$Unique_ID{BRK02055}
$Pretitle{}
$Title{NITROGLYCERIN (SYSTEMIC)}
$Subject{Nitro-Bid Plateau Caps (Marion)
Nitrocap T.D. (Vortech)
Nitrocine Timecaps (Schwarz Pharma)
Nitrogard (Parke-Davis)
Nitroglycerin (Lilly)
Nitroglyn (Key) Nitrolin (Henry Schein)
Nitrolingual (Rorer)
Nitrong (Wharton)
Nitrospan (Rorer)
Nitrostat (Parke-Davis)}
$Volume{}
$Log{}

Copyright (C) 1991 Publications International, Ltd.


NITROGLYCERIN (SYSTEMIC)
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BRAND NAMES (Manufacturers):
     Nitro-Bid Plateau Caps (Marion)
     Nitrocap T.D. (Vortech)
     Nitrocine Timecaps (Schwarz Pharma)
     Nitrogard (Parke-Davis)
     Nitroglycerin (Lilly)
     Nitroglyn (Key) Nitrolin (Henry Schein)
     Nitrolingual (Rorer)
     Nitrong (Wharton)
     Nitrospan (Rorer)
     Nitrostat (Parke-Davis)
TYPE OF DRUG:
     Antianginal
INGREDIENT:
     nitroglycerin
DOSAGE FORMS:
     Sustained-release tablets (2.6 mg, 6.5 mg, and 9 mg)
     Sustained-release capsules (2.5 mg, 6.5 mg, and 9 mg)
     Sublingual tablets (0.15 mg, 0.3 mg, 0.4 mg, and 0.6 mg)
     Buccal tablets, controlled release (1 mg, 2 mg, and 3 mg)
     Oral spray (6.4 mg per dose)
STORAGE:
     Nitroglycerin tablets, capsules, and oral spray should be stored in a
       tightly capped bottle in a cool, dry place.
     The sublingual tablets should be kept in their original glass container.
       A small, temporary supply of tablets can also be stored in a
       stainless-steel container that is now available.  The pendant-type
       container, which can be worn around your neck, is a convenient storage
       place for an emergency supply.  NEVER store them in the refrigerator or
       the bathroom medicine cabinet, because the drug may lose its potency.

USES

     This medication is used to treat angina (chest pain).  Nitroglycerin is a
vasodilator, which relaxes the muscles of the blood vessels, causing an
increase in the oxygen supply to the heart.
     The oral tablets and capsules do not act quickly; they are used to
prevent chest pain.  The sublingual tablets and oral spray act quickly and can
be used to relieve chest pain after it has started.

TREATMENT

     You should take the sustained-release tablets or capsules with a full
glass of water on an empty stomach one hour before or two hours after a meal.
The tablets and capsules should be swallowed whole.  Chewing, crushing, or
breaking them destroys their sustained-release activity and possibly increases
the side effects.
     NEVER chew or swallow the sublingual or buccal tablets.  The sublingual
tablet and oral spray forms of the drug are absorbed directly through the
lining of the mouth.  The sublingual tablet should be allowed to dissolve
under the tongue or against the cheek.
     To use the spray, remove the plastic cover on the container.  Then,
without shaking the container, spray the medication onto or under the tongue.
Try not to inhale the spray.  Close your mouth after each spray, and try to
avoid swallowing right away.  Nitroglycerin spray loses its effectiveness if
it is swallowed.
     Take one tablet or one or two spray doses at the first sign of chest
pain.  Sit down while you are waiting for the medicine to take effect.  Do not
eat, drink, or smoke while nitroglycerin is in your mouth.  Try not to swallow
while nitroglycerin is dissolving, and do not rinse your mouth afterward.
Sublingual nitroglycerin or nitroglycerin spray should start working in one to
three minutes.  If there is no relief, take another tablet in five minutes.
IF YOU TAKE THREE TABLETS OR THREE SPRAY DOSES WITHOUT ANY SIGN OF
IMPROVEMENT, CALL A DOCTOR IMMEDIATELY OR GO TO A HOSPITAL EMERGENCY ROOM.  As
a preventive measure, take a nitroglycerin sublingual tablet or a spray dose
five or ten minutes before heavy exercise, exposure to high altitudes or
extreme cold, or any other potentially stressful situation.  Be sure to carry
some nitroglycerin sublingual tablets or oral spray with you at ALL times.
     The buccal tablet should be placed between the upper lip and the gum on
either side of the front teeth or between the cheek and the gum.  The tablet
is held in place by a sticky gel seal that develops once the tablet is in
contact with saliva.  If you wear dentures, the tablet can be placed anywhere
between the cheek and the gum.  Avoid drinking hot liquids or touching the
tablet with your tongue.  This can cause the tablet to dissolve faster and
could increase the risk of side effects.  If the tablet is swallowed by
mistake, replace it with another tablet.  Nitroglycerin buccal tablets lose
their effectiveness when swallowed.  Try not to take the buccal tablet at
bedtime in order to avoid inadvertently swallowing and choking on the tablet
while you are sleeping.
     If you miss a dose of the sustained-release tablets or capsules, take the
missed dose as soon as possible, unless it is more than halfway through the
interval between doses.  In that case, do not take the missed dose at all;
just return to your regular dosing schedule.  Do not double the next dose.

