| NITROCARD
Nitroglycerin
Composition:
Each sustained
release tablet contains Nitroglycerin USP 2.6 mg.
Pharmacology:
Nitroglycerin relaxes
the vascular smooth muscle. Although the precise details remain
unclear, the direct effect on vascular smooth muscle appears
to be the result of liberation of free radicals of nitric oxide
(NO) which activates guanylate cyclase, resulting in increased
synthesis of cyclic GMP. It is possible that NO combines with
sulfhydryl groups in the endothelium and produces S-nitrosothiols
that stimulate guanylate cyclase production. This is enhanced
by N-acetylcysteine, which provides a source of sulfhydryl groups.
Cyclic GMP reduces stored calcium and thus interferes with calcium-activated
smooth muscle contraction.
Indications:
Nitroglycerin is
used for the prophylaxis and long term management of angina
pectoris, heart failure and myocardial infarction.
Dosage &
administration:
The dosage is determined
on the basis of individual requirement depending on the severity
of the disease, response to nitrglycerol and development of
side-effects. The usual daily dose initially 1 tablet twice
daily. The dose may be gradually increased to 2-3 tablets twice
daily.
Side-effects:
Headache, flushing,
dizziness, postural hypotension, tachycardia may occur.
Contraindications:
Hypersensitivity
to nitrates. Obstructive hypertrophic cardiomyopathy. Low cardiac
output secondary to hypovolemia. Inferior myocardial infarction
with right ventricular involvement. Raised intracranial pressure.
Mitral valve propalpse. Glaucoma.
Drug interactions:
Pharmacodynamic
interactions: Orthostatic hypotension may occur with the
combined use of calcium channel blockers, antihypertensive agents,
phenothiazine, and tricyclic antidepressants. Use of alcohol
with nitroglycerin may produce severe hypotension and collapse.
Pharmacokinetic
interactions: Oral nitroglycerin may enhance the bioavailability
of dihydroergotamine.
Use in special
groups:
Neonates:
Safety and efficacy for use in infants and children have not
been established.
Children:
Safety and efficacy for use in children has not been established.
Breast milk:
Safety and efficacy for use in nursing mother has not been established.
Pregnant women:
Safety for use during pregnancy has not been established. Use
only when clearly needed and when the potential benefits outweigh
the unknown potential hazards to the foetus.
The elderly:
Symptoms of cerebral ischaemia due to postural hypotension
may develop with rapidly acting formulations.
Packing:
Each box contains
5´10's SR Tablets. |
