Nitroglycerin causes vascular smooth muscle relaxation, and produces vasodilator effects in peripheral arteries and veins. Vein dilation promotes the accumulation of peripheral blood and reduces venous return to the heart, thereby reducing left ventricular end diastolic pressure (preload) and arterial relaxation, and reducing systemic vascular resistance and blood pressure (afterload).
Dosage & Administration of Nidocard R. 2.6
The dosage should always be adjusted according to the individual patient's requirements and responses and the severity of angina pectoris. For adults, take one tablet or capsule of nitroglycerin 2.6 mg sustained-release in the morning and evening. This should be taken on an empty stomach.
Interaction of Nidocard R. 2.6
Nitroglycerin dilates peripheral blood vessels and can increase the antihypertensive properties of vasodilators, calcium channel blockers, and β-adrenergic blockers. Concomitant use of nitrates with tricyclic antidepressants and alcohol can cause high blood pressure. Nitrate drugs combined with phosphodiesterase type 5 (PDE5) inhibitors (such as sildenafil, vardenafil, and tadalafil) can cause a decrease in blood pressure. Aspirin reduces the clearance rate and increases the hemodynamic effects of nitroglycerin. Combined use of nitroglycerin can reduce the pharmacological effects of heparin. Nitrate can increase the bioavailability of dihydroergotamine.
Patients who are known to be allergic to nitroglycerin, other organic nitrates or nitrites or pharmaceutical excipients should not use nitroglycerin. Patients with acute myocardial infarction, obvious anemia, head trauma, cerebral hemorrhage or angle-closure glaucoma are also contraindicated.
Side-Effects of Nidocard R. 2.6
The headache may occur at the beginning of treatment, but it usually disappears after a few days. If the headache persists, the dose should be reduced. Other side effects include tachycardia, orthostatic hypotension and syncope, cyanosis, and methemoglobinemia.
Pregnancy & Lactation
Unless the doctor considers it necessary, nitroglycerin should not be used during pregnancy or breastfeeding.
Precautions & Warnings
Patients who are susceptible to angle-closure glaucoma should use nitroglycerin with caution. As with other medicines for angina pectoris, stopping treatment suddenly can make symptoms worse. When long-term treatment is discontinued, the dose should be gradually reduced over a few days and the patient should be carefully monitored. The early use of nitroglycerin in acute myocardial infarction requires special attention to hemodynamic monitoring and clinical status to avoid damage from hypotension and tachycardia.
Nitrates: Coronary vasodilators
Store in a cool and dry place, away from light and heat. Keep all medicines out of the reach of children.