治療心絞痛 Treatment or prevention of angina pectoris
#仿單變更2021

Nitroglycerin, an organic nitrate, is a vasodilating agent that relieves tension on vascular smooth muscle and dilates peripheral veins and arteries. It increases guanosine 3'5' monophosphate (cyclic GMP) in smooth muscle and other tissues by stimulating guanylate cyclase through formation of free radical nitric oxide. This activity results in dephosphorylation of the light chain of myosin, which improves the contractile state in smooth muscle results in vasodilation.

Distribution:
Vd: 3 to 3.3 L/kg
Metabolism:
Hepatic; reductase, reduction, hydrolysis
Excretion:
Dialyzable: unknown
Elimination Half Life:
About 3 minutes

1. Acute circulatory failure or shock
2. Concomitant use of phosphodiesterase type 5 (PDE-5) inhibitors such as sildenafil, tadalafil, vardenafil, or avanafil
3. Concomitant riociguat use or other soluble guanylate cyclase inhibitors
4. Hypersensitivity to adhesives with transdermal patch
5. Hypersensitivity to nitroglycerin or any component of the product as well as other nitrates or nitrites
6. Increased intracranial pressure
7. Severe anemia

Fetal risk cannot be ruled out. (TH)

Infant risk cannot be ruled out. (MDX)

Common:
Hypotension, flushing, dizziness, headache, lightheadedness
Serious:
Anaphylactoid reaction, methemoglobinemia, raised intracranial pressure

Initial: 0.2 to 0.4 mg/hour and titrate to doses of 0.4 to 0.8 mg/hour.
Tolerance is minimized by using a patch-on period of 12 to 14 hours/day and patch-off period of 10 to 12 hours/day.