Glyceryl trinitrate

Nitroglycerin, also known as glyceryl trinitrate, is a medication used for heart failure, high blood pressure, and to treat and prevent chest pain from not enough blood flow to the heart or due to cocaine.

Glyceryl trinitrate

Nitroglycerin; Glyceryl trinitrate; Nitrostat; Trinitroglycerin; Nitro-dur

Angised, Angispan-TR, Glynit, Gtcr, GTN Sorbitrate, GTN Sorbitrate-CR, GTN Spray, GTN Spray Pen, Leonite, Lygly, Monit-GTN, Myonit, Myonit Insta, Myonit-SR, Myovin, Ng-Care, Nglong, Ngtel, Nig, Nig INJ, Nitorag, Nitrate, Nitrocerin, Nitrocin, Nitrocontin, Nitrocure, Nitroday, Nitroderm TTS, Nitrofast, Nitrogesic, Nitrogine, Nitroglyn, Nitroject, Nitrolife, Nitroplus, Nitrosol, Nitrovir, Nitrowok, Nizo, Olcon, Top Nitro, Vasovin.

1,3-bis(nitrooxy)propan-2-yl nitrate

• Rapidly absorbed from oral mucosa (sublingual), well absorbed from the GI tract (oral), well absorbed from the skin (topical, transdermal).
• Widely distributed
• Hepatic metabolism
• Excreted through urine

Nitroglycerin, an organic nitrate, is available in many forms as a vasodilator. Nitroglycerin is used in the treatement of angina pectoris and perioperative hypertension, to produce controlled hypotension during surgical procedures, to treat hypertensive emergencies, and to treat congestive heart failure associated with myocardial infarction.

NA

For the prevention of angina

Hypotension, paradoxical bradycardia, impaired respiration, syncope and collapse. Facial flushing, dizziness, tachycardia, throbbing headache and tolerance. Large doses can cause vomiting, restlessness, hypotension, syncope, rarely cyanosis and methaemoglobinaemia, impaired respiration, bradycardia. IV admin: IV preparation contains substantial quantities of alcohol and alcohol intoxication can occur. Sublingual Tabs/Spray: Dry mouth, localised burning sensation. Topical: Contact dermatitis, erythema, local irritation. 

• Orthostatic hypotension may be produced by combined use of calcium channel blockers, antihypertensives, phenothiazines and TCAs.
• Alcohol may cause severe hypotension and collapse.
• Enhances bioavailability of dihydroergotamine.
• May reduce the efficacy of heparin, alteplase and noradrenaline when used together.
• Infusion of glyceryl trinitrate may prolong pancuronium-induced neuromuscular blockade.
• Aspirin and other NSAIDs may reduce the therapeutic response to glyceryl trinitrate.
• Efficacy of buccal and sublingual preparations may be reduced by drugs that can cause dry mouth due to decreased dissolution. 

• Hypersensitivity.
• Severe hypotension, marked anaemia, heart failure, cardiomyopathy, hypertrophic obstructive cerebral haemorrhage or head trauma, low cardiac output secondary to hypovolaemia, inferior MI with right ventricular involvement, raised intracranial pressure. Concomitant use with phosphodiesterase type-5 inhibitors.

Store at 15-30°C. 

Molecular weight

227.0865

Molecular formula

C3H5N3O9

CAS number

55-63-0

Precautions

• Cerebrovascular disease, lung disease or cor pulmonale.
• Hypothyroidism, Severe hepatic or renal impairment, malnutrition, hypothermia.
• Pregnancy, glaucoma, lactation, cardiac tamponade, mitral valve prolapse, syncope.
• Gradual withdrawal in patients who have received prolonged high dose infusions.
• Avoid prolonged excessive hypotension.
• On continuous treatment with nitrates, Nitrate-free interval is recommended in patients to reduce the risk of tolerance.