Side effects of Rectogesic ointment

I'm going on a diving holiday in a few days, and my doctor has recently prescribed Rectogesic®, an ointment with possible side effects including low blood pressure, headaches and dizziness. Is it safe to dive after using this ointment?

Dizziness while scuba diving is hazardous, because it may cause disorientation or difficulty following essential safety protocols. Should you have an experience necessitating a rapid ascent, both you and your dive buddy would be at risk of DCS. In severe cases, lowered blood pressure may cause loss of consciousness, which if occurring underwater could cause drowning and death.

If you were to experience problems or complications such as dizziness or headache during a dive, it could be difficult to differentiate a dive-related illness from the medication's side effects. This may lead to unnecessary treatment, but more important, it may delay treatment of a potentially dangerous condition.

Another issue to consider is that having an open wound or break in the skin while diving puts you at an increased risk for infection.

Considering the underlying medical problem and the possible side effects, scuba diving is probably not advisable while taking this medication. It is up to you and your physician, however, to make an informed decision. Individuals respond differently to medications, and it is possible that you may experience minimal or no side effects, especially given that this is a topically administered medication. When making the decision about whether to dive, consider your medical history and the other medications you take in addition to the medical condition being treated and any side effects experienced.
— Mala Trivedi, M.D.
NOTE: Rectogesic is an ointment prescribed for rectal use to reduce pain of rectal fissure. One gram of rectal ointment contains 4 mg of glyceryl trinitrate (GTN). The delivered dose from 375 mg of this formulation is approximately 1.5 mg GTN. The reported side effects and interactions with some common drugs are of most concerns for divers.

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