SIDE EFFECTS

     Minor.

     Dizziness, flushing of the face, headache, light-headedness, nausea,
vomiting, or weakness.  These side effects should disappear as your body
adjusts to the medication.
     If you feel dizzy or light-headed, sit or lie down for a while; get up
slowly from a sitting or reclining position, and be careful on stairs.  To
avoid dizziness or light-headedness when you stand, contract and relax the
muscles of your legs for a few moments before rising.  Do this by pushing one
foot against the floor while raising the other foot slightly, alternating feet
so that you are "pumping" your legs in a pedaling motion.
     Acetaminophen may help to relieve headaches.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
diarrhea, fainting, palpitations, rash, or sweating.

INTERACTIONS

     Nitroglycerin can interact with other types of medications:
     1. The combination of alcohol and nitroglycerin can lead to dizziness and
fainting.
     2. Nitroglycerin can increase the side effects of the tricyclic
antidepressants.
     Before starting to take nitroglycerin, BE SURE TO TELL YOUR DOCTOR about
any medications you are currently taking, especially tricyclic
antidepressants.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
any medications, especially to nitroglycerin or isosorbide dinitrate.
     * Before starting to take this medication, be sure to tell your doctor if
you now have or if you have ever had anemia, glaucoma, a head injury, low
blood pressure, or thyroid disease or if you have recently had a heart attack.
     * If this drug makes you dizzy or light-headed, do not take part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous machinery.
     * Before surgery or other medical or dental treatment, tell your doctor
or dentist you are taking this drug.
     * Tolerance may develop to this medication within one to three months.
If it seems to lose its effectiveness, contact your doctor.
     * You should not discontinue use of nitroglycerin (if you have been
taking it on a regular basis) unless you first consult your doctor.  Stopping
the drug abruptly may lead to further chest pain.  Your doctor may, therefore,
want to decrease your dosage gradually.
     * If you have frequent diarrhea, you may not be absorbing the
sustained-release form of this medication.  Discuss this with your doctor.
     * While taking this medication, do not take any over-the-counter
(nonprescription) asthma, allergy, sinus, cough, cold, or diet preparations
unless you first check with your doctor or pharmacist.  Some of these drugs
decrease the effectiveness of nitroglycerin.
     * The cotton plug should be removed when the bottle is first opened; it
should NOT be replaced (the cotton absorbs some of the medication, decreasing
its potency).
     * Nitroglycerin is highly flammable.  Do not use it in places where it
might be ignited.
     * Be sure to tell your doctor if you are pregnant.  Although this drug
appears to be safe, extensive studies in pregnant women have not been
conducted.  Also, tell your doctor if you are breast-feeding an infant.  It is
not known whether nitroglycerin passes into breast milk.

----------------

The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
