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GoNitro (oral/sublingual) |
What is the medium of administration of the drug? |
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What is GoNitro (oral/sublingual)
GoNitro (oral/sublingual) is in a group of drugs called nitrates. GoNitro (oral/sublingual) dilates (widens) blood vessels, making it easier for blood to flow through them and easier for the heart to pump.GoNitro (oral/sublingual) is used to treat or prevent attacks of chest pain (angina).
GoNitro (oral/sublingual) may also be used for purposes not listed in GoNitro (oral/sublingual) guide.
GoNitro (oral/sublingual) side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.Seek emergency medical attention if you have symptoms of a heart attack, such as:
- chest pain or pressure;
- pain spreading to your jaw or shoulder; or
- nausea, sweating, general ill feeling.
GoNitro (oral/sublingual) can cause severe headaches, especially when you first start using it. These headaches may gradually become less severe as you continue to use GoNitro (oral/sublingual). Do not stop taking this medicine. Ask your doctor before using any headache pain medication.
Call your doctor at once if you have:
- severe or throbbing headaches that do not become less severe with continued use of GoNitro (oral/sublingual);
- pounding heartbeats or fluttering in your chest;
- slow heart rate;
- blurred vision or dry mouth; or
- a light-headed feeling, like you might pass out.
Common side effects may include:
- mild burning or tingling with the tablet in your mouth;
- headache;
- dizziness, spinning sensation;
- nausea, vomiting;
- flushing (warmth, redness, or tingly feeling);
- pale skin, increased sweating; or
- feeling weak or dizzy.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
GoNitro (oral/sublingual) dosing
Usual Adult Dose for Angina Pectoris:
For relief of acute anginal attack:Lingual spray: 1 to 2 sprays onto or under the tongue every 3 to 5 minutes as needed, up to 3 sprays in 15 minutes. If pain persists after the maximum number of doses, prompt medical attention is recommended.
Sublingual tablet: 0.3 to 0.6 mg dissolved under the tongue or in the GoNitro (oral/sublingual) pouch every 5 minutes as needed, up to 3 doses in 15 minutes. If pain persists after the maximum number of doses, prompt medical attention is recommended.
IV continuous infusion (via non PVC tubing): 5 mcg/min initially, increased by 5 mcg/min every 3 to 5 minutes as needed up to 20 mcg/min, then gradually by 10 and then 20 mcg/min if needed, up to a usual maximum of 200 and generally no more than 400 mcg/min. Starting dosages of 25 mcg/min or higher have been used with PVC administration sets.
Usual Adult Dose for Angina Pectoris Prophylaxis:
Lingual spray: 1 to 2 sprays (0.4 to 0.8 mg) onto or under the tongue 5 to 10 minutes prior to engaging in activities which might precipitate an acute attackSublingual tablet: 0.3 to 0.6 mg dissolved under the tongue or in the GoNitro (oral/sublingual) pouch 5 to 10 minutes prior to engaging in activities which might precipitate an acute attack
Topical ointment: 1/2 inch initially, applied to a non hairy area of the trunk every 6 to 8 hours during waking hours (2 times a day); titrate as needed and tolerated. If angina occurs while the ointment is in place, the dose should be increased; if angina occurs several hours after application, the dosing frequency should be increased. Usual range is 1/2 to 2 inches (7.5 to 30 mg) every 8 hours, typically applied to 36 square inches of truncal skin.
Transdermal patch: 0.1 to 0.4 mg/hr patch applied to a dry and hairless area of the upper arm or body for 12 to 14 hours per day; titrate as needed and tolerated up to 0.8 mg/hr. Application sites should be rotated to avoid skin irritation.
Transmucosal (buccal) tablet: 1 mg dissolved between the lip and gum above the upper incisors or between the cheek and gum every 3 to 5 hours during waking hours (approximately 3 times a day); titrate as needed and tolerated. If angina occurs while a tablet is in place, the dose should be increased to the next strength; if angina occurs after dissolution of tablet, the dosing frequency should be increased. Usual maintenance dosage is 2 mg three times a day. If an acute attack occurs while a tablet is in place, another tablet may be administered on the opposite side from the one already in place. Sublingual GoNitro (oral/sublingual) is recommended if prompt relief is not attained.
