Spray Manufacturer/Distributor: Square Pharmaceuticals Ltd. Generic Name: Glyceryl Trinitrate 400 mcg/Metered Inhalation Spray
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Indications
Angina pectoris caused by coronary artery disease is treated with nitroglycerin sublingual spray for immediate relief or prevention.
Pharmacology
Nitroglycerin's main pharmacological function is to relax vascular smooth muscle, resulting in a vasodilator effect on both peripheral arteries and veins, with the latter having a stronger effect. The dilation of post-capillary arteries, such as big veins, promotes peripheral blood pooling and reduces venous return to the heart, lowering left ventricular enddiastolic pressure (pre-load). Arteriolar relaxation lowers arterial pressure and lowers systemic vascular resistance (after-load).
Dosage & Administration
At the onset of an attack, 1 or 2 metered sprays should be administered under the tongue. No more than 3 metered sprays are recommended within a 15 minute period. If the chest pain persists, prompt medical attention is recommended. Nitroglycerin spray may be used prophylactically 5 to 10 minutes prior to engaging in activities which might precipitate an acute attack.
Interaction
When alcohol is used with Nitroglycerin, it can cause severe hypotension and collapse. Oral Nitroglycerin may improve dihydroergotamine bioavailability. When calcium channel blockers, phenothiazines, and tricyclic antidepressants are taken together, orthostatic hypotension can occur.
Contraindications
Hypersensitivity to nitrates or any other formulation component. Hypertrophic obstructive cardiomyopathy causes hypotension, hypovolemia, severe anemia, cerebral haemorrhage and brain damage, mitral stenosis, and angina. Phosphodiesterase inhibitors for the treatment of erectile dysfunction are given at the same time.
Side Effects
Headache, face flushing, dizziness, nausea, vomiting, feelings of weakness, postural hypotension, and reflex tachycardia are all possible nitrate side effects.
Pregnancy & Lactation
Pregnancy Classification C. In pregnant women, there are no sufficient and well-controlled trials. Nitroglycerin should only be administered to pregnant women if absolutely necessary. Whether nitroglycerin is secreted in human milk is unknown. Because many medicines are secreted in human milk, care should be used while administering Nitroglycerin spray to a nursing mother.
Precautions & Warnings
When using Nitroglycerin in the early stages of acute myocardial infarction, it's important to pay close attention to hemodynamics and clinical condition. In individuals with substantially compromised renal or hepatic function, hypothyroidism, malnutrition, or hypothermia, nitroglycerin should be taken with caution.
Storage Conditions
Store in a cool and dry place away from light and heat. Keep all medicines out of the reach of children.
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