Rectiv can cost $500-$900+ per tube. Learn how to save with coupons, discount cards, patient assistance programs, and affordable compounded alternatives.
If you've looked at the price tag on Rectiv (Nitroglycerin 0.4% rectal ointment), you might have experienced sticker shock. Without insurance, a single 30-gram tube of Rectiv can cost $500 to $900 or more at retail pharmacies. Even with insurance, copays can be steep — and many plans require prior authorization before they'll cover it.
The good news: there are legitimate ways to reduce what you pay for Rectiv. In this guide, we'll walk you through every money-saving option available in 2026, from discount cards to patient assistance programs to more affordable compounded alternatives.
Understanding the pricing helps explain your options:
For more on why Rectiv is hard to find and expensive, see: Why is Rectiv so hard to find?
Prescription discount cards can significantly reduce the out-of-pocket cost of Rectiv, especially if you're paying cash (without insurance). These cards are free to use and accepted at most major pharmacies.
Popular discount card programs to check:
How to use them:
Important note: Discount cards cannot be combined with insurance. Use whichever option gives you the lower price. Also, prices vary significantly between pharmacies — always compare before filling.
AbbVie (the parent company of Allergan, which manufactures Rectiv) may offer savings programs for eligible patients. These can include:
To check current program availability:
Manufacturer programs typically require proof of income and may have enrollment forms that need to be completed by both you and your prescriber.
If you're uninsured or underinsured and can't afford Rectiv, patient assistance programs from nonprofit organizations may help:
These resources are free to use and can connect you with programs that provide medications at reduced cost or for free.
If you have health insurance, there are steps you can take to maximize your coverage for Rectiv:
Contact your insurance company or check their website to see if Rectiv is on your plan's formulary (list of covered drugs). If it's covered, find out:
If your plan requires prior authorization, your doctor's office can submit the paperwork. This process documents that Rectiv is medically necessary for your condition. Tips to speed up the process:
If your insurance denies coverage for Rectiv, you have the right to appeal. Your doctor can write a letter of medical necessity explaining why Rectiv is the appropriate treatment for your condition. Include documentation of your diagnosis, symptom severity, and any other treatments you've tried.
For many patients, the most practical way to save money is to skip brand-name Rectiv entirely and use compounded Nitroglycerin ointment instead. This is the same active ingredient, prepared by a compounding pharmacy.
Cost comparison:
That's a savings of $400 to $800 or more per tube. For a medication you may need to use for three weeks or longer, this difference is substantial.
How to get compounded Nitroglycerin:
Keep in mind: Compounded medications are not FDA-approved and may not be covered by insurance. However, even at full cash price, they are dramatically cheaper than brand-name Rectiv.
For more on this option, see: Alternatives to Rectiv if you can't fill your prescription
Rectiv prices vary significantly from one pharmacy to another. Before filling your prescription, compare prices at:
Use tools like MedFinder to check which pharmacies have Rectiv in stock, then call to compare prices. Even among pharmacies that carry it, prices can differ by hundreds of dollars.
If cost is a major barrier and compounded Nitroglycerin is still too expensive, ask your doctor about topical Diltiazem 2%. This is a different medication that also treats chronic anal fissures by relaxing the anal sphincter. It's typically compounded for $30-$80 and has fewer headaches than Nitroglycerin.
While it's not the same medication as Rectiv, it may be equally effective for your condition. Your doctor can help you decide if it's appropriate.
For a full comparison of alternatives, read: Alternatives to Rectiv if you can't fill your prescription
Rectiv's high price doesn't mean you can't afford treatment for your chronic anal fissure. Start by comparing prices with discount cards and checking whether you qualify for manufacturer or patient assistance programs. If brand-name Rectiv is simply too expensive, compounded Nitroglycerin ointment offers the same active ingredient at a fraction of the cost.
Use MedFinder to find pharmacies that carry Rectiv, and don't hesitate to talk to your doctor about the most affordable treatment option for your situation. Relief from anal fissure pain shouldn't be out of reach because of cost.
You focus on staying healthy. We'll handle the rest.
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