Oral: 2.5 every 8 to 12 hours; titrate as needed and tolerated up to 9 mg every 8 to 12 hours
Because tolerance to GoNitro (oral/sublingual) may develop if plasma levels are maintained continuously, a nitrate free interval of 10 to 12 hours per day may be appropriate during chronic prophylaxis of angina pectoris. However, clinical studies suggest that such intermittent use may be associated with hemodynamic rebound during drug withdrawal and decreased exercise tolerance during the latter part of the nitrate free interval. Although the clinical relevance of this observation is unknown, a potentially increased risk of anginal attack during the nitrate free interval should be considered. Therefore, dosing regimens should be carefully individualized to each patient. Other antianginal drugs such as beta-blockers and calcium channel blockers may be prescribed to reduce the risk of aggravating myocardial ischemia during the drug free intervals.
Usual Adult Dose for Congestive Heart Failure:
Topical ointment: 1/2 inch initially, applied to a non hairy area of the trunk every 6 to 8 hours during waking hours ; titrate as needed and tolerated. Usual range is 1/2 to 2 inches (7.5 to 30 mg) every 8 hours, typically applied to 36 square inches of truncal skin.Transdermal patch: 0.1 to 0.4 mg/hr patch applied to a dry and hairless area of the upper arm or body for 12 to 14 hours per day; titrate as needed and tolerated up to 0.8 mg/hr. Application sites should be rotated to avoid skin irritation.
Transmucosal (buccal) tablet: 1 mg dissolved between the lip and gum above the upper incisors or between the cheek and gum every 3 to 5 hours during waking hours (approximately 3 times a day); titrate as needed and tolerated. Usual maintenance dosage is 2 mg three times a day.
Oral: 2.5 every 8 to 12 hours; titrate as needed and tolerated up to 9 mg every 8 to 12 hours
Usual Adult Dose for Myocardial Infarction:
For the initial 24 to 48 hours after an acute myocardial infarction:IV continuous infusion (via non PVC tubing): 5 mcg/min initially, increased by 5 mcg/min every 3 to 5 minutes as needed up to 20 mcg/min, then gradually by 10 and then 20 mcg/min if needed up to a usual maximum of 200 and generally no more than 400 mcg/min. Starting dosages of 25 mcg/min or higher have been used with PVC administration sets.
Usual Adult Dose for Hypertension:
IV continuous infusion : 5 mcg/min initially, increased by 5 mcg/min every 3 to 5 minutes as needed up to 20 mcg/min, then gradually by 10 and then 20 mcg/min if needed up to a usual maximum of 100 mcg/min. Starting dosages of 25 mcg/min or higher have been used with PVC administration sets.Usual Adult Dose for Anal Fissure and Fistula:
For the treatment of moderate to severe pain associated with chronic anal fissure:Apply 1 inch of ointment (375 mg of ointment equivalent to 1.5 mg of GoNitro (oral/sublingual)) intra anally every 12 hours for up to 3 weeks.
Usual Pediatric Dose for Hypertension:
Perioperative hypertension or induction of intraoperative hypotension:IV continuous infusion: 0.25 to 0.5 mcg/kg/min initially, increase by 0.5 to 1 mcg/kg/min every 3 to 5 minutes as needed up to 5 mcg/kg/min. Usual dose is 1 to 3 mcg/kg/min, but doses as high as 20 mcg/kg/min have been used.
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References
- Dailymed."Nitroglycerin: dailymed provides trustworthy information about marketed drugs in the united states. dailymed is the official provider of fda label information (package inserts).". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
- "Nitroglycerin". https://pubchem.ncbi.nlm.nih.gov/co... (accessed August 28, 2018).
- "Nitroglycerin". http://www.drugbank.ca/drugs/DB0072... (accessed August 28, 2018).
GoNitro (oral/sublingual) - Frequently asked Questions
Can GoNitro (oral/sublingual) be stopped immediately or do I have to stop the consumption gradually to ween off?
In some cases, it always advisable to stop the intake of some medicines gradually because of the rebound effect of the medicine.
It's wise to get in touch with your doctor as a professional advice is needed in this case regarding your health, medications and further recommendation to give you a stable health condition.
Who should not take GoNitro (oral/sublingual)?
You should not use GoNitro (oral/sublingual) if you are allergic to it, or if:
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you are using medicine to treat pulmonary arterial hypertension (PAH), such as riociguat (Adempas), sildenafil (Revatio), or tadalafil (Adcirca).
