Nitroglycerine

Нитроглицерин Drug photo

The description is actual on 22.10.2015

  • Latin name: Nitroglycerin
  • ATH code: C01DA02
  • Active ingredient: Nitroglycerine (Nitroglycerin)
  • Producer: Lyumi Ltd company, medico-technology holding "MTH", CJSC Binnofarm, Medisorb, Biohoney of I.I. Mechnikov, Samaramedprom, Farmamed of Ltd company, Ozone of Ltd company (Russia), GNTsLS Experimental plant of Ltd company, Microchemical NPF (Ukraine)

Structure

The tablets Nitroglycerine sublingual contain in structure active component nitroglycerine and additional components: lactose, krospovidon CL, macrogoal 6000, povidone 25.

Solution Nitroglycerine contains active component nitroglycerine and additional components: potassium dihydrophosphate, sodium chloride, a dextrose, water for injections.

Spray Nitroglycerine contains active component in structure nitroglycerine, and also as an additional component ethanol of 95%.

Release form

Is issued in the form of a pill which are taken sublingual. Tablets have white color or color, white with a yellowish shade. The tablet can be rough externally. Contain in polymeric containers or in strip planimetric packagings. In packagings from 10 to 100 pieces.

Also Solution Nitroglycerini of 1% in ampoules on 5 ml and 1% Solution Nitroglycerini in oil in capsules is issued.

Spray hypoglossal Nitroglycerine – transparent liquid without color, contains in bottles on 10 ml, in a set there is also a mechanical dispensing pump.

Also there are other forms of production of drug — hypoglossal drops, a concentrate for preparation of solution for administration of substance nitroglycerine in/in, films on a gingiva.

Pharmacological action

Nitroglycerine is a nitrogen-containing organic compound which mainly has venodilatiruyushchy effect.

Nitroglycerine formula: C3H5N3O9.

Pharmacological group of drug: nitrates and nitratopodobny means.

Reaction of receiving substance of nitroglycerine is described in textbooks in chemistry. Nitroglycerine — explosive substance, however contains in drug its very low concentration.

Substance works in view of release from a molecule of nitrogen oxide which is the natural running-down endothelial factor. Mechanism of effect of nitroglycerine following: under the influence of nitrogen oxide in cells concentration of a cyclic guanozinmonofosfataza increases, as a result, the barrier to hit of calcium ions in smooth muscle cells is formed. At the same time smooth muscle cells relax, vessels extend that reduces venous return to heart and resistance of a big circle of blood circulation, that is preloading and an afterload. As a result the need of a myocardium for oxygen decreases.

Owing to expansion of coronary vessels the coronary blood stream becomes more active, being redistributed in the area where blood circulation is reduced. It promotes improvement of delivery in an oxygen myocardium.

After decrease in venous return filling pressure decreases, the blood stream in subendocardial layers improves, pressure in a small circle of blood circulation goes down, regression of symptoms at patients with a fluid lungs decreases.

Wikipedia demonstrates that nitroglycerine makes the central braking impact on a sympathetic tone of vessels, at the same time oppressing a vascular component of forming of a pain syndrome. Under the influence of nitroglycerine there is a relaxation of smooth muscle cells of bronchial tubes, a gall bladder, urinary tract, a gullet, bilious channels, intestines.

Pharmacokinetics and pharmacodynamics

Nitroglycerine at use sublingual begins to work 1-1.5 minutes later after use. The effect proceeds on continuation about thirty minutes. From a surface of mucous it is soaked up quickly and completely. At once gets to a system blood stream. If means is applied in a dose of 0,5 mg, its bioavailability is equal to 100%, and the maximum concentration in plasma is noted 5 minutes later. Distribution volume very big. With proteins of plasma communication for 60%.

At spray reception it is quickly and completely absorbed. The maximum concentration in plasma is noted in 4 minutes. The metabolism passes quickly, with nitrate reductase participation. At the same time are formed di - and mononitrates, a final metabolite is glycerin. It is removed through kidneys. In not changed look there are less than 1% of the accepted dose. The elimination half-life at reception is sublingual equal to 2.5-4.4 min.

