Nidocard (50mg/10ml) Injection

✔️ Side Effects:

• Headache
• Dizziness
• Lightheadedness
• Low blood pressure
• Increased heart rate
• Blurred vision
• Flushing
• Tingling or prickling sensation (paresthesia)
• Nausea and vomiting
• Dry mouth
• Nervousness

✔️ How to Use Nidocard

• Take Nidocard exactly as directed by your doctor.
• For oral preparations:
• Swallow the tablet or capsule whole.
• Do not chew, crush, or break modified-release formulations.
• It may generally be taken with or without food.
• Try to take it at the same time each day when using a scheduled preparation.
• For sublingual tablets or spray, use the medicine under or onto the tongue according to the prescribed instructions. Do not swallow or inhale the spray.

✔️ Nidocard may interact with several medicines, including:

• PDE-5 inhibitors such as sildenafil and tadalafil — potentially severe or life-threatening hypotension
• Calcium channel blockers
• Other antihypertensive medicines
• Phenothiazines
• Tricyclic antidepressants
• Alcohol
• Aspirin and other NSAIDs
• Dihydroergotamine
• Heparin
• Alteplase
• Noradrenaline
• Pancuronium
• Medicines that cause dry mouth may reduce the effectiveness or dissolution of buccal and sublingual preparations.
• Combining nitrates with alcohol or other blood-pressure-lowering medicines can produce excessive hypotension, dizziness, fainting, or collapse.

✔️ Words of Advice:

• Nidocard may cause headache, dizziness, or lightheadedness, particularly when treatment begins.
• Avoid driving or operating machinery if you feel dizzy or your concentration is affected.
• Avoid alcohol because it can increase dizziness and may cause a significant fall in blood pressure.
• Headaches may become less troublesome after several days, but inform your doctor if they are severe or persistent.
• Long-term nitrate treatment can cause tolerance, meaning the medicine may become less effective. Follow the prescribed dosing schedule and any recommended nitrate-free interval.
• Do not use sildenafil, tadalafil, or other PDE-5 inhibitors with Nidocard unless specifically instructed by your doctor.
• Stand up slowly from a sitting or lying position to reduce the risk of dizziness or fainting.
• If sublingual Nidocard is being used for an acute angina attack and the chest pain does not improve after the prescribed doses, seek emergency medical attention.
• Inform your doctor if you are pregnant, planning pregnancy, or breastfeeding.

✔️ Nidocard should generally not be used in patients with:

• Hypersensitivity to glyceryl trinitrate or other nitrates
• Severe hypotension
• Marked anemia
• Hypertrophic obstructive cardiomyopathy
• Increased intracranial pressure
• Cerebral hemorrhage or recent head trauma
• Low cardiac output due to hypovolemia
• Inferior myocardial infarction with right ventricular involvement
• Concomitant use of PDE-5 inhibitors such as sildenafil or tadalafil
• Use in glaucoma or other conditions involving increased intraocular pressure requires medical assessment.

✔️ Dosage & Administration

Adult Dose

Stable Angina – Sustained-Release Oral Formulation:
Adults: 2.6–6.4 mg, 3–4 times daily, adjusted according to clinical response. Maximum: 26 mg four times daily, as prescribed.

Acute Angina – Sublingual Tablet:
Adults: 0.5 mg under the tongue every 5 minutes as required, up to 3 doses. Use at the first sign of an angina attack. If pain persists after the recommended doses, seek emergency medical care.

Angina Prophylaxis – Sublingual Tablet:
One tablet under the tongue 5–10 minutes before activities likely to trigger angina, according to medical advice.

Acute Angina – Sublingual Spray:
Adults: 1–2 sprays when required. The dose may be repeated every 3–5 minutes, but should not exceed 3 sprays within 15 minutes. Spray onto or under the tongue without inhaling. Do not rinse the mouth immediately after use.

Angina Prophylaxis – Sublingual Spray:
1–2 sprays approximately 5–10 minutes before an activity expected to provoke angina.

Acute Myocardial Infarction – Intravenous Infusion:
Adults: Initially 10–100 micrograms/minute, beginning at the lower rate and gradually adjusting according to response under close medical supervision.

Controlled Hypotension / Hypertension During Surgery – Intravenous Infusion:
Initially 5–25 micrograms/minute, adjusted according to response. The usual range is 10–200 micrograms/minute; higher doses may occasionally be required in specialist settings.

Renal Dose

Dose adjustment may be required in renal impairment. The appropriate dosing interval depends on the formulation, indication, and severity of renal dysfunction. Patients with significant renal impairment should be treated under medical supervision.

✔️ Use Nidocard carefully in patients with:

• Severe liver or kidney impairment
• Hypothyroidism
• Malnutrition
• Hypothermia
• Cerebrovascular disease
• Significant lung disease or cor pulmonale
• Glaucoma
• Mitral valve prolapse
• Cardiac tamponade
• A history of syncope
• Pregnancy or breastfeeding

✔️ Pregnancy & Lactation

If you are pregnant, planning to become pregnant, or breastfeeding, consult your doctor before using Nidocard. It is not fully established whether glyceryl trinitrate passes into breast milk, so breastfeeding use should be considered only after medical evaluation.

✔️ Storage Conditions

Store Nidocard according to the manufacturer's instructions, away from excessive heat, moisture, and direct light. Keep it out of the reach of children. Do not use the medicine after its expiry date.