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Nitroglycerin Tablets Xiao Suan Gan You for coronary heart disease and angina pectoris
Nitroglycerin Tablets Xiao Suan Gan You for coronary heart disease and angina pectoris
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Nitroglycerin Tablets
Xiaosuan Ganyou Pian
Xiao Suan Gan You Pian
Xiaosuan Ganyou Tablets
Xiaosuanganyou Pian
硝酸甘油片
FUNCTION and INDICATIONS
It is used for the treatment and prevention of coronary heart disease and angina pectoris. It can also be used to lower blood pressure or treat congestive heart failure.
INGREDIENTS
Nitroglycerin.
DESCPRIPTION
White tablets.
SPECIFICATION AND PACKAGE
0.5mg*100 tablets/box.
USAGE AND DOSAGE
Adults use 0.25-0.5 mg (half a tablet-1 tablet) sublingually. Repeat 1 tablet every 5 minutes until the pain is relieved. If the pain persists after the total amount reaches 3 tablets within 15 minutes, seek medical attention immediately. Prophylactic use 5-10 minutes before activities or bowel movements can avoid angina pectoris.
REFERENCES
ADVERSE REACTION
⑴.Headache: It can occur immediately after medication, and can be severe and persistent.
⑵.Dizziness, weakness, heart palpitations and other orthostatic hypotension may occasionally occur, especially in patients who stand upright and immobilize.
⑶.Obvious hypotensive reactions can occur at the therapeutic dose, which manifests as nausea, vomiting, weakness, sweating, paleness and collapse.
⑷.Syncope, flushing, drug eruption and exfoliative dermatitis have been reported.
CONTRAINDICATIONS
It is contraindicated in patients with early myocardial infarction (severe hypotension and tachycardia), severe anemia, glaucoma, increased intracranial pressure and known allergies to nitroglycerin. It is also contraindicated in patients who use sildenafil citrate (Viagra), which enhances the antihypertensive effect of nitroglycerin.
Warning
⑴The smallest dose that can effectively relieve acute angina pectoris should be used. Overdose may lead to tolerance. The tablet is used for sublingual oral administration and should not be swallowed.
⑵Severe hypotension may occur in small doses, especially in the upright position. When taking medicine under the tongue, the patient should take a seated position as much as possible to avoid falling down due to dizziness
⑶It should be used with caution in patients with insufficient blood volume or low systolic blood pressure.
⑷Abnormal bradycardia and aggravation of angina pectoris can be combined when hypotension is induced.
⑸Can make angina pectoris caused by hypertrophic obstructive cardiomyopathy worse.
⑹Tolerance to vascular effects and anti-angina pectoris effects can occur.
⑺If blurred vision or dry mouth occurs, the drug should be discontinued. Excessive doses can cause severe headaches.
Medicine for pregnant and lactating women
It is not known whether it causes fetal damage or affects fertility, so it can be used for pregnant women only when it is really necessary. It is also unknown whether it is excreted from human milk, so women who are breastfeeding should be cautious.
Overdose
Overdose can cause severe hypotension, tachycardia, bradycardia, conduction block, palpitations, circulatory failure leading to death, syncope, persistent throbbing headache, dizziness, visual disturbance, increased intracranial pressure, paralysis and coma with convulsions, flushing With sweating, nausea and vomiting, abdominal cramps and diarrhea, dyspnea and methemoglobinemia.
Pharmacology and Toxicology
The main pharmacological action is to relax vascular smooth muscle. Nitroglycerin releases nitric oxide (NO), which is the same as endothelial relaxing factor, activates guanylate cyclase, increases cyclic guanylate (cGMP) in smooth muscle and other tissues, and causes dephosphorylation of myosin light chain. Regulates the contraction of smooth muscles, causing blood vessels to dilate. Nitroglycerin expands the arteriovenous vascular bed, mainly to expand the veins, and its intensity of action is dose-dependent. Peripheral veins dilate, so that blood is retained in the periphery, the return blood volume decreases, and the left ventricular end diastolic pressure (preload) decreases. Dilation of arteries reduces peripheral resistance (afterload). Arteriovenous dilation reduces myocardial oxygen consumption and relieves angina pectoris. It also has a dilation effect on the branches of the epicardial coronary artery. The therapeutic dose can reduce the systolic, diastolic and mean arterial pressure. The effective coronary perfusion pressure can often be maintained, but when the blood pressure is excessively reduced or the heart rate increases to shorten the diastolic filling time, the effective coronary perfusion pressure will decrease. Increased central venous pressure and pulmonary capillary wedge compression, pulmonary vascular resistance and systemic vascular resistance are reduced. The heart rate usually increases slightly, which is probably the reflex effect of the drop in blood pressure. The heart index can increase, decrease or remain unchanged. Patients with increased left ventricular filling pressure and peripheral resistance with low cardiac index may have an increase in cardiac index. On the contrary, if the left ventricular filling pressure and cardiac index are normal, intravenous medication can slightly lower the cardiac index. There is no long-term animal test to evaluate its carcinogenicity.
Pharmacokinetics
Sublingual oral administration is immediately absorbed, and the bioavailability is 80%; while oral administration due to the first pass effect of the liver, the bioavailability is only 8%. Sublingual administration takes about 2 to 3 minutes to take effect, and 5 minutes to reach the maximum effect. The peak blood concentration is 2 to 3 ng/ml, the effect lasts for 10 to 30 minutes, and the half-life is about 1 to 4 minutes. The binding rate of plasma protein is about 60%. Mainly metabolized in the liver, the intermediate products are dinitrate and mononitrate, and the final product is glycerol. Compared with the parent drug, the two main active metabolites 1, 2- and 1, 3-dinitroglycerin have weaker effects and longer half-lives. After metabolism, it is excreted by the kidneys.
DRUG INTERACTION
If use with the other drugs at the same time may occur drug interactions,details please consult your physician or pharmacist.
STORAGE
Hermetically sealed,keep in cool and dry places.
PERIOD OF VALIDITY
36 months.
CERTIFICATE NO
Stage Food and Drug Administration Approval number:H11021022.
Manufactured
BEIJING YIMIN PHARMACEUTICAL CO.,LTD
Tips: Please read the directions for use in retail or directed by physician.
Part of the goods frequent replacement of packaging, such as goods and pictures are not exactly the same, please refer to the goods you receive.
General Cautions
Keep away from animals and children.This product has not been evaluated by the FDA. It is not intended to diagnose, treat, cure, or prevent any disease.We highly recommend that you consult with a Traditional Chinese Medical practitioner or physician before taking any products or if you have any questions regarding your health.