Nitroglycerine collects in walls of vessels and strongly contacts erythrocytes.

Indications to Nitroglycerine use

There are following indications to Nitroglycerine use:

Contraindications

People at whom the following diseases and conditions of an organism are noted cannot apply medicine:

  • high sensitivity of an organism to nitrates;
  • cardiac tamponade;
  • hypertensia is craniocereberal;
  • chronic cardial compression (if pressure decrease of filling of a left ventricle takes place);
  • the hypovolemia is uncontrollable;
  • the isolated mitral stenosis;
  • heart failure (on condition of the lowered or normal pulmonary pressure);
  • the stroke is hemorrhagic;
  • collapse;
  • hemorrhage is subarachnoidal;
  • the head injury transferred the patient recently;
  • the fluid lungs is toxic;
  • idiopathic hypertrophic subaortal stenosis;
  • glaucoma (closed-angle form) on condition of high intraocular pressure;
  • hyperthyroidism;
  • heavy anemia;
  • age of the patient till 18 flyings;
  • shock;
  • disturbance of cerebral circulation;
  • arterial hypotension;
  • at administration of drug of Sildenafil (Viagra);
  • pregnancy and natural feeding.

Before accepting drug in tablets or in other forms, it is necessary to consider that to patients with a heavy renal failure and a heavy liver failure Nitroglycerine for heart is appointed with care.

Side effects

In the course of use of Nitroglycerine for patients the passing headache often develops, there can be a feeling of dizziness, indicators of arterial pressure sometimes decrease (this symptom most often develops if the person stays in situation vertically).

If there was an overdose of tablets and other forms of drug, then at the patient the orthostatic collapse can develop, at such state at the patient indicators of arterial pressure when the person from horizontal position passes into vertical sharply fall.

Thus, it is necessary to consider that such medicine can provoke manifestation of the following side effects:

  • Nervous system, sense bodys: headache, feeling of a raspiraniye of the head, dizziness, feeling of weakness, motive concern, deterioration in clearness of sight, psychotic manifestations, exacerbation of glaucoma.
  • Heart and vessels system of a hemopoiesis: feeling of rushes of blood to the person, hypotension, strong heartbeat, a methemoglobinemia, a collapse.
  • Alimentary system: vomiting, nausea, diarrhea, emergence of dryness in a mouth.
  • Integuments: dermahemia, cyanosis.
  • Allergy: a burning sensation, an itch, contact dermatitis (if transdermalny forms are applied).
  • Other manifestations: a hypothermia, feeling of heat, development of paradoxical effects — ischemia, a stenocardia attack, development of a myocardial infarction with sudden death is possible.

Application instruction of Nitroglycerine (Way and dosage)

In modern medicine use of spirit Solution Nitroglycerini is sublingual used in rare instances. Solution is applied under language – on 2-3 drops or drip it on a sugar piece.

Tablets Nitroglycerine, application instruction

Apply tablets sublingual – keep under language to a full rassasyvaniye, at the same time it is impossible to swallow a tablet. It is necessary to take a pill at once after development of pain, on 0.5-1 mg on reception. Often patients with stable stenocardia note occurrence of effect and after use of smaller doses (1/2-1/3 tab.). Therefore, if pain quickly passed, it is possible not to rassasyvat the tablet rest. As a rule, after a tablet rassasyvaniye the effect is shown in 0.5-2 min., part of patients note improvement of a state for 3-4 minutes.

If the anti-anginal effect is absent for the first 5 minutes, it is necessary to accept 0.5 mg of means still. Even if after reception of two tablets there is no effect, it is necessary to see a doctor immediately. After sublingual reception influence of Nitroglycerine continues for 45 minutes.

In rare instances tolerance to Nitroglycerine (its sublingual forms) can develop, in that case to the patient gradually increase a dose — to 2-3 tablets.

