Nitroglycerin (Nitrodur) is in a group of drugs called nitrates. Nitroglycerin (Nitrodur) dilates (widens) blood vessels, making it easier for blood to flow through them and easier for the heart to pump. Nitroglycerin (Nitrodur) is used to treat or prevent attacks of chest pain (angina). Nitroglycerin (Nitrodur) may also be used for purposes not listed in Nitroglycerin (Nitrodur) guide.
Nitroglycerin (Nitrodur) 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.
Nitroglycerin (Nitrodur) can cause severe headaches, especially when you first start using it. These headaches may gradually become less severe as you continue to use Nitroglycerin (Nitrodur). 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 Nitroglycerin (Nitrodur);
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)
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Nitroglycerin (Nitrodur) 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 Nitroglycerin (Nitrodur) 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 attack Sublingual tablet: 0.3 to 0.6 mg dissolved under the tongue or in the Nitroglycerin (Nitrodur) 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 Nitroglycerin (Nitrodur) 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 Nitroglycerin (Nitrodur) 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 Nitroglycerin (Nitrodur)) 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.
Isosorbide Dinitrate (Nitrodur)
What is Isosorbide Dinitrate (Nitrodur)
Preventing symptoms of angina (chest pain) caused by heart disease. Isosorbide Dinitrate (Nitrodur) is used alone or with other medicines. Isosorbide Dinitrate (Nitrodur) is NOT intended for the immediate relief of acute attacks of angina. It may also be used for other conditions as determined by your doctor. Isosorbide Dinitrate (Nitrodur) is a nitrate. It works by relaxing the blood vessels in the body, allowing them to widen. This lets more blood flow through the blood vessels, which reduces the work the heart has to do to pump blood. This reduces the oxygen needs of the heart and decreases chest pain.
Important safety information:
Isosorbide Dinitrate may cause dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Isosorbide Dinitrate (Nitrodur) with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
Isosorbide Dinitrate (Nitrodur) may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
Check with your doctor before you drink alcohol while you are taking Isosorbide Dinitrate (Nitrodur). Drinking alcohol may increase the risk of low blood pressure with Isosorbide Dinitrate (Nitrodur).
Isosorbide Dinitrate (Nitrodur) may give you daily headaches. This should become less noticeable with time. Do not change how you use Isosorbide Dinitrate (Nitrodur) to avoid these headaches. Talk with your doctor for ways to lessen this side effect.
Isosorbide Dinitrate (Nitrodur) should not be used to stop an attack of angina; it is intended only for prevention of an attack.
Isosorbide Dinitrate (Nitrodur) may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Isosorbide Dinitrate (Nitrodur).
PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Isosorbide Dinitrate (Nitrodur) while you are pregnant. It is not known if Isosorbide Dinitrate (Nitrodur) is found in breast milk. If you are or will be breast-feeding while you use Isosorbide Dinitrate (Nitrodur), check with your doctor. Discuss any possible risks to your baby.
When used for long periods of time without a break, Isosorbide Dinitrate (Nitrodur) may not work as well. This is known as TOLERANCE. Increasing the dose is not effective in managing tolerance to Isosorbide Dinitrate (Nitrodur). Tolerance to other nitrates or nitrites may also occur. Be sure to have a "nitrate-free" period of time each day to help prevent this tolerance. Talk with your doctor if Isosorbide Dinitrate (Nitrodur) stops working well. Do not take more than prescribed. Some people who use Isosorbide Dinitrate (Nitrodur) for a long time without a break may develop a physical need to continue taking it. This is known as physical DEPENDENCE. If you take Isosorbide Dinitrate (Nitrodur) without a break and then suddenly stop taking it, you may get WITHDRAWAL symptoms. These may include chest pain, heart attack, or possibly sudden death. Be sure to have a "nitrate-free" period of time each day; this may help prevent dependence and withdrawal problems.
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Isosorbide Dinitrate (Nitrodur) side effects
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Dizziness; flushing of the face and neck; headache; light-headedness.
Seek medical attention right away if any of these SEVERE side effects occur:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fainting; fast or slow heartbeat; nausea; new or worsening chest pain; vomiting.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
Active ingredients: Nitroglycerin/Isosorbide Dinitrate
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Following the study conducted by gmedication.com on Nitrodur, 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 Nitrodur. 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.
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