Nitroglicerin sublingual tablets 0.5 mg. №40 vial

Description

Nitroglicerin composition
Main active ingredient: nitroglycerin.
Excipients: microcrystalline cellulose, potato starch, povidone, colloidal anhydrous silicon dioxide, magnesium stearate, aspartame, crospovidone, lactose monohydrate.

Release form
Available in sublingual tablets, each containing 0.5 mg nitroglycerin (diluted with lactose).

Pharmacological properties
Nitroglicerin 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
Nitroglicerin is used for the relief and short-term prophylaxis of angina attacks.
With sublingual use, 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;
• acute myocardial infarction with low left ventricular filling pressure;
• 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
Nitroglicerin is taken at the onset of an angina attack.
At the first signs of an incipient attack (acute burning or stabbing pain in the region of the heart), you need to put 1 tablet under the tongue.
It must be taken immediately at the first symptoms of an angina attack. Keep in mouth until completely absorbed. Do not swallow or chew the tablet, as excess nitroglycerin may pass through the mucous membrane.
If after 3-5 minutes the chest pain has not gone away, you need to take another 1 tablet of the drug. If, after taking the third pill, the attack of heart pain has not passed, you need to seek specialized medical help.
With frequent attacks of angina pectoris, it is advisable to use prolonged action nitroglycerin preparations.

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 2 years from the date of manufacture.
Storage temperature should not exceed 25 ° C.