Glyceryl trinitrate

Generic Medicine Info
Hypertrophic obstructive cardiomyopathy, increased intracranial pressure (e.g. cerebral haemorrhage, head trauma), inadequate cerebral circulation, severe anaemia, closed-angle glaucoma, severe hypotension (systolic blood pressure <90 mmHg), arterial hypoxaemia, severe/uncontrolled hypovolaemia, extreme bradycardia, migraine or recurrent headache, acute circulatory failure and shock, cardiogenic shock with inadequate end-diastolic pressure, myocardial insufficiency due to obstruction, aortic or mitral stenosis, pericardial tamponade, constrictive pericarditis, toxic pulmonary oedema. Concomitant use with phosphodiesterase type 5 inhibitors (e.g. sildenafil), and riociguat.
Special Precautions
Patients with cerebrovascular disease, lung disease or cor pulmonale, recent history of MI, hypothyroidism, hypoxaemia or ventilation/perfusion imbalance due to lung disease or ischaemic heart failure, hypothermia, malnutrition, volume depletion, pre-existing hypotension, orthostatic dysfunction. Patch/topical ointment: Not indicated for treatment of acute angina attacks. Avoid abrupt withdrawal. Severe renal and hepatic impairment. Elderly. Pregnancy and lactation. Patient Counselling This drug may cause dizziness, light-headedness, headache, blurred vision, and postural hypotension; if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood pressure and heart rate.
Adverse Reactions
Significant: Severe hypotension, shock, paradoxical bradycardia, increased intracranial pressure, dose-related headache, methaemoglobinaemia, drug tolerance, hypoxaemia. Ear and labyrinth disorders: Vertigo. Cardiac disorders: Tachycardia. Gastrointestinal disorders: Nausea, vomiting. General disorders and administration site conditions: Asthenia; application site reactions (e.g. irritation, rash, pruritus, erythema, burning or stinging sensation). Nervous system disorders: Dizziness, drowsiness, paraesthesia. Rarely, cerebral ischaemia. Psychiatric disorders: Restlessness. Vascular disorders: Orthostatic hypotension, flushing, syncope.
Drug Interactions
Enhanced hypotensive effects with other vasodilators and antihypertensives (e.g. ACE inhibitors, β-blockers, calcium channel blockers, diuretics), neuroleptics, TCAs, MAOIs, sapropterin, sublingual apomorphine. Increased vasodilating effects with N-acetylcysteine. Reduced absorption of sublingual nitrates with drugs that cause dry mouth (e.g. anticholinergics). May increase serum concentrations of ergot derivatives (e.g. dihydroergotamine). May diminish anticoagulant effect of heparin. May accelerate plasma clearance of tissue plasminogen activators (IV).
CIMS Class
Anorectal Preparations / Anti-Anginal Drugs
ATC Classification
C05AE01 - glyceryl trinitrate ; Belongs to the class of muscle relaxants. Used in the topical treatment for the treatment of hemorrhoids and anal fissures.
C01DA02 - glyceryl trinitrate ; Belongs to the class of organic nitrate vasodilators. Used in the treatment of cardiac disease.
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