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NITRATES


Brand & Generic Names

Apo-ISDN Nitro-Dur II
Cardilate Nitrogard-SR
Cedocard-SR NITROGLYCERIN (GLYCERYL
Coradur TRINITRATE)
Coronex Nitroglyn
Deponit Nitrol
Dilatrate-SR Nitrolin
Duotrate Nitrolingual
ERYTHRITYL TETRANITRATE Nitronet
Glyceryl Trinitrate Nitrong
ISMO Nitrong SR
Iso-Bid Nitrospan
Isonate Nitrostat
Isorbid Novosorbide
Isordil NTS
ISOSORBIDE DINITRATE PENTAERYTHRITOL TETRANITRATE
Isotrate Pentritol
Klavikordal Pentylan
Naptrate Peritrate
Niong Peritrate Forte
Nitro-Bid Peritrate SA
Nitrocap P.E.T.N.
Nitrocap T.D. Sorbitrate
Nitrocine Sorbitrate SA
Nitrodisc Transderm-Nitro
Nitro-Dur Tridil


Basic Information

  • Habit forming? No
  • Prescription needed? Yes
  • Available as generic? Yes
  • Drug class: Antianginal (nitrate)

Uses

  • Reduces frequency and severity of angina attacks.
  • Treats congestive heart failure.

Dosage & Usage Information

How to take:
Extended-release tablets or capsules-- Swallow each dose whole with liquid.
Chewable tablet--Chew tablet at earliest sign of angina, and hold in mouth for 2 minutes.
Regular tablet or capsule--Swallow whole with liquid. Don't crush, chew or open.
Buccal tablets (Nitrogard)--Allow to dissolve in side of mouth.
Translingual spray (nitrolingual)--Spray under tongue according to instructions enclosed with prescription.
Ointment--Apply as directed.
Patches--Apply to skin according to package instructions.
Sublingual tablets--Place under tongue every 3 to 5 minutes at earliest sign of angina. If you don't have complete relief with 3 or 4 tablets, call doctor.

When to take:
Swallowed tablets--Take at the same times each day, 1 or 2 hours after meals.
Sublingual tablets or spray--At onset of angina.
Ointment--Follow prescription directions.
Patches--According to physician's instructions.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Relaxes blood vessels, increasing blood flow to heart muscle.

Time lapse before drug works:
Sublingual tablets and spray--1 to 3 minutes.
Other forms--15 to 30 minutes. Will not stop an attack, but may prevent attacks.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.


Overdose

SYMPTOMS:
Dizziness; blue fingernails and lips; feeling of pressure in head, fever, fainting; shortness of breath; weak, fast heartbeat; convulsions.

WHAT TO DO:

  • Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
  • See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

    In case of overdose, see Overdose section.

Common:

    Headache, flushed face and neck, dry mouth, nausea, vomiting.

Infrequent:

  • Fainting, rapid heartbeat.
  • Restlessness, blurred vision, dizziness.

Rare:

  • Rash.
  • Severe irritation, peeling.

Warnings & Precautions

Don't take if:
You are allergic to nitrates, including nitroglycerin.

Before you start, consult your doctor:

  • If you are taking non-prescription drugs.
  • If you plan to become pregnant within medication period.
  • If you have glaucoma.
  • If you have reacted badly to any vasodilator drug.
  • If you drink alcoholic beverages or smoke marijuana.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons.

Pregnancy:
Studies inconclusive on harm to unborn child. Decide with you doctor whether drug benefits justify risk to unborn child.

Breast-feeding:
No problems expected. Consult your doctor.

Infants & children:
Not recommended.

Prolonged use:

  • Drug may become less effective and require higher doses.
  • Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check blood pressure, heart rate.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes.

Discontinuing:
Except for sublingual tablets, don't discontinue without doctor's advice until you complete prescribed dose, even though symptoms diminish or disappear.

Others:

  • If discomfort is not caused by angina, nitrate medication will not bring relief. Call doctor if discomfort persists.
  • Periodic urine and laboratory blood studies of white cell counts recommended if you take nitrates.
  • Keep sublingual tablets in original container. Always carry them with you, but keep from body heat if possible.
  • Sublingual tablets produce a burning, stinging sensation when placed under the tongue. Replace supply if no burning or stinging is noted.

Possible Interaction with Other Drugs

GENERIC NAME COMBINED EFFECT
------------------------ -----------------------
Anticholinergics* Increased internal eye pressure.
Antidepressants, Excessive blood
tricyclic (TCA)* pressure drop.
Antihypertensives* Excessive blood pressure drop.
Beta-adrenergic Excessive blood
blockers* pressure drop.
Calcium channel Decreased blood
blockers* pressure.
Carteolol Possible excessive blood pressure
drop.
Cholinergics* Decreased cholinergic effect.
Ephedrine Decreased nitrate effect.
Guanfacine Increased effects of both drugs.
Lisinopril Possible excessive blood pressure
drop.
Narcotics* Excessive blood pressure drop.
Nicardipine Reduced angina attacks.
Nimodipine Reduced angina attacks.
Phenothiazines* May decrease blood pressure.
Sotalol Possible excessive blood pressure
drop.
Sympathomimetics* Possible reduced effects of both
medicines.


Possible Interaction with Other Substances

INTERACTS WITH COMBINED EFFECT
--------------- ---------------
Alcohol: Excessive blood pressure drop.
Beverages: None expected.
Cocaine: Reduced effectiveness of nitrates.
Foods: None expected.
Marijuana: Decreased nitrate effect.
Tobacco: Decreased nitrate effect.



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