Nitro SR 2.6 Tablet, 1 Strip

✔️ Possible Side Effects | Nitro SR 2.6

• Headache
• Dizziness or lightheadedness
• Blurred vision
• Low blood pressure
• Increased heart rate
• Tingling or pricking sensation (paresthesia)

Most side effects are mild and improve as your body adjusts to the medicine. Inform your doctor if symptoms persist or worsen.

✔️ Words of Advice:

• Nitro SR 2.6 may cause dizziness; avoid driving or operating machinery until you know how it affects you.
• Avoid alcohol, as it can increase dizziness and the risk of low blood pressure.
• Headaches are common at the start of treatment and usually subside with continued use.
• Long-term use may lead to tolerance; follow your doctor’s dosing schedule carefully.
• Do not use erectile dysfunction medicines (such as sildenafil or tadalafil) while taking Nitro SR 2.6, as this may cause a dangerous drop in blood pressure.

✔️ Dosage & Administration | Nitro SR 2.6

Adult Dosage (Summary)

Sustained-release tablets/capsules (Stable Angina):
2.6–6.4 mg, 3–4 times daily; dose adjusted according to response
Maximum: 26 mg, 4 times daily

Sublingual tablets (Acute Angina Relief):
0.5 mg under the tongue every 5 minutes, up to 3 doses

Sublingual spray:
1–2 sprays as needed; may repeat every 3–5 minutes (maximum 3 sprays in 15 minutes)

Intravenous use (hospital setting):
Dosage adjusted based on clinical response and condition

Use in Kidney Disease

Creatinine clearance 10–50 mL/min: Dose may be given every 24–72 hours

Creatinine clearance <10 mL/min: Dose interval may be extended to every 72–96 hours

✔️ Nitro SR (glyceryl trinitrate) is contraindicated in patients with:

• Known hypersensitivity to nitrates or any component of the formulation
• Severe hypotension
• Acute or chronic heart failure
• Marked anemia
• Hypertrophic obstructive cardiomyopathy
• Cerebral hemorrhage or recent head injury
• Low cardiac output due to hypovolemia
• Inferior myocardial infarction with right ventricular involvement
• Raised intracranial pressure
• Concomitant use of phosphodiesterase type-5 inhibitors (e.g., sildenafil, tadalafil)

✔️ Use During Lactation

It is not known whether glyceryl trinitrate passes into breast milk. Use during breastfeeding should be approached with caution and only if clearly needed.

✔️ Use Nitro SR with caution in patients with:

• Severe hepatic or renal impairment
• Hypothyroidism
• Malnutrition or hypothermia
• Cerebrovascular disease
• Chronic lung disease or cor pulmonale
• Pregnancy and lactation
• Glaucoma
• Mitral valve prolapse
• Cardiac tamponade
• History of syncope

Patients receiving high-dose or prolonged infusions should have the medicine withdrawn gradually to avoid rebound effects. Excessive or prolonged hypotension should be avoided.

To reduce the risk of nitrate tolerance, a nitrate-free interval is recommended during continuous therapy.

✔️ Drug Interactions

May increase the bioavailability of dihydroergotamine

Intravenous glyceryl trinitrate may prolong pancuronium-induced neuromuscular blockade

May reduce the effectiveness of heparin, alteplase, and noradrenaline when used concurrently

Drugs that cause dry mouth may reduce the effectiveness of buccal and sublingual nitrate preparations

Aspirin and other NSAIDs may decrease the therapeutic response to glyceryl trinitrate

Potentially Serious Interactions

Severe orthostatic hypotension may occur when used with:

• Calcium channel blockers
• Antihypertensive agents
• Phenothiazines
• Tricyclic antidepressants (TCAs)

Alcohol may cause profound hypotension, dizziness, or collapse and should be avoided

✔️ Storage:

Store in a cool and dry place away from sunlight. • Keep out of sight and reach of children.