Spray Nitroglycerine, application instruction

Use of spray for prevention of an attack of stenocardia provides use under language of 1-2 doses. For receiving one dose it is necessary to press the dosing valve. It is impossible to use more than 3 doses for 15 minutes. If at the patient the acute left ventricular failure developed, it is possible to apply 4 and high doses during the short period.

It is important to control efficiency of treatment, to regulate doses, and, in case of long reception – to replace with drugs of other groups.

Overdose

At overdose of medicine at the patient development of a headache can be noted, arterial pressure also decreases, reflex tachycardia, orthostatic hypotension, dizziness, vomiting and diarrhea, face reddening, an adynamy, feeling of heat, strong drowsiness is noted.

It is necessary to remember that reception of very high doses of medicine (that is more than 20 mg/kg) can lead to cyanosis, a methemoglobinemia, a tachypnea, dispnoe, to an orthostatic collapse. If there was a serious overdose, the lethal outcome is also possible. The death at overdose by Nitroglycerine can occur if timely not to give help to the patient who accepted a medicine overdose. In that case in several hours there can come the coma, and later – death.

If there was an easy overdose, it is necessary to transfer the person to lying situation, having made it so that his legs were raised. If heavy overdose is noted, use of the general methods of therapy of shock and intoxication of an organism practices. In particular, fill the volume of the circulating blood, appoint Norepinephrinum, the Dopamine. It is contraindicated to apply Epinephrinum.

If at the patient the methemoglobinemia developed, reception of vitamin C in the form of sodium salt practices, to accept inside or intravenously. The hemodialysis, an oxygenotherapy, hemotransfusion is appointed.

It is also necessary to note that the risk of serious effects increases at reception of Nitroglycerine after alcohol. The lethal dose of Nitroglycerine and alcohol is not defined, but at such combination the risk of serious effects sharply increases in any doses.

Interaction

Medicine can interact with other drugs from what Nitroglycerine should be accepted carefully at such combinations:

  • At a concomitant use of salicylates nitroglycerine level in plasma increases.
  • At a concomitant use of barbiturates the nitroglycerine metabolism becomes more active. If to accept Nitroglycerine along with adrenomimetika, their pressor action will decrease.
  • Nitroglycerine lowers anticoagulating effect of Heparin (at introduction intravenously).
  • Hypotensive and systemic vazodilatiruyushchy action of Nitroglycerine amplifies at a concomitant use of anti-adrenergic, hypotensive drugs, and also Sildenafila of citrate, vazodilatator, tricyclic antidepressants, antagonists of calcium, MAO inhibitors, quinidine, ethanol, Novokainamida.
  • Anti-anginal activity of Nitroglycerine increases at reception with N-Acetylcysteinum, Methionine, APF inhibitors, salicylates.
  • At reception of Unithiolum a hyposensitivity to Nitroglycerine is recovered.
  • Anti-anginal and vasodilating action decreases at a concomitant use of Digidroergotamin, alpha adrenomimetikov, m cholinolytics, Pituitrinum, the Histamine, stimulators of TsNS, corticosteroids, vegetative gangliyev, poisons of bees and snakes.

Terms of sale

The recipe is necessary for acquisition of drug; the doctor writes out the recipe on Latin.

Storage conditions

It is necessary to protect from moisture, to store at a temperature no more than 25 °C.

Period of validity

Period of storage of nitroglycerine – 2 years.

Special instructions

It is necessary to watch that Solution Nitroglycerini did not get on integuments as it can be soaked up and lead to development of a headache.

It is necessary to consider not only what tablets are applied to, but also their side effects. In particular, it is necessary to remember that at their reception arterial pressure can sharply decrease and be shown dizziness. These symptoms at the use of alcohol are most expressed, during the hot period and at exercise stresses.

Over time at the patient accustoming to drug therefore increase in a dose can be required can be noted. If against administration of drug the headache develops, this symptom can be reduced, having lowered a dose of medicine or having accepted at the same time Validol.

At reception reaction therefore at this time it is not necessary to drive transport can be slowed down and to work with exact and dangerous mechanisms.

To reduce risk of development of side effects, it is not necessary to accept means along with the drugs rendering hypotensive and vazodilatiruyushchy effect.

