12-24 Hours
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GTN
Eskayef Pharmaceuticals Ltd.
Generic: Glyceryl Trinitrate (nitroglycerine)
Safety Advices
বাংলা
English
UNSAFE
Consuming alcohol while taking GTN may cause symptoms such as flushing, increased heart beat, nausea, thirst, chest pain and low blood pressure (Disulfiram reaction).
SAFE IF PRESCRIBED
GTN is generally considered safe to use during pregnancy. Animal studies have shown low or no adverse effects to the developing baby; however, there are limited human studies.
SAFE IF PRESCRIBED
GTN is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.
UNSAFE
GTN may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
SAFE IF PRESCRIBED
GTN is probably safe to use in patients with kidney disease. Limited data available suggests that dose adjustment of GTN may not be needed in these patients. Please consult your doctor.
CONSULT YOUR DOCTOR
There is limited information available on the use of GTN in patients with liver disease. Please consult your doctor.
Medicine Overview of GTN 400mcg Spray
Introduction
GTN is used to treat and prevent heart-related chest pain (angina). Angina occurs when the heart muscle is not getting enough blood. This medicine works by relaxing and widening blood vessels so blood can flow more easily to the heart. GTN should be taken in the dose and duration as advised by your doctor. It may be taken with or without food, preferably at a fixed time each day. Do not consume more than the recommended dose, as this may have harmful effects on your body. You can develop tolerance to this medicine over time, which means that the same...
... Show moreUses of GTN
- Angina (heart-related chest pain)
Side effects of GTN
Common
- Blurred vision
- Decreased blood pressure
- Dizziness
- Headache
- Increased heart rate
- Lightheadedness
- Paresthesia (tingling or pricking sensation)
How to use GTN
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. GTN may be taken with or without food, but it is better to take it at a fixed time.
How GTN works
GTN is a nitrate. It works by relaxing the blood vessels which decreases the oxygen demand of the heart and reduces its workload, thereby preventing/treating attacks of angina (chest pain).
What if you forget to take GTN?
If you miss a dose of GTN, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
- GTN may cause dizziness or sleepiness. Do not drive or do anything that requires concentration until you know how it affects you.
- Do not consume alcohol while taking GTN as it may cause increased dizziness.
- It may cause headaches which usually go away after a few days of continued treatment. Inform your doctor if it persists.
- You may develop tolerance to GTN with time, meaning that the same dose may be less effective next time. Follow the prescribed dosing schedule to avoid this.
- Stop taking medications (prescribed for erectile dysfunction) like sildenafil or tadalafil while on treatment with GTN as it may cause low blood pressure.
Brief Description
Indication
Angina pectoris, Acute myocardial infarction, Severe hypertension, Pulmonary edema.
Adult Dose
Oral Stable angina Adult: As SR tab/cap: 2.6-6.4 mg 3-4 times daily, adjust according to response. Max: 26 mg 4 times daily. Sublingual Tablet Angina Pectoris (Acute Relief) 0.5 mg SL q5min up to 3 times; use at first sign of angina Angina Pectoris (Prophylaxis) 1 tablet SL 5-10 minutes before activities likely to provoke angina attacks Sublingual Spray Angina 1-2 spray(s) PRN for angina, may repeat q3-5min, not to exceed 3 sprays in 15 minutes Spray onto or under tongue; do not inhale, expectorate or rinse mouth for 5-10 minutes Seek medical attention if pain persists after 3 doses...
... Show moreRenal Dose
Renal Failure
CrCl: 10-50 mL/min: Administer q24-72hr
CrCl: <10 mL/min: Administer q72-96hr
Contraindication
Hypersensitivity. Severe hypotension, heart failure, marked anaemia, hypertrophic obstructive cardiomyopathy, cerebral haemorrhage or head trauma, low cardiac output secondary to hypovolaemia, inferior MI with right ventricular involvement, raised intracranial pressure. Concomitant use with phosphodiesterase type-5 inhibitors.
Mode of Action
Glyceryl trinitrate acts on the enzyme nitric oxide stimulating guanylate cyclase in the vascular smooth muscle cells resulting in the relaxation of smooth muscles. It reduces venous return (preload) and facilitates subendocardial blood flow with redistribution into ischaemic areas. It relieves coronary vasospasm and dilates arterioles reducing afterload. It is useful for relief and prevention of anginal attacks.
Precaution
Severe hepatic or renal impairment, hypothyroidism, malnutrition, hypothermia. Cerebrovascular disease, lung disease or cor pulmonale. Pregnancy, lactation, glaucoma, mitral valve prolapse, cardiac tamponade, syncope. Gradual withdrawal in patients who have received prolonged high dose infusions. Avoid prolonged excessive hypotension. Nitrate-free interval is recommended in patients on continuous treatment with nitrates to reduce risk of tolerance.
Lactation: not known whether the drug crosses into breast milk, use caution
Side Effect
Common
Headache,Hypotension,Tachycardia,Dizziness,Lightheadedness,Blurred vision,Flushing,N/V,Nervousness,Xerostomia
Serious
Methemoglobinemia (rare),Syncope,Prolonged bleeding time,Exfoliative dermatitis,Unstable angina,Rebound hypertension,Thrombocytopenia
Sublingual Tabs/Spray: Dry mouth, localised burning sensation. Buccal tablets: Delayed dissolution, may be swallowed by mistake.
Potentially Fatal: Hypotension, paradoxical bradycardia, impaired respiration, syncope and collapse.
Interaction
Enhances bioavailability of dihydroergotamine. Glyceryl trinitrate infusion may prolong pancuronium-induced neuromuscular blockade. May reduce the efficacy of heparin, alteplase and noradrenaline when used together. Efficacy of buccal and sublingual preparations may be reduced by drugs that can cause dry mouth due to decreased dissolution. Aspirin and other NSAIDs may reduce the therapeutic response to glyceryl trinitrate.
Potentially Fatal: Orthostatic hypotension may be produced by combined use of calcium channel blockers, antihypertensives, phenothiazines and TCAs. Alcohol may cause severe hypotension and collapse.
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