Nitroglycerin Transdermal

Nitroglycerin Transdermal is a prescription medication used for the treatment of chest pain (Angina Pectoris). 

• Nitroglycerin Transdermal is available under the following different brand names: Nitro-Dur, Minitran, Deponit, Transdermal Nitroglycerin, Nitrocine, glyceryl trinitrate Transdermal

Common side effects of Nitroglycerin Transdermal include:

• headache, and
• light-headedness

Serious side effects of Nitroglycerin Transdermal include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• worsening chest pain,
• pounding heartbeats,
• fluttering in the chest,
• slow heart rate,
• light-headedness,
• chest pain or pressure,
• pain spreading to the jaw or shoulder,
• nausea, and
• sweating

Rare side effects of Nitroglycerin Transdermal include:

1. none 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheartedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Patch

• 0.1 mg/hr
• 0.2 mg/hr
• 0.3 mg/hr
• 0.4 mg/hr
• 0.6 mg/hr
• 0.8 mg/hr

Angina Pectoris

Adult and Geriatric dosage

• 1 Patch once a day: Start with the smallest unit in series & titrate
• Patches may be applied to any skin surface, except on extremities below the knees or elbows
• Nitrate-free period of 10-12 hours duration (overnight) needed to prevent tolerance
• Minitran 0.1, 0.2, 0.4, 0.6 mg/hour
• Nitro-Dur 0.1, 0.2, 0.3, 0.4, 0.6, 0.8 mg/hour
• Transdermal-nitro glycerine 0.1, 0.2, 0.4, 0.6 mg/hour

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Nitroglycerin Transdermal has severe interactions with the following drugs:
• avanafil
• bromocriptine
• cabergoline
• dihydroergotamine
• dihydroergotamine intranasal
• argulid mesylates
• ergotamine
• methylergonovine
• riociguat
• sildenafil
• tadalafil
• vardenafil
• Nitroglycerin Transdermal has serious interactions with the following drugs:
• cabergoline
• ergoloid mesylates
• ergotamine
• lofexidine
• methylergonovine
• Nitroglycerin Transdermal has moderate interactions with the following drugs:
• arginine
• benazepril
• bretylium
• bupivacaine implant
• dapsone topical
• tetracaine
• Nitroglycerin Transdermal has minor interactions with the following drugs:
• acetylcysteine
• acetylcysteine (Antidote)
• ethanol

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity to organic nitrates or adhesives
• Recent use (within several days) of PDE-5 inhibitors (.g, avanafil, sildenafil, tadalafil, or vardenafil) may cause dangerously low hypotension; the time course of the interaction appears to be related to the PDE-5 inhibitor half-life
• Concomitant administration with guanylate stimulator riociguat (may cause hypotension)

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Nitroglycerin Transdermal?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Nitroglycerin Transdermal?”

Cautions

• Use caution in alcohol use increased ICP (.g, head trauma, cerebral hemorrhage-potential contraindication), hyperthyroidism, hypertrophic cardiomyopathy, increased IOP, postural hypotension, volume depletion, low systolic BP
• The benefits of Transdermal nitroglycerin in patients with acute myocardial infarction or congestive heart failure are not established; if one elects to use nitroglycerin in these conditions, careful clinical or hemodynamic monitoring must be used to avoid hazards of hypotension and tachycardia
• The Transdermal system should not be used to treat acute angina attacks
• Severe hypotension, particularly with upright posture, may occur with even small doses of nitroglycerin, particularly in the elderly; use caution
• Nitrate therapy may aggravate angina caused by hypertrophic cardiomyopathy, particularly in the elderly
• A cardioverter/defibrillator should not be discharged through a paddle electrode that overlies a patch; the arcing that may be seen in this situation is harmless but may be associated with local current concentration that can cause damage to the paddle and burns to the patient
• Discarded patches should be kept out of reach of children and pets
• Chest pain, acute myocardial infarction, and even sudden death were reported during temporary withdrawal of nitrates from industrial workers with long-term exposure to unknown high doses of organic nitrates, demonstrating the existence of true physical dependence
• Use with caution in elderly patients who may be volume-depleted, are on multiple medications, or who, for whatever reason, are already hypotensive; hypotension induced by nitroglycerin may be accompanied by paradoxical bradycardia and increased angina pectoris; elderly patients may also be more susceptible to hypotension and may be at greater risk of falling at therapeutic doses
• Drug interaction overview
  • Amplification of vasodilatory effects of the patch by phosphodiesterase inhibitors, .g, sildenafil can result in severe hypotension; the time course and dose dependence of this interaction have not been studied; appropriate supportive care has not been studied, but seems reasonable to treat this as a nitrate overdose, with an elevation of extremities and with central volume expansion

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risks during pregnancy.
• Lactation
  • Not known whether the drug crosses into breast milk, use caution