Nitroglycerin, 0.5 mg 40 pcs

Dilates blood vessels (mainly coronary/cardiac arteries and brain vessels), relaxes smooth muscles of the gastrointestinal tract, biliary tract and other organs.

Along with decreasing resistance of coronary and peripheral vessels, nitroglycerin decreases venous return of blood to the heart, contributes to redistribution of blood flow in the myocardium (heart muscle) in favor of the focus of ischemia and reduction of ischemic lesions in myocardial infarction, increases inotropic (contractile) myocardial function.

Like other organic nitrates, nitroglycerin improves metabolic processes (metabolism) in the myocardium and reduces myocardial oxygen demand.

Indications

For sublingual and buccal use: control and prevention of angina attacks; as an emergency remedy for acute myocardial infarction and acute left ventricular failure in the pre-hospital phase.

For oral administration: relief and prevention of angina attacks, rehabilitation treatment after myocardial infarction.

Intravenous administration: acute myocardial infarction, including those complicated by acute left ventricular failure; unstable angina pectoris; pulmonary edema.

For topical application: prophylaxis of angina attacks.

Active ingredient

Composition

On one tablet:

the active ingredient:

Nitroglycerin with dextrose (nitroglycerin with glucose) – 0.5 mg (in terms of 100% substance);

auxiliary substances:

aspartame – 0.3 mg,

colloidal silica (aerosil) – 0.9 mg,

stearic acid – 0.4 mg,

croscarmellose sodium – 1.0 mg,

potato starch – 2.6 mg,

microcrystalline cellulose – 34.8 mg.

How to take, the dosage

The tablet (half or whole) is placed under the tongue and not swallowed (held in the mouth until completely absorbed).

Interaction

Concomitant use with vasodilators, ACE inhibitors, calcium channel blockers, beta-adrenoblockers, diuretics, tricyclic antidepressants, MAO inhibitors, ethanol, ethanol-containing drugs may increase the hypotensive effect of glyceryl trinitrate.

Concomitant use with beta-adrenoblockers, calcium channel blockers increases the antianginal effect.

Concomitant use with sympathomimetics may decrease the antianginal effect of glyceryl trinitrate, which in turn may decrease the pressor effect of sympathomimetics (resulting in possible arterial hypotension).

When concomitant use of agents with anticholinergic activity (including tricyclic antidepressants, disopyramide) hyposalivation and dry mouth occur.

There is limited evidence that acetylsalicylic acid used as an analgesic increases the plasma concentration of nitroglycerin (glyceryl trinitrate). This may be accompanied by increased hypotensive effect and headaches.

A number of studies have observed a decrease in the vasodilatory effect of nitroglycerin (glyceryl trinitrate) with prolonged therapy with acetylsalicylic acid.

It is believed that the antiplatelet effect of acetylsalicylic acid may be enhanced with nitroglycerin (glyceryl trinitrate).

In concomitant use with nitroglycerin the effects of acetylcholine, histamine, norepinephrine are reduced.

Against the background of IV administration of nitroglycerin, the anticoagulant effect of heparin may be reduced.

Concomitant use may increase the bioavailability of dihydroergotamine and decrease the antianginal effect of nitroglycerin (glyceryl trinitrate).

Concomitant use with novocainamide may increase the hypotensive effect and develop collapse.

Concomitant use with rizatriptan, sumatriptan increases the risk of coronary artery spasm; with sildenafil – risk of severe arterial hypotension and myocardial infarction; with quinidine – possible orthostatic collapse; with ethanol – sudden weakness and dizziness.

Special Instructions

With caution is used in patients with severe cerebral atherosclerosis, cerebral circulatory disorders, susceptibility to orthostatic hypotension, severe anemia, elderly patients as well as in hypovolemia and severe liver and renal function disorders (parenterally).

The development of tolerance to the effect of nitrates is possible with long-term use. To prevent tolerance, a 10-12 hour break of their use during each 24-hour cycle is recommended.

If an attack of angina occurs when nitroglycerin (glyceryl trinitrate) is used topically, it should be stopped by taking glyceryl trinitrate under the tongue.

At the time of treatment, alcohol should be avoided.

Impact on driving and operating machinery

Glyceryl trinitrate may decrease the speed of psychomotor reactions, which should be considered when driving vehicles or engaging in other potentially dangerous activities.

Contraindications

Side effects

Cardiovascular system: dizziness, headache, tachycardia, skin hyperemia, fever, arterial hypotension; rarely (especially in overdose) – collapse, cyanosis.

Digestive system disorders: nausea, vomiting.

CNS disorders: rarely (especially in overdose) – anxiety, psychotic reactions.

Allergic reactions: rare – skin rash and itching.

Local reactions: mild itching, burning, redness of the skin.

Others: methemoglobinemia.

Overdose

Symptoms: BP decrease (below 90 mmHg) with orthostatic dysregulation, severe dizziness, headache, fainting, shortness of breath, marked weakness, palpitations, increased body temperature, seizures, asthenia, somnolence. When using high doses – collapse, cyanosis, methemoglobinemia, dyspnea and tachypnea.

Treatment: if symptoms of overdose occur, immediately lay the patient down, elevate the legs and call a physician immediately.

Similarities