Drug name: Nitroglycerin

Active substance: Nitroglycerin

Pharmacological effects: Nitroglycerin is a well known nitrate with a primary effect of vessel dilation. The nitrates work by releasing a the nitrogen oxide in the blood which is a naturally occurring endothelial relaxing factor – mediator of guanylate cyclase direct activator. The increased concentration of cyclic guanosine monophosphate leads to relaxation of the smooth muscle. Nitroglycerine thus exerts antianginal and spasmolytic effects, relaxes smooth muscle of the vessel walls, bronchi, gastrointestinal tract and renal duct.

Indications: The drug is indicated in treatment of Ischemic heart disease and its symptoms as well as other conditions including:

• Angina
• Myocardial infarction
• Unstable and post-infarction angina
• Lung swelling
• Angina resistant to other types of therapy
• Manageable hypotension during surgery
• Obstruction of the retina central artery

Warnings and Precautions: The drugs should not be used in the following conditions:

• Hypersensitivity to any components of the preparations.

The drug should be used with caution in the following cases:

• Hemorrhagic insult
• Cerebral hypertension
• Acute heart attack
• Chronic heart failure
• Glaucoma
• Severe anemia
• Thyreotoxicosis
• Arterial hypotension
• Hypertrophic cardiomyopathy
• Pregnancy
• Lactation period
• Age blow 18 years

For prolonged forms(Nitrolong):

• Increased peristalsis of the gastrointestinal tract
• Malabsorption syndrome

Side effects: Drugs may cause side-effects which in specific patients may manifest differently. In the following paragraph we want to underline the most serious and frequent side effect of Nitroglycerin that were identified by the drug manufacturers. The possibility of the adverse effect manifestation depends only on the individual and his specific traits. Nitroglycerin side effects include:

• Cardiovascular system: dizziness, headaches, tachycardia, skin hyperemia, fervescence, decreased arterial pressure, orthostatic collapse, cyanosis
• Gastrointestinal tract: dry mouth, nausea, vomiting, stomach pain
• CNS: anxiety, psychotic reactions, retardation, disorientation
• Allergic reactions: skin rash, itching
• Local reactions: skin hyperemia, skin itching, burning, allergic dermatitis
• Other: blurry vision, weakness, hypothermia, methemoglobinemia

For full information on any risks and adverse effects associated with Nitroglycerin, please consult your doctor, read the included leaflet or contact our customer support service.

Interactions: Before using Nitroglycerin please tell your doctor which drugs or supplements you are already taking including those bought without a prescription. Also check if any additional medicine which you will take during the course of Nitroglycerin therapy are safe in combination. Especially mention if you are taking the following groups of drugs:

• Erectile dysfunction treatment
• Vasodilatators
• Hypertension treatment
• ACE inhibitors
• Alpha blockers
• Beta-blockers
• Ca2+ channel blockers
• Tricyclic antidepressants
• MAO inhibitors
• Phosphodiesterase inhibitors
• Ethanol
• Heparin

Patients information: Nitroglycerin is not to be shared with healthy individuals. It is strictly FORBIDDEN to use the drugs in treatment of any conditions unrelated to their indications. The product as well as utilized vials, syringes, needles if used during the course of treatment should be kept out of reach of children and never reused.