For the purpose of stopping of an attack of stenocardia it is impossible to chew a tablet not to allow hit of excess amount of active ingredient in a blood stream.

Synonyms

Angiolingval, Nitroglitserol, Anginin, Angibidum, Angised, Glyceryl trinitrate, Angorinum, Nitranginum, Mioglitserin, Nitrocardiolum, Nitromintum, Nitroglynum, Nitrostat, Nitrozell, Trinitrogliiyerol, Trinitrinum, Trinitrolum.

Analogs of drug are drugs Nirmin, Nit-ret, Nitradisk, Nitroxoline, Nitrosorbidum, Nitromintum an aerosol, etc. Before replacing medicine, it is necessary to consult with the doctor surely.

To children

Use of Nitroglycerine for treatment of children does not practice.

With alcohol

It is not necessary to accept alcohol along with Nitroglycerine as the risk of development of serious side effects increases.

At pregnancy and a lactation

It is contraindicated during pregnancy and natural feeding. Reception only according to vital indications is possible.

Responses

Responses demonstrate that this drug it becomes frequent real "rescuer" for the people having stenocardia. Especially often it is applied by elderly patients. Works very quickly, removes attacks. However many patients note that at drug intake side effects, most often – a severe headache, dizziness often develop.

The Nitroglycerine price where to buy

The Nitroglycerine price in tablets averages 40 — 60 rubles for 40 pieces.

The price of spray of 10 ml makes about 100 rubles. It is possible to buy medicine in any drugstore.

Zdravzona

  • No. 40 nitroglycerine 0,5mg tablet/Pharmstandard /
  • Tablet No. 40 nitroglycerine 0,5mg sublingvalnyeozon Ltd company
  • Nitroglycerine of 0,1% solution for in/in introductions of 5 ml No. 10 ampulybiomed of I. I. Mechnikov of joint stock company
  • Nitroglycerine of 0,1% 10 ml No. 10 of amp. Microgene of NPO Federal State Unitary Enterprise
  • Nitroglycerine 500 of mkg No. 40 of a kapsulylyuma of Ltd company

Drugstore of IFC

  • Nitroglycerine tbl 500 mkg No. 40 **, Ooorossiya's Ozone
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Apteka24

  • Nitroglitserin40
  • Nitroglycerine solution inf. 1% of amp. 2 ml No. 10 Aktsiyaoz GNTSLS (Ukraine, Kharkiv)
  • No. 40 Technologist tablet 0.5mg nitroglycerine (Ukraine, Uman)
  • No. 40 Health tablet 0.0005g nitroglycerine (Ukraine, Kharkiv)
  • Nitroglitserinoz GNTSLS (Ukraine, Kharkiv)

Paniapteka

  • Nitroglycerine solution inf. 1% of amp. 2 ml No. 10
  • Tab. nitroglycerine 0.0005g No. 40 Technologist
  • Tab. nitroglycerine 0.0005g No. 40 Technologist
  • Tab. nitroglycerine 0.0005g No. 40 Technologist
  • Tab. nitroglycerine 0.0005g No. 40 Technologist

BIOSPHERE

  • Nitroglycerine of 0,5 mg No. 40 of the tab. sublingv. Ozone of Ltd company (Russia)
  • Nitroglitserin-KZ 0,5 mg No. 40 of the tab. sublingv. Technologist of closed joint stock company (Ukraine)
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Section: Cardiological Cardiovascular
in more detail

Education: "Pharmacy" graduated from the Rovno state basic medical college majoring in. Graduated from the Vinnytsia state medical university of M. I. Pirogov and internship on its base.

Experience: From 2003 to 2013 – worked at positions of the pharmacist and manager of a pharmaceutical booth. It is awarded by diplomas and distinctions for long-term and honest work. Articles on medical subject were published in local editions (newspaper) and on various Internet portals.

PAY ATTENTION! Information on drugs on the website is help generalizing, collected from public sources and can form the basis for making decision on use of medicines it is not aware of treatment. Before medicine use Nitroglycerine surely consult with the attending physician.