Nitroglycerin sublingual tablets 0.5mg №10×4

Name Nitroglycerin tabl p/z. The main active ingredient Nitroglycerin Release form Tablets Dosage 0.5 mg Indications for use Relief and short-term prevention of angina attacks. Method of administration and doses The attending physician sets the dose and treatment regimen individually, depending on the patient’s sensitivity to nitroglycerin preparations, indications, and the specific clinical situation. With caution, the drug should be used for severe violations of the liver and / or kidneys. The usual dose of the drug for angina pectoris is 1 tablet under the tongue, in many patients with stable angina, the effect also occurs from a smaller dose (1/2-1/3 tablets), therefore, if the pain passes quickly, it is recommended to spit out the rest of the tablet that has not had time to resolve . Usually, the antianginal effect appears after 0.5-2 minutes; 75% of patients report improvement within the first 3 minutes; and another 15% – within 4-5 minutes. In the absence of a therapeutic effect during the first 5 minutes, it is necessary to take another tablet of the drug. In the absence of a therapeutic effect after 2-3 times of administration, it is necessary to call a doctor (the likelihood of developing a myocardial infarction). The duration of action of nitroglycerin is about 45 minutes. Tolerance to sublingual forms of nitroglycerin rarely develops, however, when it occurs in some patients, the dose of the drug has to be gradually increased, bringing it up to 2-3 tablets. Use during pregnancy and lactation The safety of use during pregnancy and lactation has not been proven. During pregnancy and breastfeeding, taking the drug is possible only if the expected benefit to the mother outweighs the possible risk to the fetus or child. Precautions Before using the drug for the first time, you should consult your doctor! While taking the drug, a significant decrease in blood pressure is possible, the appearance of dizziness with a sharp transition to a vertical position from a “lying” or “sitting” position, while drinking alcohol, doing physical exercises and hot weather. With frequent use of nitroglycerin, addiction may develop, requiring an increase in dosage. The severity of headache while taking the drug can be reduced by reducing its dose and / or concomitantly taking Validol. During the treatment period, alcohol is not allowed. Use with caution in cerebrovascular pathology, severe liver or kidney disease, hypothyroidism, hypoxemia, recent myocardial infarction, primary pulmonary hypertension, migraine, a tendency to develop orthostatic hypotension, malnutrition, deficiency of methemoglobin reductase, glucose-6-phosphate dehydrogenase. To prevent hypotension, it is recommended to take nitroglycerin in the supine or sitting position. Taking nitroglycerin in a standing position can not only contribute to fainting, but also to a weakening of the antianginal effect, the development of the “steal” syndrome (increased myocardial ischemia), especially in patients with widespread atherosclerosis of the coronary vessels. If the symptoms of angina do not go away after taking three doses of the drug, the patient should immediately consult a doctor. In order to prevent the development of tolerance, it is recommended to maintain an interval between taking nitrates daily (8-12 hours). In the event of the development of tolerance, you should temporarily stop taking the drug (for several days) and replace it with antianginal agents of other pharmacotherapeutic groups. The storage conditions of the drug should be strictly observed. If the integrity of the package or storage conditions are violated, the effectiveness of the drug may decrease. Due to the lactose content, the drug is contraindicated in patients with rare congenital galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Features of use in elderly patients When using nitrates in the elderly, the risk of developing adverse reactions such as hypotension and fainting increases. In this category of patients, the drug is recommended to be taken with caution, if possible, in a sitting or lying position. Use in children The drug is contraindicated in children due to the lack of data on efficacy and safety. Interaction with other drugs The hypotensive effect of the drug may be excessive in the case of uncontrolled simultaneous administration of antihypertensive drugs, tricyclic antidepressants, alcohol, diuretics, beta-blockers, monoamine oxidase inhibitors (MAOIs). With caution, nitroglycerin with procainamide should be taken, since it is possible to increase the hypotensive effect and the development of collapse. The combined use of nitroglycerin with phosphodiesterase type 5 inhibitors, which are used to treat erectile dysfunction or pulmonary hypertension, is strictly contraindicated due to the risk of severe hypotension. The use of nitroglycerin is possible not earlier than 24 hours after taking drugs containing sildenafil and vardenafil, not earlier than 48 hours after taking drugs containing tadalafil. N-acetylcysteine may enhance the vasodilating effect of nitroglycerin. The likelihood of developing tolerance increases when used in combination with long-acting nitrate preparations. Drugs that cause dry mouth (eg, anticholinergics, antimuscarinics) may decrease the effectiveness of sublingual nitrates by reducing absorption. The anticoagulant effect of heparin may be reduced when used concomitantly with nitrates. Early and frequent monitoring of the effectiveness of anticoagulant therapy is recommended in combination therapy with nitrates and heparin. An increase in the hypotensive effect of apomorphine may occur as a result of the concomitant use of nitroglycerin. Ergot alkaloids, by inhibiting nitrate-induced coronary vasodilation, may exacerbate angina pectoris. Nitroglycerin may reduce the first pass effect and metabolism of dihydroergotamine. Contraindications Hypersensitivity to the active substance, to other nitrates, or to any of the excipients; arterial hypotension (systolic pressure less than 90 mm Hg); vascular collapse; angle-closure glaucoma; shock; acute myocardial infarction with low filling pressure of the left ventricle; toxic pulmonary edema; hemorrhagic stroke; conditions accompanied by a decrease in the filling pressure of the left ventricle (isolated mitral stenosis, constrictive pericarditis); hypertrophic cardiomyopathy; simultaneous reception with phosphodiesterase inhibitors (for example, sildenafil, vardenafil, tadalafil); anemia, increased intracranial pressure (including after traumatic brain injury), bradycardia, cardiac tamponade, aortic stenosis. Pregnancy, breastfeeding, childhood. Composition Each tablet contains: nitroglycerin (in the form of nitroglycerin with glucose) – 0.5 mg; excipients: potato starch, microcrystalline cellulose, anhydrous colloidal silicon dioxide, calcium stearate, lactose monohydrate. Overdose Symptoms: severe arterial hypotension, tachycardia, collapse, cyanosis, methemoglobinemia. Treatment: in case of collapse, the patient should take a horizontal position with legs raised up. With methemoglobinemia, intravenous administration of methylene blue is indicated (an average of 0.1-0.15 ml of a 1% solution per 1 kg of body weight). In severe cases, plasma substitutes, sympathomimetics, oxygen are prescribed. Side effects From the side of the central nervous system: blurred vision, headache (especially at the beginning of the course of treatment, decreases with prolonged therapy), dizziness and a feeling of weakness, restlessness, fainting, drowsiness, cerebral ischemia. From the side of the cardiovascular system: arterial hypotension, reddening of the skin of the face, tachycardia, bradycardia, vascular collapse. Sometimes, with a sudden decrease in blood pressure, there may be an increase in angina symptoms (paradoxical “nitrate reactions”). From the digestive tract: a slight burning sensation in the oral cavity, rarely – nausea, vomiting, heartburn. From the hemopoietic system: rarely – methemoglobinemia, cyanosis. Other: allergic reactions are possible; rarely – exfoliative dermatitis, increased intraocular pressure; with prolonged use of the drug in high doses – drug withdrawal syndrome; development of tolerance. Storage conditions In a place protected from moisture and light at a temperature not exceeding 25 ° C. Keep out of the reach of children. Buy Nitroglycerin sublingual tablets 0.5mg No. 10×4 Price for Nitroglycerin sublingual tablets 0.5mg No. 10×4