of application.
sphinctersaurus how often were you applying it? and were you keeping the doses consistent?
I would try lowering the overall dose and spacing it out over 3 times a day application without missing a day so you dont give your body a chance to desensitize to it.

I was told no more than a pea-sized amount of ditiazem is necessary per application. I don't think that more is necessarily better with that ointment!! :roll:

On my Rectogesic tube it says apply a 2.5cm line on the finger and insert your finger at least half way up the rectum to apply, the tube actually has a measuring line on it for exactness, this is the way I've been applying it when used and always have.

Like cheryl, I was told to only use a pea-sized amount of Diltiazem as more doesn't have a better effect

I've totally abondoned the Rectogesic now. It was the only way to rule it out as the cause of some of my symptoms. I haven't had any in 14 days. The headaches are gone, but the other symtoms persist. I got the results back from my vulval biopsy and it showed "Acute contact dermatitis", which apparently could be caused by the Rectogesic. The Gynae explained that even though it never physically touches that area directly, it could still have an effect on a wider area indirectly, as Rectogesic is a vasodilator which works by simply relaxing the smooth muscles that line the walls of blood vessels. The upshot, I think, is that it can potentially have an effect on a larger area than just the area of application alone. Anyway, I'm using Diltiazem now, which I suppose has the potential to cause these problems as well, but hey, I need to use something, so I'll see how it goes!
With my latest script for Diltiazem, I was given a little spoon to measure the dose. It measures a hell of a lot more than a pea sized amount. It's a quarter teaspoon measure, which is probably more like about 4 small peas. It's a challenge to apply that much, I can tell you! Slippery!! Perhaps I'll reduce it! Every Doctor or Pharmacist I've consulted regarding how much Diltiazem to use has been predictably clueless. One Pharmacist actually said "I don't know", to which I replied "what do you mean, you don't know, and how can you not know?” Then he said "just use as much as you want, more is better". Hey, I can’t argue with that! How can more not be better? Works for Chocolate and Gravy!
Not together though ... don’t eat Chocolate and Gravy together.
This is what we are dealing with!