Nitroglycerin (Glyceryl Trinitrate)
- Atc Codes:C01DA02#C05AE01
- CAS Codes:55-63-0
- PHARMGKB ID:55-63-0
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Deponit, Glytrin, Nitro «Pohl», Nitroderm TTS, Nitrolingual, Perlinganit, Rectogesic; Belgium: Deponit, Diafusor, Minitran, Nitroderm TTS, Nitrolingual, Rectogesic, Trinipatch, Willlong; Bulgaria: Nitrolingual, Perlinganit; Cyprus: Glytrin, Nitroderm TTS, Nitrong; Denmark: Discotrine, Nitroglycerin, Nitrolingual, Nitromex; Estonia: Nitrocine, Nitroglycerin; Finland: Nitro, Nitromex; France: Cordipatch, Diafusor, Discotrine, Epinitril, Natispray, Nitriderm TTS, Nitronal, Trinipatch, Trinitrine Simple; Germany: Anore-Nitro, Corangin Nitrospray, Deponit, Gallolingual N, Glonoinum, Loion Spray, Minitrans, Nitrangin, Nitriderm TTS, Nitro-Dur, Nitroderm TTS, Nitroglycerinum, Nitrolingual, Nitronal, Perlinganit, Rectogesic, Trinitrosan; Greece: Cardiplast, Epinitril, Nitrodyl, Nitrolingual, Nitrong, Nitrosylon, Pancoran, Solinitrina, Supranitrin, Trinipatch; Hungary: Epinitril, Glonoinum, Nitroderm TTS, Nitro-Dur, Nitrolingual, Nitromint, Rectogesic, Sustac; Ireland: Deponit, Dermatrans, Epinitril, Glytrin, Nitrocine, Nitro-Dur, Nitrolingual, Nitromin, Rectogesic, Suscard, Sustac, Transiderm-Nitro; Italy: Adesitrin, Deponit, Dermatrans, Epinitril, Keritrina, Minitran, Natispray, Nitraket, Nitrocor, Nitroderm TTS, Nitro-Dur, Nitrogli, Nitrosylon, Top-Nitro, Triniplas, Trinitrina, Venitrin; Latvia: Nitrocine, Nitrocor, Nitroglycerin, Nitromint; Lithuania: Deponit, Nitro-Pohl, Nitrocine, Nitroglycerin, Nitroglycerinum, Nitrolingual, Nitromint, Nitrong, Sustac; Luxembourg: Deponit, Diafusor, Minitran, Natispray, Nitradisc, Nitroderm TTS, Nitrolingual, Nitrong, Nysconitrine, Perlinganit, Trinipatch, Willlong; Malta: Minitran, Nitroderm TTS, Nitrolingual; Netherlands: Deponit, Glytrin, Minitran, Nitro «Pohl», Nitroderm TTS, Nitro-Dur, Nitroglycerine, Nitrolingual, Transiderm TTS, Transiderm-Nitro, Trinipatch; Poland: Minitran, Nitracor, Nitroderm TTS, Nitrodisc, Nitro-Dur, Nitroglycerinum, Nitrolingual, Nitro-Mack, Nitromint, Nitroven, Perlinganit, Polnitrin, Rectogesic, Sustonit, Trimonit; Portugal: Dermatrans, Diafusor, Epinitril, Glytrin, Nitradisc, Nitroderm TTS, Nitro-Dur, Nitromint, Plastranit, Rectogesic; Romania: Deponit, Nitroderm TTS, Nitroglicerina, Nitromint, Trinitrosan; Slovakia: Nitroderm TTS, Nitroglycerin, Nitromint, Rectogesic; Slovenia: Nitroderm TTS, Nitro-Dur, Nitrolingual, Nitronal; Spain: Cordiplast, Dermatrans, Diafusor, Epinitril, Minitran, Nitradisc, Nitroderm TTS, Nitro-Dur, Nitroplast, Solinitrina, Trinipatch, Trinispray, Vernies; Sweden: Glytrin, Minitran, Nitroglycerin, Nitrolingual, Nitromex, Rectogesic, Suscard, Transiderm-Nitro; UK: Deponit, Glytrin, Minitran, Nitrocine, Nitro-Dur, Nitroglycerin, Nitrolingual, Nitronal, Percutol, Suscard, Transiderm-Nitro.
North America
Canada: Glonoinum, Minitran, Nitro-Dur, Nitroglycerin, Nitroject, Nitrol, Nitrostat, Transderm-Nitro, Trinipatch; USA: Minitran, Nitro-Dur, Nitrolingual, Nitromist, Nitrostat.
Latin America
Argentina: Enetege, Niglinar, Nitroderm TTS, Nitro-Dur, Nitrogray; Brazil: Nitradisc, Nitroderm TTS, Tridil; Mexico: Anglix, Cardinit, Minitran, Nitradisc, Nitroderm TTS, Nitro-Dur.
