$Unique_ID{BRK03255} $Pretitle{} $Title{nitroglycerin (topical)} $Subject{topical Deponit Wyeth Nitro-Bid Marion Nitrodisc Searle Nitro-Dur Key Transdermal System Bolar Nitrol Adria Nitrostat Parke-Davis Transderm-Nitro Ciba Antianginal nitroglycerin angina chest pain vasodilator muscles blood vessels oxygen} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. nitroglycerin (topical) ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) Deponit (Wyeth) Nitro-Bid (Marion) Nitrodisc (Searle) Nitro-Dur (Key) nitroglycerin (various manufacturers) Nitroglycerin Transdermal System (Bolar) Nitrol (Adria) Nitrostat (Parke-Davis) Transderm-Nitro (Ciba) TYPE OF DRUG Antianginal INGREDIENT nitroglycerin DOSAGE FORMS Ointment (2%) Transdermal system (the patch delivers 0.1 mg, 0.2 mg, 0.3 mg, 0.4 mg, or 0.6 mg per hour) STORAGE Nitroglycerin ointment and patches should be stored at room temperature in their original containers. The ointment container should always be tightly capped. USES Nitroglycerin is used to prevent angina (chest pain). It is a vasodilator, which relaxes the muscles of the blood vessels, causing an increase in the oxygen supply to the heart. The ointment and patches do not act quickly--they should not be used to treat chest pain that has already started. TREATMENT The ointment comes with an applicator with which the prescribed dosage can be easily measured and applied. Before a new dose is applied, the previous dose should be thoroughly removed. Each dose should be applied to a new site on the skin. Do not rub or massage the ointment into the skin. Just spread the ointment in a thin, even layer, covering an area of about the same size each time. Avoid contact of the ointment with other parts of the body, since it is absorbed wherever it touches the skin. Either use plastic or rubber gloves to apply the ointment, or wash your hands immediately after application. Cover the ointment only if directed to do so by your doctor. The transdermal system (patches) allows controlled, continuous release of nitroglycerin. Patches are convenient and easy to use. For best results, apply the patch to a hairless or clean-shaven area of skin, avoiding scars and wounds. Choose a site (such as the chest or upper arm) that is not subject to excessive movement. It is all right to bathe or shower with a patch in place. In the event that a patch becomes dislodged, discard and replace it. Replace a patch by applying a new unit before removing the old one. This allows for uninterrupted drug therapy, and skin irritation is minimized since the site is changed each time. If redness or irritation develops at the application site, consult your physician. Do not trim or cut the patches. This alters the dose of the medication. If you miss an application of this medication, apply the missed application as soon as possible, unless it is more than halfway through the interval between doses. In that case, do not apply the missed application 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 drug. If you feel dizzy or light-headed, sit or lie down for a while; get up slowly, 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. If you are experiencing headaches acetaminophen may help to relieve them slightly. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about 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 or have a heart condition. * 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. Be especially careful when going up and down stairs. * Before having surgery or any other medical or dental treatment, be sure to tell your doctor or dentist that you are taking this medication. * Tolerance to this medication may develop within one to three months. If it seems to lose its effectiveness, contact your doctor. * You should not discontinue use of nitroglycerin 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. * 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. * 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. The safety of this drug during pregnancy has not been determined. Although this drug appears to be safe, extensive studies in pregnant women have not yet 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.