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Author: Admin | 2025-04-28
Expiration date: 06/2026DOSAGE FORMSspray sublingual metered 0.4 mg/dose 300 dosesMANUFACTURERSMicrochem NPF (Ukraine)GROUPAnti-anginal agents - nitrates and nitritesCOMPOSITIONThe active ingredient nitroglycerinINTERNATIONAL NONPROPRIETARY NAMENitroglycerinSYNONYMSDeponit 10, Nirmin, Neath RET, Nitradisc, Nitro, Nitro Mac, Nitro Mak Ampoules, Nitro Mack retard, Paul Infus Nitro, Nitro-dur, Nitro, nick Nitro-time, Nitroglycerin, Nitroglycerin microgranules, Nitroglycerin Nycomed, Nitroglycerin prolonged, Nitrogranulong, Nitroderm TTS 10, TTS Nitroderm 5, Nitrogent, Nitrokor, Nitromist, Nitrong Forte, Nitromarketing TTS, Nitrosol, Nitrospray, Nitrospray-ICN, Perlinganit, Sustak Forte, Sustonit, TrinitrolongPHARMACOLOGICAL ACTIONNitroglycerin is an organic nitrogen-containing compound with a primary venodilation action. Effects of nitroglycerin due to its ability to release its molecule of nitric oxide, a natural endothelial relaxing factor. Nitric oxide increases the intracellular concentration of cyclic guanosine monophosphate, which prevents the penetration of calcium ions into smooth muscle cells and causes their relaxation. The relaxation of smooth muscles of the vascular wall and causes vasodilation, which reduces venous return to heart (preload) and the resistance of the systemic circulation (afterload). This reduces the load on the heart and the need of myocardium in oxygen. Expansion of coronary vessels and improves coronary blood flow and contributes to its redistribution in the region with reduced blood circulation, which increases oxygen delivery to the myocardium.The decrease in venous return leads to a decrease in filling pressure of the right atrium, improve blood supply of the upper subendocardialnah layers, reducing the pressure in the pulmonary circulation and regression of symptoms oteke light. Nitroglycerin relaxes smooth muscle cells of the bronchi, urinary tract, gallbladder, bile ducts, esophagus, small and large intestine. The action begins quickly, the effect is for 1-1.5 minutes and lasts about 30 minutes. Nitroglycerin very quickly and adequately absorbed into the systemic circulation after sublingual application through the mucous membranes of the mouth. Bioavailability is approximately 100%, as it eliminates the effect of "first passage" through the liver. Relationship with blood plasma proteins is 60%. Maximum concetrate in the blood plasma is reached after 5 minutes. Rapidly metabolized with the participation nitratereductase, with the formation of di - and mononitrates, the final metabolite is glycerol. Excreted by the kidneys as metabolites. Total clearance is 25-30 l/min After administration of the drug under the tongue T1/2 from blood plasma is 2.5-4.4 minutes. Excreted by the kidneys, less than 1% of the dose excreted unchanged.INDICATIONS FOR USERelief of angina, prophylaxis of angina prior to physical stress.CONTRAINDICATIONSHypersensitivity to organic nitrates, shock, collapse, age of 18 years (efficacy and safety have not been established), concomitant use of inhibitors of phosphodiesterase 5 (like sildenafil, vardenafil or tadalafil), because they potentiate hypotensive effect of nitrates. With caution (comparing risk and benefit): intracranial hypertension, cardiac tamponade, uncontrollable hypovolemia in patients with heart failure with normal or low pulmonary artery pressure, hypotension (systolic blood pressure less
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