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CARDIOVASCULAR SYSTEM › CARDIAC THERAPY › VASODILATORS USED IN CARDIAC DISEASES › Organic nitrates
trolnitrate, combinations
C01DA59
Forms & Strengths
- Extended-release tablets: 20mg, 30mg, 40mg, 60mg, 80mg, 120mg
- Immediate-release tablets: 5mg, 10mg, 20mg
- Sublingual tablets: 5mg, 10mg
- Spray: 0.4mg/spray, 0.8mg/spray
- Patch: 5mg/24hr, 10mg/24hr
Adult Dosing
- Angina pectoris: 20-120mg orally tid
- Acute angina: 0.4-0.8mg spray or 5-10mg sublingually as needed
- Prophylactic: 20-60mg orally 30 minutes to 1 hour before activity
Pediatric Dosing
- Safety and efficacy not established in pediatric patients
- Use with caution and under close medical supervision
Indications
- Treatment and prevention of angina pectoris
- Prophylactic management of angina
Mechanism of Action
- Relaxes vascular smooth muscle by stimulating guanylate cyclase
- Increases cGMP, leading to vasodilation and decreased blood pressure
Contraindications
- Concomitant use of phosphodiesterase inhibitors
- Concomitant use of riociguat
- Hypersensitivity to nitrates
- Severe hypotension or shock
Adverse Reactions
- Headache, dizziness, lightheadedness, and orthostatic hypotension
- Tachycardia, palpitations, and flushing
- Nausea, vomiting, and methemoglobinemia
Drug Interactions
- Increased hypotension with concomitant use of antihypertensives, beta-blockers, and calcium channel blockers
- Increased risk of hypotension with concomitant use of phosphodiesterase inhibitors and riociguat
Curated Content: Needs Vetting Before Put to Clinical Use