Asia
Japan: Dydrene, Meditrans, Millis, Millisrol, Minitro, Nitroderm TTS, Nitroglycerin, Nitropen, Vasolator.
Drug combinations
Nitroglycerin: Acidum arsenicosum; Acidum nitricum; Acidum phosphoricum; Aconitum napellus; Adonis vernalis; Amanita muscaria; Ammonium carbonicum; Anamirta cocculus; Apis mellifera; Apocynum cannabinum; Arnica montana; Asarum europaeum; Aurum chloratum; Aurum iodatum; Avena sativa; Belladonna; Berberis vulgaris; Calcium carbonicum naturale; Calendula officinalis; Cephaelis ipecacuana; Chininum sulfuricum; Cinchona pubescens; Cinnamomum camphora; Citrullus colocynthis; Clematis recta; Cobaltum metallicum; Coffea arabica; Conium maculatum; Convallaria majalis; Crataegus spp.; Cuprum metallicum; Cyclamen purpurascens; Cytisus scoparius spp; Dextrose; Digitalis purpurea; Erysimum cheiri; Eupatorium perfoliatum; Ferula assafoetida; Galium odoratum; Gelsemium sempervirens; Hamamelis virginiana; Humulus lupulus; Hydrastis canadensis; Hypericum perforatum; Iberis amara; Iris versicolor; Kalium carbonicum; Kalium phosphoricum; Kalmia latifolia; Lachesis mutus; Lilium lancifolium; Lobelia inflata; Lycopodium clavatum; Matricaria recutita; Melilotus officinalis; Mercurius solubilis Hahnemann; Naja naja; Natrium sulfuricum; Natrium tetrachloroauratum; Nicotiana tabacum; Packera aurea; Paris quadrifolia; Petroleum rectificatum; Phosphorus; Pinus sylvestris; Podophyllum peltatum; Primula veris; Pulsatilla pratensis; Rauwolfia serpentina; Rhododendron spp.; Sanguinaria canadensis; Schoenocaulon officinale; Secale cornutum; Selenicereus grandiflorus; Selenium; Silybum marianum; Spigelia anthelmia; Stannum metallicum; Strophanthus gratus; Strychnos ignatii; Strychnos nux-vomica; Thuja occidentalis; Toxicodendron quercifolium; Veratrum viride; Veronica virginica; Viscum album; Vitex agnus-castus; Zanthoxylum spp.
Chemistry
Nitroglycerin: C~3~H~5~N~3~O~9~. Mw: 227.09. 1,2,3-Propanetriol, trinitrate. CAS-55-63-0.
Pharmacologic Category
Vasodilating Agents; Nitrates and Nitrites. Homeopathic products. (ATC-Code: C01DA02; C05AE01).
Mechanism of action
Works by relaxation of smooth muscle, producing vasodilator effect on peripheral veins and arteries with more prominent effects on veins. Primarily reduces cardiac oxygen demand by decreasing preload (left ventricular end-diastolic pressure). May modestly reduce afterload. Dilates coronary arteries and improves collateral flow to ischemic regions.
Therapeutic use
Treatment of angina pectoris. Congestive heart failure (especially when associated with acute myocardial infarction). Pulmonary hypertension. Hypertensive emergencies occurring perioperatively (especially during cardiovascular surgery).
Pregnancy and lactiation implications
Use with caution in pregnant and nursing women.
Unlabeled use
Esophageal spastic disorders (sublingual).
Contraindications
Hypersensitivity to organic nitrates. Hypersensitivity to isosorbide, nitroglycerin, or any component of the formulation. Concurrent use with phosphodiesterase-5 inhibitors (sildenafil, tadalafil, or vardenafil). Angle-closure glaucoma (intraocular pressure may be increased). Head trauma or cerebral hemorrhage (increase intracranial pressure). Severe anemia. Allergy to adhesive (transdermal product). Additional contraindications for I.V. product: hypotension, uncorrected hypovolemia, inadequate cerebral circulation, constrictive pericarditis, pericardial tamponade.
Warnings and precautions
Severe hypotension can occur (paradoxical bradycardia and increased angina pectoris can accompany hypotension). Orthostatic hypotension can also occur (ethanol can accentuate this). Use with caution in volume depletion, hypotension, and right ventricular infarctions; also in hypertrophic cardiomyopathy (nitrates may reduce preload, exacerbating obstruction and cause hypotension and/or worsening of heart failure). Avoid concurrent use with phosphodiesterase-5 inhibitors (e.g. sildenafil, tadalafil, vardenafil). Avoid use of long-acting agents in acute myocardial infarction or heart failure.