What is the dosing for topical nitrates to treat anal fissures?

Updated: Nov 09, 2018
  • Author: Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Different dosing of topical nitrates has also been studied, from 0.05% to 0.4%, without a difference in healing rates. [29, 30, 31] Topical nitrates have also been compared with nitroglycerin patches applied to a remote area, with similar cure rates. [32]

One small randomized controlled trial between topical diltiazem gel (2%) or glyceryl trinitrate ointment (0.2%) showed a healing rate of 92% with diltiazem compared with 60% with glyceryl trinitrate (P< .001). [33] Adverse effects were more common with glyceryl trinitrate.

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