Nitrofix, an organic nitrate, is a vasodilator that has effects on both arteries and veins. This is a metered dose spray containing Nitrofix. Nitrofix delivers Nitrofix (400 mcg per spray, 200 metered sprays) in the form of spray droplets under the tongue.
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The principal pharmacological action of nitroglycerin is relaxation of vascular smooth muscle, producing a vasodilator effect on both peripheral arteries and veins, with more prominent effects on the latter. Dilation of the post-capillary vessels, including large veins, promotes peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular enddiastolic pressure (preload). Arteriolar relaxation reduces systemic vascular resistance and arterial pressure (afterload).
Nitroglycerin forms free radical nitric oxide (NO), which activates guanylate cyclase, resulting in an increase of guanosine 3’5’-monophosphate (cyclic GMP) in smooth muscle and other tissues. This eventually leads to dephosphorylation of myosin light chains, which regulates the contractile state in smooth muscle and results in vasodilation.
Spray: At the onset of an attack, one metered dose spray or two metered dose sprays should be administered under the tongue. A spray may be repeated approximately every 5 minutes as needed. A maximum of 3 metered sprays is recommended within 15 minutes. If chest pain persists after a total of 3 sprays, prompt medical attention is recommended. May be used prophylactically 5 minutes to 10 minutes before engaging in activities that might precipitate an acute attack.
Patients receiving antihypertensive drugs, beta-adrenergic blockers or phenothiazines and nitrates should be observed for possible additive hypotensive effects. Concomitant use of nitrates and alcohol may cause hypotension. The vasodilatory and hemodynamic effects of Nitrofix may be enhanced by concomitant administration of Aspirin.
It is contraindicated for patients who are using PDE5 inhibitors (Sildenafil, Vardenafil & Tadalafil), patients who have severe anemia, increased intracranial pressure, hypersensitivity to it or to other nitrates or nitrites & acute circulatory failure or shock.
There is no evidence relating to the safety of nitrates in pregnancy and lactation. Nitrates should be administered to pregnant women and nursing mothers unless considered essential by the physician. It is not known whether Nitroglycerin is excreted in human milk.
Only the smallest dose is required for effective control of the acute anginal attack. Excessive use may lead to
the development of tolerance. Nitrofix should be used with caution in patients who may be volume-depleted or are already hypotensive.
The most common adverse reactions are headache, flushing, and hypotension.
Priming of Nitroglycerin Spray: Before you use Nitroglycerin Spray for the first time, you must prime it. To prime your Nitroglycerin Spray, follow the steps below:
Giving a dose of Nitroglycerin Spray:
Special Instruction:
Keep out of reach of children. Store in a dry place, below 25°C temperature and protected from light.
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