Meds and you

27 September 2013

Nitroglycerin

Nitroglycerin is a nitrate vasodilator. Nitrate vasodilators are drugs that widen and relax blood vessels to reduce the workload on the heart.

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Nitroglycerin is the active ingredient of Nitrolingual spray (Nappi code : 787256-005).

General information
Nitroglycerin is a nitrate vasodilator. Nitrate vasodilators are drugs that widen and relax blood vessels to reduce the workload on the heart, and thereby also improve the supply of oxygen-rich blood to the heart.

In South Africa nitroglycerin is registered for the prevention or treatment of acute angina, a suffocating chest pain, which results when partially clogged arteries restrict the flow of oxygen-rich blood to the heart; and chronic heart failure, a condition where the heart can no longer pump enough blood to the body.

If you develop chest pain during exercise, taking nitroglycerin before exercise will increase the amount of exercise you can do before chest pain begins.

Nitroglycerin does not cure any of these conditions, but merely keeps its symptoms under control. For this drug to be effective, it has to be taken regularly.

The first few doses of this drug may cause dizziness if you get up suddenly from sitting or lying down. It is advised to get up carefully until you know how this drug affects you.

Treatment should not be stopped abruptly, especially if you have been taking this drug for a prolonged period of time. To prevent the return of symptoms you should decrease your dose gradually only as directed by your doctor.

How does nitroglycerin work?
Vasodilators relax smooth muscle within blood vessels via a direct effect it has on these arterial muscles. As a result it widens and relaxes blood vessels to reduce the workload on the heart, and to increase the supply of oxygen-rich blood to the heart. This leads to chest pain subsiding.

Fast facts

Drug schedule: schedule 3
Available as: nitroglycerin is available as an oral spray and as an intravenous solution.
What does it do? Nitroglycerin widens blood vessels to reduce chest pain.
Overdose risk: medium
Dependence risk: low
Is nitroglycerin available as a generic? no
Is nitroglycerin available on prescription only? yes

User information

Onset of effect: the spray takes effect within minutes.
Duration of action: the spray has a short action and its effect may last up to 2 hours
Stopping this medicine: the decision to stop using this drug should only be made after consulting your doctor.
Prolonged use: some patients may develop a tolerance to the effect of nitroglycerin, which causes its effects to be reduced over time. Speak to your doctor if you suspect your treatment to be losing it efficacy.

Special precautions
Consult your doctor before using this drug if:

  • you have anaemia
  • you have glaucoma
  • you have history of a head injury
  • you have history of heart attack
  • you have low blood pressure
  • you have an underactive thyroid
  • you are taking any other medication

Pregnancy: avoid. It is unknown how this product may affect your baby. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.
Porphyria: this medication is safe for use.
Infants and children: this medication is not intended for use in children.
The elderly: no special precautions need to be taken.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.
Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effects

Side Effect
Frequency
Consult your doctor

Common
Rare
Only if severe
In all cases
headache
X

X

dizziness
X

X

flushing
X

X

fainting

X
X

heart rhythm disturbances

X
X

nausea and vomiting

X
X

skin rash

X

X
eye pain

X

X

Interactions

Drug interactions

alcohol reduced blood pressure - risk of dizziness and fainting
medication for high blood pressure reduced blood pressure - risk of dizziness and fainting
aspirin risk of increased GTN side effects
heparin Blood-clotting effect of heparin is reduced
sildenafil causes life-threatening lowering of blood pressure and should be avoided at all times when taking nitrates
sumatriptan possible vasospasm of coronary arteries which may worsen angina

Overdose action
A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

Recommended dosage
Adults, sublingual: 1 - 3 sprays under the tongue within 2 minutes. Do not inhale the spray.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 
 

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