Do not take erectile dysfunction medicine (Viagra, Cialis, Levitra, Stendra, Staxyn, sildenafil, avanafil, tadalafil, vardenafil) while you are taking GoNitro (oral/sublingual). Using erectile dysfunction medicine with GoNitro (oral/sublingual) can cause a sudden and serious decrease in blood pressure.
You should not use sublingual GoNitro (oral/sublingual) if you have:
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severe anemia (low red blood cells);
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a head injury, brain tumor, or other condition that causes increased pressure inside the skull; or
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early signs of a heart attack (chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating, general ill feeling).
To make sure GoNitro (oral/sublingual) is safe for you, tell your doctor if you have:
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congestive heart failure;
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heart rhythm disorder (especially if you take medicine to treat this condition);
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a history of heart attack, stroke, or head injury;
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low blood pressure;
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glaucoma;
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migraine headaches; or
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if you are dehydrated.
FDA pregnancy category C. It is not known whether GoNitro (oral/sublingual) will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.
It is not known whether GoNitro (oral/sublingual) passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
How should I take GoNitro (oral/sublingual)?
Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Keep this medicine on hand at all times in case of an angina attack. Get your prescription refilled before you run out of medicine completely.
GoNitro (oral/sublingual) is usually taken at the first sign of chest pain. If possible, try to rest or stay seated when you use this medication. GoNitro (oral/sublingual) can cause dizziness or fainting.
You may use GoNitro (oral/sublingual) sublingual within 5 to 10 minutes before an activity you think might cause chest pain. Follow your doctor's instructions.
If you use GoNitro (oral/sublingual) sublingual spray to treat an angina attack: At the first sign of an attack, apply the spray directly on or under your tongue. Close your mouth after each spray. Do not inhale the spray. Do not shake the spray before or during use. You may use additional sprays every 5 minutes, but not more than 3 sprays in 15 minutes.
The GoNitro (oral/sublingual) sublingual tablet should be placed under your tongue and allowed to dissolve slowly. Do not chew or swallow it. You may use additional tablets every 5 minutes, but not more than 3 tablets in 15 minutes.
Seek emergency medical attention if your chest pain gets worse or lasts more than 5 minutes, especially if you have trouble breathing or feel weak, dizzy, or nauseated, or lightheaded.
You may feel a slight burning or stinging in your mouth when you use this medicine. However, this sensation is not a sign of how well the medication is working. Do not use more medication just because you do not feel a burning or stinging.
Do not crush, chew, break, or open an extended-release capsule. Swallow it whole.
This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using GoNitro (oral/sublingual).
If you take GoNitro (oral/sublingual) on a regular schedule to prevent angina, do not stop taking it suddenly or you could have a severe attack of angina.
Store the tablets in the glass container at room temperature, away from moisture and heat. Keep the bottle tightly closed when not in use.
Keep the spray away from open flame or high heat, such as in a car on a hot day. The canister may explode if it gets too hot.
What other drugs will affect GoNitro (oral/sublingual)?
Many drugs can interact with GoNitro (oral/sublingual). Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with GoNitro (oral/sublingual), especially:
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aspirin or heparin;
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a diuretic or "water pill";
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medicine to treat depression or mental illness; or
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ergot medicine to treat migraine headache, such as dihydroergotamine, ergotamine, ergonovine, or methylergonovine.
This list is not complete and many other drugs can interact with GoNitro (oral/sublingual). This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.
Can GoNitro (oral/sublingual) be taken or consumed while pregnant?
Please visit your doctor for a recommendation as such case requires special attention.
Can GoNitro (oral/sublingual) be taken for nursing mothers or during breastfeeding?
Kindly explain your state and condition to your doctor and seek medical advice from an expert.
Reviews
Following the study conducted by gmedication.com on GoNitro (oral/sublingual), the result is highlighted below. However, it must be clearly stated that the survey and result is based solely on the perception and impression of visitors and users of the website as well as consumers of GoNitro (oral/sublingual). We, therefore, urge readers not to base their medical judgment strictly on the result of this study but on test/diagnosis duly conducted by a certified medical practitioners or physician.Patient reports
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The information was verified by Dr. Vishal Pawar, MD Pharmacology