Nitroglycerin sublingual tablets 0.5 mg container 40 pcs

Nitroglycerin (1,2,3-propanetriol trinitrate) is an antianginal drug that promotes the formation of nitric oxide in smooth muscles. It reduces preload on the heart by dilating peripheral veins. Reduced blood flow to the right atrium helps reduce pressure in the pulmonary circulation. The drug reduces afterload on the heart by dilating arteries. It reduces myocardial oxygen demand by reducing preload and afterload. In addition, the drug promotes redistribution of coronary blood flow in areas with reduced blood circulation. It increases tolerance to exercise in patients with coronary artery disease and angina.

With sublingual administration, therapeutic plasma concentrations are reached within a few minutes. Bioavailability is 100%. Metabolized in the liver with the participation of nitrate reductase. Binding to plasma proteins is 60%. The half-life with sublingual administration is 20 minutes. Excreted mainly by the kidneys.

Relief of angina attacks; myocardial infarction (as part of complex therapy); acute left ventricular failure (as part of complex therapy).

It is applied sublingually. The dose and treatment regimen are set individually depending on the indications and the specific clinical situation.

When stopping angina attacks: immediately after the onset of pain, one tablet is placed under the tongue and kept in the mouth until completely dissolved, without swallowing. Usually, the antianginal effect appears after 0.5-2 minutes. If there is no antianginal effect within 3-5 minutes, another tablet should be taken.

Shock, collapse, hypertension (systolic blood pressure below 100 mm Hg, diastolic blood pressure below 60 mm Hg), acute myocardial infarction with low left ventricular filling pressure, hypertrophic obstructive cardiomyopathy, increased intracranial pressure (including hemorrhagic stroke, after recent head injury), angle-closure glaucoma with high intraocular pressure, hypersensitivity to nitrates, simultaneous use with sildenafil.

Dizziness, headache, tachycardia, hyperemia of the skin, feeling of heat, arterial hypotension are possible; rarely (in case of overdose) collapse, cyanosis; nausea, vomiting; in some cases – allergic reactions (skin rash, itching).

Use with caution in patients with severe cerebral atherosclerosis, cerebral circulation disorders, with a tendency to orthostatic hypotension, with severe anemia, in elderly patients, as well as with hypovolemia and severe liver and kidney function disorders. Avoid drinking alcohol during treatment. Nitroglycerin may reduce the speed of psychomotor reactions, which should be taken into account when driving vehicles or engaging in other potentially dangerous activities.

The use of nitroglycerin during pregnancy and breastfeeding is possible only if the expected benefit to the mother outweighs the potential risk to the fetus or infant.

With simultaneous use with other vasodilators, ACE inhibitors, calcium channel blockers, β-adrenoceptor blockers, diuretics, tricyclic antidepressants, MAO inhibitors, sildenafil, ethanol and ethanol-containing drugs, there is an increase in the hypotensive effect of nitroglycerin; with β-blockers, calcium antagonists – an increase in the antianginal effect; with dihydroergotamine – an increase in its concentration in the blood plasma is possible. The use of nitroglycerin simultaneously with quinidine or novocainamide can cause orthostatic collapse.

Symptoms – headache, dizziness, tachycardia, nausea and vomiting, hypotension, feeling of heat or chills, increased sweating, dyspnea, increased intracranial pressure (cerebral symptoms up to the development of seizures and coma), methemoglobinemia (cyanosis and tachypnea).

Treatment – give the patient a horizontal position (legs are raised above the level of the head), administer plasma substitutes, sympathomimetics, and give oxygen. To eliminate methemoglobinemia, the drug of choice is methylene blue.

In a cool, dry place, protected from light.