Nitrocard 2.6mg Tablet 1 Strip

✔️ Important Safety Advice

• Nitrocard may cause sleepiness or dizziness. Avoid driving or operating machinery until you know how the medication affects you.
• Alcohol can intensify the dizziness and blood pressure-lowering effects of Nitrocard. Avoid consuming alcohol while on this medication.
• Headaches are a common side effect, especially at the start of treatment. These usually subside with continued use. Contact your doctor if they persist.
• Continuous use may lead to tolerance, reducing the drug’s effectiveness over time. Always follow the prescribed schedule to minimize this risk.
• Avoid using Nitrocard alongside erectile dysfunction medications such as sildenafil or tadalafil, as the combination may cause a significant drop in blood pressure.

✔️ Common Side Effects of Nitrocard 2.6

• Headache
• Dizziness and lightheadedness
• Blurred vision
• Low blood pressure (hypotension)
• Fast heart rate (tachycardia)
• Tingling or prickling sensation (paresthesia)

✔️ Administration Guidelines: Nitrocard 2.6

• Take Nitrocard exactly as directed by your physician.
• Swallow tablets whole; do not crush, chew, or break them.
• It can be taken with or without food, but ideally at the same time daily for best results.

✔️ Adult Dosage Guidelines: Nitrocard 2.6

Oral (Sustained-Release Tablet/Capsule) – Stable Angina

• Initial dose: 2.6 mg to 6.4 mg, taken three to four times daily
• Dose adjustments: Titrate based on clinical response
• Maximum dose: 26 mg, up to four times daily

Sublingual Tablet

For Acute Relief of Angina Pectoris:

• 0.5 mg under the tongue every 5 minutes, up to 3 doses
• Administer at the onset of chest pain

For Angina Prophylaxis (Before Exertion):

• Take 1 tablet sublingually 5 to 10 minutes prior to physical activity likely to provoke angina

✔️ Renal Dose Adjustment

Creatinine Clearance (CrCl) 10–50 mL/min:

Administer every 24 to 72 hours

CrCl <10 mL/min:

Administer every 72 to 96 hours

✔️ Drug Interactions

• Glyceryl trinitrate can increase the absorption and effects of dihydroergotamine.
• Intravenous administration may prolong the neuromuscular blocking action of pancuronium.
• Co-administration with heparin, alteplase, or noradrenaline may diminish their effectiveness.
• Drugs that cause dry mouth may reduce the effectiveness of buccal or sublingual nitrate formulations by limiting dissolution.
• Aspirin and other NSAIDs might interfere with the therapeutic action of glyceryl trinitrate.
• ⚠️ Potentially life-threatening interaction: Concurrent use with calcium channel blockers, antihypertensive agents, phenothiazines, or tricyclic antidepressants (TCAs) can cause severe orthostatic hypotension.
• Alcohol can significantly amplify the risk of severe low blood pressure and collapse.

✔️ Avoid use in patients with:

• Known allergy to glyceryl trinitrate or related compounds
• Severe hypotension or heart failure
• Significant anaemia
• Hypertrophic obstructive cardiomyopathy
• History of cerebral bleeding or head trauma
• Low cardiac output due to hypovolemia
• Right ventricular infarction (especially with inferior myocardial infarction)
• Increased intracranial pressure
• Concurrent use of phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil) due to the risk of extreme hypotension

✔️ Use with caution in patients with:

• Severe liver or kidney dysfunction
• Thyroid disorders, such as hypothyroidism
• Malnutrition or hypothermia
• Cerebrovascular disease or chronic lung condition,s including cor pulmonale
• Mitral valve prolapse or cardiac tamponade
• History of fainting (syncope)
• Pregnancy or breastfeeding — safety in lactation is unclear; use only if needed
• Patients who have been on prolonged high-dose nitrate therapy should have the dose tapered gradually to prevent withdrawal effects
• Avoid prolonged or excessive drops in blood pressure
• A nitrate-free interval is recommended during chronic therapy to help prevent the development of tolerance

✔️ Storage:

Store below 25°C. Do not freeze. Keep all medicines out of reach of the children.