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CARDIOVASCULAR SYSTEM › CARDIAC THERAPY › VASODILATORS USED IN CARDIAC DISEASES › Organic nitrates
glyceryl trinitrate
C01DA02
Forms & Strengths
- tablets 0.3-0.6mg
- sublingual spray 0.4-1.2mg/dose
- transdermal patch 5-15mg/24h
- intravenous 5-200mcg/min
Adult Dosing
- angina: 0.3-0.6mg sublingually as needed
- acute myocardial infarction: 10-20mcg/min IV, titrate to response
- heart failure: 10-50mcg/min IV
Pediatric Dosing
- limited data, use with caution
- neonates and infants: 0.5-1mcg/kg/min IV, titrate to response
Indications
- angina pectoris
- acute myocardial infarction
- unstable angina
- heart failure
- hypertensive emergencies
Mechanism of Action
- vasodilation via release of nitric oxide
- decreased preload and afterload
- dilation of coronary arteries
Contraindications
- hypersensitivity to nitrates
- recent phosphodiesterase inhibitor use
- closed-angle glaucoma
- severe anemia
- head trauma or cerebral hemorrhage
Adverse Reactions
- headache
- orthostatic hypotension
- reflex tachycardia
- methemoglobinemia
- allergic skin reactions
Drug Interactions
- enhanced hypotension with sildenafil and other phosphodiesterase inhibitors
- increased risk of methemoglobinemia with primaquine and other oxidizing agents
- concomitant use with aspirin may decrease nitrate efficacy
Curated Content: Needs Vetting Before Put to Clinical Use