Nitro-Mik sublingual spray doz.0.4 mg/ doses 15 ml. (300 doses )

Description

Nitro-Mik composition and form of release
Main active ingredient: nitroglycerin.
Excipients: propylene glycol, ethanol 96%, purified water.

Release form
It is produced in the form of a sublingual metered spray, in 15 ml vials, which contains 300 doses of the drug. 1 dose contains 0.4 mg of nitroglycerin.

Pharmacological properties
Nitro-Mik belongs to the group of pharmaceuticals-vasodilators, organic nitrates, which are used in the treatment of cardiac diseases.
Refers to antianginal, vasodilator, coronary dilator drugs.
The drug effectively relieves angina attacks due to the mechanism of action of nitric oxide (free radical) released when entering the body. The latter has the property of activating guanylate cyclase, causing an increase in the content of a certain monophosphate in smooth muscle cells of blood vessels, which, in turn, causes relaxation of smooth muscle fibers of the walls of blood vessels.
In addition, nitroglycerin has a sympathomimetic effect on the heart muscle, releases catecholamines in the brain, myocardium, and affects the troponin-tropomyosin complex.
It inhibits vascular tone due to its ability to inhibit the emerging pain syndrome.
With heart failure and angina pectoris, it causes an increase in cardiac output, allows you to successfully endure physical activity, and reduces both the severity and the number of heart attacks.
Reduces the load of venous blood on the heart, lowering the filling of the left ventricle (diastolic), lowering the total peripheral vascular resistance, blood pressure.
As a result of these properties, the load on the heart and the oxygen demand of the heart muscle are reduced, improving coronary blood flow, increasing the threshold for the possible occurrence of ischemia of the heart muscle.

Indications
Nitro-Mik is used for:

• treatment of angina attacks;
• prevention of angina attacks;
• exercise or emotional stress, which can trigger attacks of angina pectoris;
• adjuvant therapy in cases requiring emergency care in acute left ventricular failure (cardiac asthma);
• lowering blood pressure in acute myocardial infarction;
• prevention of spasms of coronary vessels caused by cardiac catheterization during coronary angiography.

When applied, an attack of angina pectoris stops after 1-2 minutes, hemodynamic and antianginal effects persist for 30 minutes.

Contraindications
You should not use the specified drug if the patient has had a previous hypersensitivity (allergy) with respect to one of the components that are part of the drug – both basic and auxiliary.
Also, use is contraindicated for:

• shock, collapse, arterial hypotension;
• hypertrophic obstructive cardiomyopathy;
• increased intracranial pressure (including with hemorrhagic stroke, after a recent head injury);
• angle-closure glaucoma;
• bradycardia, cerebral ischemia, cardiac tamponade.

Do not use concomitantly with sildenafil and other phosphodiesterase inhibitors.
Use with caution in hypovolemia, anemia, hyperthyroidism, impaired cerebral circulation, severe renal or hepatic failure, aortic stenosis, toxic pulmonary edema.
Do not drink alcohol!
Do not use the sauna, do not take hot showers / bathrooms.

Application during pregnancy and lactation
Treatment of pregnant women with this drug is contraindicated.
During treatment with this drug, breastfeeding should be suspended.

Method of administration and dosage
Nitro-Mik is applied by spraying a spray into the mouth.
Recommended dosages:

• with attacks of angina pectoris – 1-2 sprays, sublingually (on the tongue), no more than 3 sprays in 1 quarter of an hour;
• with expected physical activity – 1 spray 15 minutes before physical activity;
• cardiac asthma – 1-3 sprays (after 10 minutes it can be repeated if the effect has not occurred);
• preparation for coronary angiography – 1-2 sprays.

You should not inhale the drug when applied, for this you need to hold your breath when using the spray.
There should be a time interval of at least 30 seconds between two sprays.
You do not need to shake the bottle before use.
Correction is not required when used by elderly patients.

Overdose
An overdose of this drug can cause the body to react in the form of:

• lowering blood pressure below 90 mm Hg;
• headache, dizziness;
• fainting, tachycardia;
• nausea, vomiting;
• shortness of breath, weakness;
• fever, fever, increased sweating, chills.

When using a dosage higher than 20 μg per 1 kg of body weight, the patient may experience collapse, cyanosis of the lips, nails or palms, methemoglobinemia, dyspnea and tachypnea.
With symptoms of an overdose of nitroglycerin, the patient needs to be helped to take a horizontal position by lifting the lower limbs.
In case of excessive overdoses, symptomatic treatment is prescribed, plasma substitutes, oxygen are given, with methemoglobinemia – methylene blue.

Side effects
Side effects can occur in the form:

• reflex tachycardia, hyperemia of the skin;
• sensations of heat, arterial hypotension, including orthostatic collapse, cyanosis, pallor of the skin, methemoglobinemia;
• nausea, vomiting, dry mouth, abdominal pain, diarrhea;
• excitability, visual impairment, exacerbation of glaucoma, hypothermia.
• allergic reactions including skin rash, itching, anaphylactic shock.

In rare cases, a reverse reaction of the body is possible in the form of an increase in the symptoms of angina pectoris (the so-called paradoxical “nitrate” reactions).

Storage conditions and periods
This medicinal product is able to retain its medicinal properties for 4 years from the date of manufacture.
Storage temperature should not exceed 30 ° C.